《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (3): 331-338.doi: 10.3969/j.issn.1006-9771.2025.03.010

• 应用研究 • 上一篇    下一篇

睡眠时长模式对中老年日常生活活动能力的影响

林利霞1,2, 曾秋婵1,2, 郭蕴源1,2, 梁荣相1,2, 吴昊1,2, 邵玉萍1,2()   

  1. 1.湖北中医药大学体育健康学院，湖北武汉市 430065
    2.湖北时珍实验室，湖北武汉市 430065
  • 收稿日期:2024-12-26 修回日期:2025-01-03 出版日期:2025-03-25 发布日期:2025-03-25
  • 通讯作者: 邵玉萍(1972-)，女，汉族，湖北仙桃市人，硕士，教授，主要研究方向：运动康复与健康促进、老年病防治、传统运动养生研究，E-mail：1763@hbucm.edu.cn。
  • 作者简介:林利霞(1992-)，女，汉族，河南安阳市人，博士，讲师，主要研究方向：慢性病康复与管理、中老年健康。
  • 基金资助:
    1.湖北省科技厅技术创新计划-重点研发专项-自主创新类项目(合作研发)(2023BCB029);2.体医融合·民族传统体育传承与创新基地(培育类)

Relationship between patterns of sleep duration and activities of daily living among middle-aged and older adults

LIN Lixia1,2, ZENG Qiuchan1,2, GUO Yunyuan1,2, LIANG Rongxiang1,2, WU Hao1,2, SHAO Yuping1,2()   

  1. 1. School of Physical Education and Health, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China
    2. Hubei Shizhen Laboratory, Wuhan, Hubei 430065, China
  • Received:2024-12-26 Revised:2025-01-03 Published:2025-03-25 Online:2025-03-25
  • Contact: SHAO Yuping, E-mail: 1763@hbucm.edu.cn
  • Supported by:
    Hubei Provincial Department of Science and Technology Innovation Program - Key Research and Development Project - Independent Innovation Category (Collaborative Research)(2023BCB029);Integration of Sports and Medicine - National Traditional Sports Heritage and Innovation Base(Cultivation Category)

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摘要：

目的 探讨夜间和日间睡眠时长模式对中老年日常生活活动能力(ADL)的影响。

方法 数据来源于中国健康与养老追踪调查(CHARLS)采集的11 085例45岁及以上中老年人。基线调查时(2011)，通过调查问卷收集研究人群的夜间和日间睡眠时长。基于夜间睡眠时长的第33、66百分位数，将研究人群分为3组，分别赋值为1、2、3分；基于日间睡眠时长的第33、66百分位数将研究人群分为3组，分别赋值为3、2、1分；将夜间和日间睡眠分值相加(2~6分)。将睡眠总分值为6分定义为模式一(代表夜间睡眠时长较长而无日间睡眠或时长较短)，类似地，将睡眠总分值为5、4、3、2分别定义为模式二、三、四、五(代表夜间睡眠时长较短而日间睡眠时长较长)。基线及2013、2015、2018年随访时，采用Katz版日常生活活动能力量表进行评估。采用COX比例风险回归模型评估睡眠时长模式与ADL受限的关联。

结果 本研究共随访63 015人年，11 085例样本，其间3 239人发生ADL受限。研究人群夜间睡眠时长的第33、66百分位数分别为6.00 h、7.00 h，日间睡眠时长的第33、66百分位数分别为0.00 h、1.00 h。其中，模式一1 522例，模式二2 196例，模式三4 299例，模式四2 304例，模式五764例。调整年龄、性别、体质量指数、婚姻状况、教育水平、地区、吸烟、饮酒、慢性病、抑郁状况、季节后，与睡眠时长模式一相比，模式三、模式四、模式五中老年人发生ADL受限的风险更高(P < 0.05)，且趋势性检验P < 0.001。未发现性别、年龄、季节与睡眠时长模式间的交互作用(P > 0.05)。与夜间睡眠时长≥ 9 h且日间睡眠时长< 2 h人群相比，夜间睡眠时长< 7 h且日间睡眠时长≥ 2 h者发生ADL受限的风险较高(P < 0.05)。

结论 夜间睡眠时长较短而日间睡眠时长较长的中老年人发生ADL受限的风险较高。睡眠节律可能影响中老年人群ADL，通过管理中老年人睡眠时长模式，可能有助于预防ADL受限的发生。

关键词: 中老年人, 残疾, 睡眠模式, 日常生活活动能力, 中国健康与养老追踪调查

Abstract:

Objective To evaluate the patterns of sleep duration by integrating nocturnal and daytime sleep, and to explore their associations with activities of daily living (ADL) in middle-aged and older adults.

Methods The data of sleep and ADL were obtained from 11 085 subjects aged 45 and older, which were collected from the China Health and Retirement Longitudinal Study (CHARLS). At enrollment in 2011, data on nocturnal and daytime sleep duration were collected through questionnaires. Firstly, subjects were divided into three groups based on the 33rd and 66th percentiles of nocturnal sleep duration, assigned scores of 1, 2 and 3, respectively. Subsequently, subjects were divided into three groups based on the 33rd and 66th percentiles of daytime sleep duration, assigned scores of 3, 2 and 1, respectively. Finally, the scores for nocturnal and daytime sleep were summed to create a total sleep score ranging from 2 to 6. A total sleep score of 6 was defined as sleep duration pattern 1, indicating a longer nocturnal sleep duration with no or shorter daytime sleep duration. Similarly, total sleep scores of 5, 4, 3 and 2 were defined as sleep duration patterns 2, 3, 4 and 5, respectively, with sleep duration pattern 5 indicating a shorter nocturnal sleep duration and a longer daytime sleep duration. The status of ADL was assessed using the Activities of Daily Living Scale (Katz edition) at baseline and during follow-up in 2013, 2015 and 2018. The association between sleep duration patterns and the risk of ADL disability was evaluated using a Cox proportional hazards model.

Results A total of 63 015 person-years were followed, with 11 085 subjects, during which 3 239 individuals experienced ADL disability. The 33rd and 66th percentiles of the nocturnal sleep duration in the study population were 6.00 hours and 7.00 hours, respectively; while the 33rd and 66th percentiles of the daytime sleep duration were 0.00 hours and 1.00 hours, respectively. Of those, 1 522 were classified into sleep duration pattern 1, 2 196 into sleep duration pattern 2, 4 299 into sleep duration pattern 3, 2 304 into sleep duration pattern 4, and 764 into sleep duration pattern 5. Compared to sleep duration pattern 1, the risk of ADL disability of patterns 3, 4 and 5 were higher (P < 0.05), with P-value for the trend less than 0.001, after adjusting for age, sex, body mass index, marital status, educational level, residence, smoking, drinking, history of chronic diseases, depression status and season. No interaction effect between gender, age and season, and sleep duration patterns was observed (P > 0.05). Compared to subjects with nocturnal sleep duration ≥ 9 hours and daytime sleep duration < 2 hours, those with nocturnal sleep duration < 7 hours and daytime sleep duration ≥ 2 hours had a higher risk of ADL disability (P < 0.05).

Conclusion Older adults who sleep less at night but take longer naps during the day are at a higher risk of experiencing limitations in their ADL. Sleep patterns may influence ADL among middle-aged and older populations, and managing their sleep duration patterns could help prevent the onset of ADL limitations.

Key words: middle-aged and older, disability, sleep patterns, activities of daily living, China Health and Retirement Longitudinal Study

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