| Background and objective:Sleep is an important factor in maintaining energy,keeping and improving physical health.It is essential for human health and people spend about one third of their time sleeping every day.It is an important part of regulating the circadian rhythm of the human body and plays an important role in maintaining the homeostasis of the body,protecting brain functions,enhancing learning and memory,and regulating the immune system.A growing body of research shows that sleep is an independent risk factor for many chronic diseases,such as cardiovascular disease,high blood pressure,diabetes,obesity and mental illness.Napping is very common in China,where the traditional concept is that it can improve drowsiness,supplement the lack of sleep at night,and benefit physical and mental health.However,some studies have found that taking a long nap will increase the risk of some chronic diseases,especially in the elderly.As a country where napping is very popular in China,the health impact of siesta habits has received widespread attention.The results of previous studies on sleep mostly show the impact of sleep quality on health,and there are few studies on the relationship between sleep and health at different sleep times,such as nap and the time to falling asleep.Furthermore,most of the literature on sleep time is often about the relationship between sleep time and specific diseases,and there are few studies on the relationship between sleep time and physical health,mental health,and health-related quality of life.Health evaluation based on health-related quality of life can comprehensively and accurately reflect the health status of individuals or groups,as well as the impact on their physical function,psychological and social function,and show the positive and negative factors of health from positive and negative aspects.Therefore,this study analyzed the influence of different different sleep time and combination of sleep time patterns on health-related life quality from the perspective of comprehensive health evaluation,aiming to provide references for helping people to establish good sleep habits,formulate effective health interventions and improve health level in the future.Method:The subjects of this study were 1,886 healthy people surveyed from March 2015 to May 2016 by the oriental hospital of Beijing university of Chinese medicine,hebei college of traditional Chinese medicine and the medical experimental center of China academy of Chinese medical sciences.(1)The survey content mainly includes:(1)Background Investigation:gender,age,education level,smoking habit,drinking habit,exercise habit,sedentary habit,height,weight,previous medical history,etc;(2)Sleep Status:night sleep duration,napping,the time of falling asleep.The duration of sleep,time of falling asleep were obtained by the Pittsburgh sleep quality index(PSQI).Information on napping was collected by researchers who asked "do you have a habit of napping" and "how long do you take naps";(3)Health-Related Quality of Life:the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36).The SF-36 scale can be used to evaluate the physical and mental health status of a research subject from the physical component summary(PCS)and mental component summary(MCS).The physical component summary(PCS)consists of four dimensions:physical function(PF),role-physical(RP),physical pain(BP)and general health(GH).The mental component summary(MCS)consists of four dimensions:vitality(VT),social functioning(SF),role-emotional(RE)and mental health(MH).The higher the score in each field and dimension,the better the quality of life.Statistical analysis:(1)Comparison of differences between groups:Chi-square test and Analysis of variance were used to analyze the differences in the distribution of basic conditions and health-related quality of life scores of people with different sleep times.(2)Correlation analysis:pearson correlation analysis was used to analysis night sleep time,napping time,the time of falling asleep and SF-36.(3)Regression analysis:Gender,age,educational level,smoking habit,drinking habit,exercise habit,sedentary habit and previous medical history were used as control variables,and multiple linear regression and logistic regression were used to analyze the effects of different sleep times and sleep time patterns on health-related quality of life.Results:Among the 1886 subjects,650 were males and 1236 were females,with an average age of 31.6±12.73 years.1.HRQOL of respondents with different sleep times(1)HRQOL of respondents with night sleep duration:Compared with the 6-8h group,the<6h group had lower scores in the PCS(79.10 VS.82.46)domain and its PF(91.58 VS.93.50)?RP(84.07 VS.87.69)?BP(77.54 VS.81.10)?GH(63.20 VS.67.56)dimensions(P<0.05),MCS(75.06 VS.77.69)domain and its VT(67.51 VS.71.17)?SF(86.07 VS.88.66)?MH(73.16 VS.75.25)dimensions(P<0.05);?8h group had higher scores in the BP dimension(83.31 VS.81.10)(P<0.05),MCS(79.79 VS.77.69)domain and its SF(90.77 VS.88.66)dimension(P<0.05).(2)HRQOL of respondents with napping habits:The scores of the napping group in the PCS(80.70 VS.82.38)domain and its PF(92.02 VS.93.37)?GH(65.30 VS.67.78)dimensions were higher than that of the no napping group(P<0.05),and the scores of VT(69.01 VS.71.44)?SF(87.34 VS.89.20)?MH(73.84 VS.75.80)dimensions in MCS domain were higher than that of the no napping group(P<0.05).(3)HRQOL of respondents with the time of falling asleep:Compared with the group of the time of falling asleep<24:00,the scores of PCS(80.56 VS.82.08)domain and its RP(84.15 VS.87.52)dimension,MCS(73.22 VS.78.70)domain and its VT(66.87 VS.71.53).SF(85.60 VS.89.30)?RE(68.71 VS.77.98)?MH(71.70 VS.75.99)dimensions were significantly higher than those of the>24:00 group(P<0.05).2.Correlation and regression analysis of different sleep duration and HRQOL:(1)Correlation and regression analysis of night sleep duration and HRQOL:There was a significant positive correlation between sleep time at night and PCS(r=0.144,P<0.001)and MCS(r=0.136,P<0.001).The multivariate linear regression model found that night sleep duration had a statistically significant effect on PCS(b '=0.128,P<0.001)domain and MCS(b'=0.157,P<0.001)domain,HRQOL decreased with the extension of night sleep duration.The logistic regression model was found that compared with the reference group at night sleep time of 6-8h,night sleep duration ?6h group was in the PCS(OR=1.391,P<0.05)and MCS(OR=1.390,P<0.05)increased the risk of low quality of life scores,but the effect of night sleep duration?8h on HRQOL was not significant(P>0.05).