Abstract: Objective To investigate the association of daily sleep duration and night-time awakenings over the preceding week with peripheral hemoglobin (Hb) levels in children aged 0 - 6 years in Northwestern China, in order to provide new evidence for anemia prevention and child health management. Methods From January 2021 to June 2023, this cross-sectional study enrolled 3 812 children aged 0 - 6 years from four provinces (Shaanxi, Gansu, Ningxia, Qinghai). Basic information about the children and their sleep patterns over the preceding week (including daily sleep duration and number of night-time awakenings) were collected via a standardised questionnaire,alongside testing of peripheral blood haemoglobin levels. The Dallman method was employed to correct for the effect of altitude on haemoglobin values. Univariate analysis and multivariable linear regression models were used to analyze the association between sleep parameters and Hb levels. Results After adjusting for confounders, multivariable linear regression analysis revealed that frequent night-time awakenings (≥2 times) were significantly associated with lower Hb levels compared to no awakenings (β=-0.074, P<0.001). This association remained stable across gender and age subgroups. Stratified analysis by season showed that shorter sleep duration (<10 hours) in summer (β=-0.296, P<0.001) and frequent night-time awakenings (≥2 times) in winter (β=-0.129, P<0.001) were both significantly associated with lower Hb levels. Conclusions Poor sleep continuity, particularly frequent night-time awakenings (≥2 times), is significantly associated with lower Hb levels among children aged 0 - 6 in Northwestern China. Improving the continuity of children's sleep may help maintain normal haemoglobin levels, offering a new perspective for the prevention and control of childhood anaemia.

Key words: fragmented sleep, haemoglobin, northwestern region, health management, cross-sectional study, children

摘要： 目的 分析西北地区0~6岁儿童近一周每日睡眠时长及夜醒次数与末梢血红蛋白(Hb)水平的关联性,为儿童健康管理提供科学依据。方法 2021年1月—2023年6月,采用横断面研究设计,于西北地区(陕、甘、宁、青)纳入 3 812 名0~6岁儿童。通过标准化问卷收集儿童基本信息及近一周的睡眠情况(包括每日睡眠时长、夜醒次数),并检测末梢血Hb水平。采用Dallman法校正海拔对Hb值的影响。使用单因素分析和多因素线性回归模型分析睡眠因素与Hb水平的关联。结果 多因素线性回归分析显示,夜醒次数≥2次与较低的Hb水平显著相关(β=-0.074,P<0.001),该关联在不同性别和年龄组中均存在。季节性分析显示,夏季睡眠时长不足10h组Hb水平更低(β=-0.296,P<0.001),冬季频繁夜醒(≥2次)与Hb水平之间存在显著负向关联(β=-0.129,P<0.001)。结论 西北地区0~6岁儿童较少的夜醒次数与较高的Hb水平相关。改善儿童睡眠连续性可能有助于维持正常Hb水平,为儿童贫血防控提供新视角。

关键词: 睡眠片段化, 血红蛋白, 西北地区, 健康管理, 横断面研究, 儿童