中国四省中老年人睡眠时长与抑郁症状的关联性研究

张晓帆; 刘峰; 刘万普; 叶先明; 崔缤尹; 王惠君

Abstract

张晓帆,刘峰,刘万普,叶先明,崔缤尹,王惠君.中国四省中老年人睡眠时长与抑郁症状的关联性研究[J].Chinese journal of Epidemiology,2021,42(11):1955-1961

中国四省中老年人睡眠时长与抑郁症状的关联性研究

Relationship between sleep duration and depressive symptoms in middle-aged and elderly people in four provinces of China

Received:September 30, 2020

DOI：10.3760/cma.j.cn112338-20200930-01210

KeyWord: 中老年人睡眠时长抑郁症状 U形关联

English Key Word: Middle-aged and elderly people Sleep duration Depressive symptom U-shaped association

FundProject:神经系统疾病专病社区队列研究（2017YFC0907701）

Author Name	Affiliation	E-mail
Zhang Xiaofan	National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Liu Feng	Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, China
Liu Wanpu	Cangxian County Center for Disease Control and Prevention, Cangxian 061000, China
Ye Xianming	Qingyuan County Center for Disease Control and Prevention, Qingyuan 323800, China
Cui Binyin	Hengyang Prefectural Center for Disease Control and Prevention, Hengyang 421001, China
Wang Huijun	National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China	wanghj@ninh.chinacdc.cn

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Abstract:

目的探索中老年人睡眠时长与抑郁症状的关联性。方法选取2018-2019年"神经系统疾病专病社区队列研究"基线调查的≥ 55岁中老年人11 931名，通过问卷调查了解调查对象的基本信息、生活方式、食物摄入频率、疾病史、睡眠时长等；测量身高、体重，计算得到BMI；根据老年抑郁量表（GDS-30）筛选是否患有抑郁症状，分别采用限制性立方样条模型和多因素logistic回归模型分析睡眠时长与抑郁症状的关联。结果 ≥ 55岁中老年人群中，自报睡眠时长不到7 h者占17.79%，自报睡眠时长≥ 9 h者占16.84%，抑郁症状检出率为7.95%。在调整了地区、年龄、性别等因素后，限制性立方样条结果显示，睡眠时长与抑郁症状患病风险呈U形关联；多因素logistic回归分析结果显示，与睡眠7~8 h相比，睡眠时长为≤ 5 h、6 h和≥ 9 h的≥ 55岁中老年人患抑郁症状的风险分别是前者的1.749倍（95%CI：1.279~2.392）、1.284倍（95%CI：1.021~1.615）和1.260倍（95%CI：1.033~1.538）；女性睡眠时长≤ 5 h、6 h和≥ 9 h患抑郁症状的风险分别是前者的2.115倍（95%CI：1.473~3.038）、1.605倍（95%CI：1.213~2.123）和1.313倍（95%CI：1.011~1.705）；55~64岁中老年人睡眠时长≤ 5 h和≥ 9 h患抑郁症状的风险分别是前者的1.806倍（95%CI：1.014~3.217）和1.478倍（95%CI：1.060~2.061）；65~74岁老年人睡眠时长≤ 5 h患抑郁症状的风险是前者的2.112倍（95%CI：1.327~3.361）；差异均有统计学意义（P<0.05）。男性、≥ 75岁老年人睡眠时长与抑郁症状的关联无统计学意义（P>0.05）。结论睡眠不足或过长与中老年人抑郁症状独立相关，二者呈U形关联，尤其要关注女性和55~64岁的中老年人。

English Abstract:

Objective To explore the relationship between sleep duration and depressive symptoms in middle-aged and elderly people. Methods A total of 11 931 middle-aged and elderly people aged ≥ 55 years who participated in the baseline survey of the "Community Cohort Study of Specialized Nervous System Diseases" in China from 2018 to 2019 were selected to obtain basic information about their lifestyle, food intake frequency, disease history, sleep duration. The body height and weight were measured, and body mass index (BMI) were calculated. The subjects with depressive symptoms were screened with the Geriatric Depression Scale (GDS-30). Restricted cubic spline model and multivariate logistic regression model were used to analyze the relationship between sleep duration and depressive symptoms. Results Among the middle-aged and elderly people aged ≥ 55 years, 17.79% reported sleep duration less than 7 hours, 16.84% reported that their sleep duration ≥ 9 hours, and the detection rate of depression symptoms was 7.95%. After adjusting for factors such as region, age, gender, the restricted cubic spline results showed the U-shaped relationship between sleep duration and the risk for depressive symptoms, the results of multivariate logistic regression analysis showed that the risk for depressive symptom in middle-aged and elderly people aged ≥ 55 years with sleep duration ≤ 5 hours, 6 hours, and ≥ 9 hours were 1.749(95%CI:1.279-2.392), 1.284(95%CI:1.021-1.615) and 1.260(95%CI:1.033-1.538) times higher compared with the counterparts with sleep duration 7-8 hours, the risk for depressive symptom in women with sleep duration ≤ 5 hours, 6 hours and ≥ 9 hours were 2.115 (95%CI:1.473-3.038), 1.605(95%CI:1.213-2.123) and 1.313(95%CI:1.011-1.705) times higher, respectively, compared with counterparts with sleep duration 7-8 hours, the risk for depressive symptoms in 55-64-year-old middle-aged and elderly people with sleep duration ≤ 5 hours and ≥ 9 hours were 1.806 (95%CI:1.014-3.217) and 1.478 (95%CI:1.060-2.061) times higher compared with counterparts with sleep duration 7-8 hours, and the risk for depressive symptoms in elderly people aged 65-74 years with sleep duration ≤ 5 hours was 2.112 (95%CI:1.327-3.361)times higher compared with counterparts with sleep duration 7-8 hours, the differences were all significant (P<0.05). There was no statistically significant association between sleep duration and depressive symptoms in men and in elderly people aged ≥ 75 years (P>0.05).Conclusion Insufficient or prolonged sleep was independently associated with depressive symptoms in middle-aged and elderly people, showing a U-shaped relationship, especially in women and in middle-aged and elderly people aged 55-64 years.

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