(2)Correlation and regression analysis of napping and HRQOL:There was a significant positive correlation between nap time and PCS(r=0.068,P<0.001)and MCS(r=0.047,P<0.05).The multiple linear regression model find that the nap time statistically significant effect on PCS domain(b=0.052,P<0.05),in the field of PCS HRQOL increases with the increase of napping time,but found no such results in the field of MCS(b=0.035,P>0.05).In the Logistic regression model with PCS and MCS as dependent variables,the influence of napping habit on life quality was not significant(P>0.05).(3)Correlation and regression analysis at the time of falling asleep and HRQOL:There was no significant correlation between the time of falling asleep and PCS domain(P>0.05),but there was a significant negative correlation between the time of falling asleep and MCS domain(r=-0.158,P<0.001).The multiple linear regression model found that the time of asleep had a statistically significant influence on PCS domain(b'=-0.062,P<0.05)and MCS domain(b'=-0.125,P<0.001),and HRQOL decreased with the increase of sleep time.A logistic regression model was found that compared with the reference group at the time of falling asleep of ?24:00,<24:00 group was in the PCS domain(OR=1.284,P<0.05)and MCS domain(OR=1.557,P<0.05)increased the risk of low quality of life scores.3.Effects of different sleep time patterns on HRQOL:(1)Effects of night sleep duration combined with napping on health-related quality of life:The PCS and MCS scores were used as the dependent variables,and the sleep time patterns group of the combination of night sleep time and nap habits was used as the independent variable,a logistic regression model was found.?In the PCS domain,compared with those who slept for 6-8h at night with the habit of napping,those who slept for less than 6h at night without the habit of napping(OR=1.421,P<0.05)and those who slept for less than 6h at night with the habit of napping(OR=1.429,P<0.05)have an increased risk of low quality of life scores.However,there was no statistically significant increase in the risk of low quality of life score(P>0.05)compared with those who slept for 6-8h at night without the habit of napping and those who slept for more than 8h at night with or without the habit of napping(P>0.05).?In the MSC domain,compared with those who slept for 6-8h at night with the habit of napping,those who slept for less than 6h at night without the habit of napping(OR=1.418,P<0.05)have an increased risk of low quality of life scores.However,there was no statistically significant increase in the risk of low quality of life score(P>0.05)compared with those who slept for less than 6h at night with the habit of napping,slept for 6-8h at night without the habit of napping and those who slept for more than 8h at night with or without the habit of napping(P>0.05).(2)Effects of night sleep duration combined with the time of fall asleep on health-related quality of life:The PCS and MCS scores were used as the dependent variables,and the sleep time pattern group of the combination of night sleep time and the time of fall asleep was used as the independent variable,a logistic regression model was found.?In the PCS domain,compared with those who slept for 6-8h at night with falling asleep before 24:00,those who slept for less than 6h at night with falling asleep?24:00(OR=1.433,P<0.05)have an increased risk of low quality of life scores.However,there was no statistically significant increase in the risk of low quality of life score compared with those who slept for less than 6h at night with falling asleep?24:00,slept for 6-8h at night with falling asleep?24:00 and those who slept for more than 8h at night with falling asleep before or after 24:00(P>0.05).?In the MCS domain,compared with those who slept for 6-8h at night with falling asleep before 24:00,those who slept for less than 6h at night with falling asleep<24:00(OR=1.359,P<0.05)and ?24:00(OR=1.846,P<0.05)have an increased risk of low quality of life scores.However,there was no statistically significant increase in the risk of low quality of life score compared with those who slept for 6-8h at night with falling asleep?24:00 and those who slept for more than 8h at night with falling asleep before or after 24:00(P>0.05).Conclusion:Different sleep duration and combination of sleep duration patterns have different effects on health-related quality of life.(1)Those with night sleep duration scored the lowest in the physical and psychological domains and it positively affected the scores of physiological and psychological domains.People who don't get enough sleep have lower quality of life scores and worse quality of life.Those who have the habit of napping have scores higher in physiological and psychological domains,and napping time positively affects the score of physiological domain,but has no significant effect on psychological domain.A trend was observed that the quality of life of people who have the habit of napping was better than those who did not.Those who fell asleep later had the lowest scores in the physiological and psychological fields,and the time of falling asleep negatively affected the scores in the physiological and psychological fields.The quality of life score is worse when you fell asleep later.(2)The combination of night sleep duration and napping habits showed that those who have insufficient sleep time at night have a nap habit during the day,which may reduce the negative impact of short sleep time on the psychological field.(3)The combination of night sleep duration and the time of falling asleep showed that those who with insufficient sleep time at night fall asleep earlier,which may reduce the negative effect of short sleep time on health-related quality of life,especially in the psychological domain.In summary,this study believes that people with short sleep duration,no napping,and those who fall asleep late have poor health-related quality of life.Those who with insufficient sleep time at night fall asleep earlier,which may reduce the negative effect of short sleep time on psychological fields.Who have insufficient sleep time at night have a nap habit during the day,which may reduce the negative impact of short sleep time on health-related quality of life,especially in the psychological field.Therefore,ensuring adequate sleep time,reasonably arranging naps and falling asleep as soon as possible may have a good reference for forming good sleep habits and improving life quality and health level. |
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