睡眠类型与睡眠时间对医学生自评健康的独立与联合效应研究

丁攀; 李缙永; 叶晓丽; 尹筱晗; 钱丹妮; 钟崇洲; 施红英

Abstract

丁攀,李缙永,叶晓丽,尹筱晗,钱丹妮,钟崇洲,施红英.睡眠类型与睡眠时间对医学生自评健康的独立与联合效应研究[J].Chinese journal of Epidemiology,2022,43(11):1796-1803

睡眠类型与睡眠时间对医学生自评健康的独立与联合效应研究

Independent and joint effect of chronotype and sleep duration on self-rated health in medical students

Received:April 26, 2022

DOI：10.3760/cma.j.cn112338-20220426-00349

KeyWord: 睡眠类型睡眠时间自评健康医学生

English Key Word: Chronotype Sleep duration Self-rated health Medical student

FundProject:国家社会科学基金（21BRK021）；浙江省哲学社会科学规划课题重点项目（21NDJC013Z）；国家级大学生创新创业训练计划（202010343008）；浙江省大学生科技创新活动计划（2022R413C079）

Author Name	Affiliation	E-mail
Ding Pan	Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China
Li Jinyong	Renji College, Wenzhou Medical University, Wenzhou 325035, China
Ye Xiaoli	Publicity Department, Wenzhou Medical University, Wenzhou 325035, China
Yin Xiaohan	Renji College, Wenzhou Medical University, Wenzhou 325035, China
Qian Danni	Renji College, Wenzhou Medical University, Wenzhou 325035, China
Zhong Chongzhou	Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China
Shi Hongying	Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China	shying918@163.com

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Abstract:

目的探讨睡眠类型、睡眠时间对医学生自评健康状况较差的独立及联合效应。方法本研究为横断面调查。采用按比例分层整群随机抽样的方法在浙江省某医科大学选取1 526名在校医学生作为研究对象。调查内容主要包括基本人口学特征、睡眠类型、睡眠时间、夜宵、久坐时间和体力活动时间等生活方式信息以及自评健康状况。采用logistic回归模型控制可疑混杂变量后评价睡眠类型、睡眠时间与自评健康的关联性。结果医学生睡眠类型为晚睡晚起型者最多（664人，43.5%），其次为中间型（442人，29.0%）、早睡早起型（420人，27.5%）。自评健康状况较差的报告人数占42.8%（653人）。不同睡眠类型医学生自评健康状况较差报告率不等：与早睡早起型相比，中间型、晚睡晚起型者自评健康状况较差比例更高，调整OR值（95%CI）分别为1.69（1.23~2.31）、2.43（1.81~3.26），趋势检验P<0.001。与每晚睡眠时间≥8 h者相比，睡眠时间为7、≤6 h者自评健康状况较差的OR值（95%CI）分别为1.40（1.07~1.84）、2.38（1.69~3.37），趋势检验P<0.001。睡眠类型与睡眠时间存在联合效应，调整各种混杂因素后，与早睡早起型且每晚睡眠时间≥8 h的医学生相比，晚睡晚起型且睡眠时间≤6 h者自评健康状况较差的OR值最大，OR值（95%CI）为6.53（3.53~12.09）。结论晚睡晚起型及睡眠不足均与医学生自评健康状况较差的OR值增加有关联，且两者具有联合效应。建议医学生应尽量早睡早起，并保持充足睡眠，促进健康。

English Abstract:

Objective To investigate the independent and joint effects of chronotype and sleep duration on self-rated health in medical students. Methods A cross-sectional study was conducted in 1 526 medical students selected through proportional stratified cluster random sampling from a medical university in Zhejiang province. A questionnaire survey was conducted to collect the information about their basic demographic characteristics, chronotype, sleep duration, and other lifestyle factors such as midnight snack, sedentary behavior, physical activity, meal time, and self-rated health. The independent and joint effects of chronotype and sleep duration on self-rated health were assessed by logistic regression model after controlling for confounding variables. Results The numbers of the students with evening chronotype, neutral chronotype, and morning chronotype were 664 (43.5%), 442 (29.0%), and 420 (27.5%), respectively. Among the medical students, 42.8% (653) had poor self-rated health. Compared with those with the morning chronotype, the adjusted ORs for those with neutral chronotype and evening chronotype were 1.69 (95%CI:1.23-2.31) and 2.43 (95%CI:1.81-3.26), respectively, trend test P<0.001. Compared with those with sleep duration of 8 h or above per night, the adjusted ORs for those with sleep duration of 7 and ≤ 6 h per night were 1.40 (95%CI:1.07-1.84) and 2.38 (95%CI:1.69-3.37), respectively, trend test P<0.001. In the joint effect, compared with those with the morning chronotype and sleep duration of 8 h or above per night, the adjusted OR for those with evening chronotype and sleep duration of ≤ 6 h per night was 6.53 (95%CI:3.53-12.09).Conclusions Both evening chronotype and insufficient sleep were associated with increased odds of poor self-rated health in medical students, and they had joint effects. Therefore, it is necessary to promote early to bed, early to rise and adequate sleep in medical student to maintain their health.

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