目的 分析我国青少年失眠症状与学校表现的相关性。方法 运用分层整群抽样法对上海市4 966名青少年进行失眠症状和学校表现的横断面调查。采用青少年睡眠障碍问卷(ASDQ)和学业成绩教师评估问卷(TSAF)分别对青少年失眠状况和学校表现进行评估。结果 调查对象平均年龄为(15.59±2.04)岁,男性占49.3%。多因素分析结果显示,失眠症状与青少年学校表现相关,具体因素有入睡困难与注意力不集中(OR=1.30,95%CI:1.11~1.52,P=0.001)、学业成绩差(OR=1.24,95%CI:1.06~1.45,P=0.007)及人际交往受挫(OR=1.26,95%CI:1.08~1.48,P=0.003);睡眠维持障碍与注意力不集中(OR=1.25,95%CI:1.06~1.46,P=0.007)和学习自觉性差(OR=1.22,95%CI:1.04~1.44,P= 0.017)相关;再次入睡困难与学习自觉性差(OR=1.20,95%CI:1.00~1.45,P=0.048)相关。结论 青少年失眠症状与学校不良表现具有相关性,应当引起足够重视,及时进行筛查和干预,以促进青少年睡眠健康和学校表现。
Abstract
Objective To analyze the associations of insomnia symptoms with school performance among adolescents in China. Methods A stratified,cluster random sample of 4 966 adolescents participated in a cross-sectional survey.The Adolescent Sleep Disturbance Questionnaire (ASDQ) and the Teacher School Achievement Form (TSAF) were used to assess insomnia symptoms and adolescents' school performance,respectively. Results The age of the participants was (15.59±2.04) years old,and 49.3% of which were boys.Multivariate regression model demonstrated that insomnia symptoms were associated with school performance among adolescents.Falling asleep problem was associated with poor attention (OR=1.30,95%CI:1.11~1.52,P=0.001),frustrating academic achievement (OR=1.24,95%CI:1.06~1.45,P=0.007),and unsatisfying school relationship (OR=1.26,95%CI:1.08~1.48,P=0.003).Continuous sleep problem was found to be linked to an increased likelihood of poor attention (OR=1.25,95%CI:1.06~1.46,P=0.007) and poor motivation of study (OR=1.22,95%CI:1.04~1.44,P=0.017).Reinitiating sleep problem was associated with poor motivation of study (OR=1.20,95%CI:1.00~1.45,P=0.048). Conclusions Insomnia symptoms are associated with poor school performance.The significance of our findings lies in calling for serious attention and timely screening and intervention,so as to promote adolescent sleep health and school performance.
关键词
青少年 /
失眠症状 /
学校表现
Key words
adolescents /
insomnia symptoms /
school performance
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Vallido T,Peters K,O'Brien L,et al.Sleep in adolescence:a review of issues for nursing practice[J].J Clin Nurs,2009,18(13):1819-1826.
[2] Li S,Yang Q,Chen Z,et al.Homework schedule:an important factor associated with shorter sleep duration among Chinese school-aged children[J].Behav Sleep Med,2014,12(5):389-397.
[3] Liu X,Zhao Z,Jia C,et al.Sleep patterns and problems among chinese adolescents[J].Pediatrics,2008,121(6):1165-1173.
[4] Fortier-Brochu E,Beaulieu-Bonneau S,Ivers H,et al.Insomnia and daytime cognitive performance:a meta-analysis[J].Sleep Med Rev,2012,16(1):83-94.
[5] Roberts RE,Roberts CR,Duong HT.Sleepless in adolescence:prospective data on sleep deprivation,health and functioning[J].J Adolesc,2009,32(5):1045-1057.
[6] Kronholm E,Puusniekka R,Jokela J,et al.Trends in self-reported sleep problems,tiredness and related school performance among Finnish adolescents from 1984 to 2011[J].J Sleep Res,2015,24(1):3-10.
[7] Kilincaslan A,Yilmaz K,Oflaz SB,et al.Epidemiological study of self-reported sleep problems in Turkish high school adolescents[J].Pediatrics Int,2014,56(4):594-600.
[8] Mak KK,Lee SL,Ho SY,et al.Sleep and academic performance in Hong Kong adolescents[J].J Sch Health,2012,82(11):522-527.
[9] Li S,Arguelles L,Jiang F,et al.Sleep,school performance,and a school-based intervention among school-aged children:a sleep series study in China[J].PLoS One,2013,8(7):e67928.
[10] Chung KF,Cheung MM.Sleep-wake patterns and sleep disturbance among Hong Kong Chinese adolescents[J].Sleep,2008,31(2):185.
[11] 杨玉凤.儿童发育行为心理评定量表[M].北京:人民卫生出版社,2016,1:191-193.
[12] Liu X,Liu L,Owens JA,et al.Sleep patterns and sleep problems among schoolchildren in the United States and China[J].Pediatrics,2005,115(1 Suppl):241-249.
[13] Zhang J,Xu Z,Zhao K,et al.Sleep habits,sleep problems,sleep hygiene,and their associations with mental health problems among adolescents[J].J Am Psychiatr Nurses Assoc,2017.doi:10.1177/1078390317715315
[14] Ravid S,Afek I,Suraiya S,et al.Sleep disturbances are associated with reduced school achievements in first-grade pupils[J].Dev Neuropsychol,2009,34(5):574-587.
[15] Bruni O,Ferini-Strambi L,Russo PM,et al.Sleep disturbances and teacher ratings of school achievement and temperament in children[J].Sleep Med,2006,7(1):43-48.
[16] Amaral O,Garrido A,Pereira C,et al.Sleep patterns and insomnia among portuguese adolescents:a cross-sectional study[J].Aten Primaria,2014,46:191-194.
[17] Johnson EO.Epidemiology of DSM-IV insomnia in adolescence:Lifetime prevalence,chronicity,and an emergent gender difference[J].Pediatrics,2006,117(2):e247-e256.
[18] Chen T,Wu Z,Shen Z,et al.Sleep duration in Chinese adolescents:biological,environmental,and behavioral predictors[J].Sleep Med,2014,15(11):1345-1353.
[19] McCoy JG,Tartar JL,Bebis AC,et al.Experimental sleep fragmentation impairs attentional set-shifting in rats[J].Sleep,2007,30(1):52-60.
[20] Chen Z,Wimmer RD,Wilson MA,et al.Thalamic circuit mechanisms link sensory processing in sleep and attention[J].Front Neural Circuits,2015,9:83.
[21] Beebe DW,Rose D,Amin R.Attention,Learning,and Arousal of Experimentally Sleep-restricted Adolescents in a Simulated Classroom[J].J Adolesc Health,2010,47(5):523-525.
[22] Curcio G,Ferrara M,De Gennaro L.Sleep loss,learning capacity and academic performance[J].Sleep Med Rev,2006,10(5):323-337.
[23] Nieuwenhuis ILC,Takashima A.The role of the ventromedial prefrontal cortex in memory consolidation[J].Behav Brain Res,2011,218(2):325-334.
[24] Srinivasan V,Pandi-Perumal SR,Trakht I,et al.Pathophysiology of depression:role of sleep and the melatonergic system[J].Psychiatry Res,2009,165(3):201-214.
[25] Blunden SL,Chervin RD.Sleep problems are associated with poor outcomes in remedial teaching programmes:a preliminary study[J].J Paediatr Child Health,2008,44(5):237-242.
基金
国家自然科学基金面上项目(81072314);上海市公共卫生优秀学科带头人培养计划(GWDTR201222)