社区中老年人夜间睡眠时间轨迹与抑郁症的关系：一项中国纵向队列研究-现代医学

社区中老年人夜间睡眠时间轨迹与抑郁症的关系：一项中国纵向队列研究

单位：广西中医药大学护理学院, 广西南宁 530200

分类号：R749.4

出版年·卷·期（页码）：2025·53·第九期（1443-1451）

摘要：

目的： 探讨社区中老年人夜间睡眠时间变化轨迹与抑郁症的关系。方法： 基于中国健康与养老追踪调查(CHARLS)的人群队列，收集2011年、2013年、2015年、2018年和2020年中老年人的夜间睡眠时间数据，以2020年流调中心抑郁量表(CES-D)评估的抑郁状况作为随访结局。采用组轨迹模型(GBTM)建立社区中老年人夜间睡眠时间的异质性轨迹，Logistic回归分析夜间睡眠时间变化轨迹与抑郁症之间的关系。结果： 对2 300名中老年人进行了10年的追踪，识别出4种睡眠时长轨迹：低水平下降组(占比6.3%，AvePP=0.845)、中水平下降组(占比29.0%，AvePP=0.797)、中水平稳定组(占比52.6%，AvePP=0.819)和高水平渐增组(占比12.1%，AvePP=0.816)。在调整所有协变量的模型2中，与高水平渐增组相比，低水平下降组(OR=3.93, 95%CI:2.45~6.43)、中水平下降组(OR=2.31, 95%CI:1.70~3.16)和中水平稳定组(OR=1.48, 95%CI:1.11~1.97)抑郁症的发生率显著升高，表明夜间睡眠时间短是抑郁症的危险因素。结论： 社区中老年人夜间睡眠时间轨迹可分为4类，夜间睡眠时间短且持续下降是抑郁症的重要危险因素，因而早期识别中老年人夜间睡眠的发展轨迹尤为重要。

Objective: To explore the relationship between the trajectory of the nighttime sleep duration and depression in middle-aged and elderly people in the community. Methods: Based on the population cohort data of China Health and Retirement Longitudinal Study(CHARLS), the nighttime sleep duration data of middle-aged and elderly people were collected in 2011, 2013, 2015, 2018, and 2020. Depressive symptoms, which were assessed in 2020 using the Center for Epidemiologic Studies Depression Scale(CES-D), served as the follow-up outcome. The group-based trajectory model(GBTM) was used to establish a heterogeneous trajectory of the nighttime sleep duration in middle-aged and elderly people in the community. Logistic regression was used to analyze the relationship between the trajectory of the nighttime sleep duration and depression. Results: A total of 2 300 middle-aged and elderly people were followed up for 10 years, and four nighttime sleep duration trajectories were identified: low-level decline group(6.3%, AvePP=0.845), medium-level decline group(29.0%, AvePP=0.797), medium-level stable group(52.6 %, AvePP=0.819) and high-level gradual increase group(12.1%, AvePP=0.816). In Model 2, which adjusted for all covariates, the incidence of depression was significantly higher in the low-level decline group(OR=3.93, 95% CI 2.45-6.43), the medium-level decline group(OR=2.31, 95% CI 1.70-3.16), and the medium-level stable group(OR=1.48, 95% CI 1.11-1.97) compared to the high-level gradual increase group. These findings suggested that short nighttime sleep duration was a risk factor for depression. Conclusion: The nighttime sleep duration trajectories of middle-aged and elderly people in the community can be divided into four categories, short and continuous decline of nighttime sleep time is an important risk factor for depression. Therefore, early identification of the development trajectory of nighttime sleep in middle-aged and elderly people is particularly important.

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