社区中老年人午睡频率与夜间睡眠的关系

目的 探讨中老年社区居民午睡频率与夜间睡眠的关系。方法 2010年9月—2011年3月，在上海市2个区5个居委会中随机抽取478名45~80岁的中老年社区居民进行面对面询问调查。分别采用匹兹堡睡眠质量指数（PSQI）问卷评估受试者的睡眠质量，蒙特利尔认知评估（MoCA）问卷检测受试者的认知功能，自行设计问卷调查受试者的基本情况。根据午睡频率将受试者分为经常午睡组（≥3次/周）、偶尔午睡组（1~2次/周）和对照组（≤3次/月）。结果 发放问卷478份，其中有效问卷443份，有效率92.68%。经常午睡组受试者的平均年龄和腰围均明显大于对照组（P<0.01），但认知总分明显低于对照组（P<0.01）；经常午睡组受试者的文化程度、在职状况以及慢性病自报率与对照组比较差异均有统计学意义（P<0.05或P<0.01）。在调整了受试者的年龄、文化程度、在职状况、腰围、慢性病自报率以及认知评分等因素后，经常午睡组的睡眠障碍评分、日间功能评分以及PSQI总分均明显高于偶尔午睡组和对照组（P<0.05或P<0.01）；经常午睡组和偶尔午睡组的夜间睡眠床上总时间均明显短于对照组（P<0.01）；三组的夜间上床到入睡时间、实际睡眠时间和睡眠效率比较差异无统计学意义（P>0.05）。结论 午睡频率增加和中老年人夜间睡眠质量自评差密切相关，无充分证据显示午睡频率与夜间睡眠时间特征指标有关。

Relationship between afternoon nap and nocturnal sleep in middle and old aged community residents

Objective To investigate the relationship between afternoon nap and nocturnal sleep in middle and old aged community residents. Methods A total of 478 residents aged between 45 and 80 years were selected for face-to-face survey by cluster sampling method from 5 communities in 2 districts of Shanghai from September 2010 to March 2011. Pittsburgh sleep quality Index (PSQI) questionnaire was employed to evaluate the sleeping quality, Montreal cognitive assessment (MoCA) questionnaire was adopted to the assess the cognition function, and self-designed questionnaire was used to obtain the basic information of residents. According to afternoon nap frequencies, residents were divided into frequent afternoon nap group (≥3 times/week), occasional afternoon nap group (1 to 2 times/week) and control group (≤3 times/month). Results There were 443 valid questionnaires, with the effective rate of 92.68%. The mean age and waist circumference in frequent afternoon nap group were significantly higher than those in control group (P<0.01), but the cognition score in frequent afternoon nap group was significantly lower than that in control group (P<0.01). There were significant differences in the degree of education, employment status and self-report rate of chronic diseases between frequent afternoon nap group and control group (P<0.05 or P<0.01). After adjustment by factors such as age, degree of education, employment status, waist circumference, self-report rate of chronic diseases and cognition status, the sleep disorder score, daytime function score and total PSQI score in frequent afternoon nap group were significantly higher than those in occasional afternoon nap group and control group (P<0.05 or P<0.01), the total bed time in frequent afternoon nap group and occasional afternoon nap group was significant less than that in control group (P<0.01), and there was no significant difference in sleep latency, sleep duration and sleep efficiency among three groups (P>0.05). Conclusion The increase of afternoon nap frequency is closely associated with the poor nocturnal sleep quality of middle and old aged people, while there is no sufficient evidence that afternoon nap frequency is related to nocturnal sleep time pattern.