青年人睡眠与心理健康双向关系的meta分析

摘要/Abstract

摘要： 目的对青年人睡眠与心理健康间的双向关系进行系统综述和meta分析。方法在PubMed、 PsychINFO、 Embase、 Scopus、 MEDLINE、 PsycArticles、中国知网等数据库中检索2012年1月—2023年5月关于青年人睡眠与心理健康关系的中英文文献,由2名研究者独立对纳入文献进行筛选、数据提取及质量评价,应用Stata 14.0软件进行meta分析。结果共36篇文献纳入meta分析,其中横断面研究28篇,队列研究4篇,干预研究4篇。研究结果显示,睡眠质量与抑郁（OR=2.71,95%CI：1.44~5.11）、焦虑（OR=3.73,95%CI：1.81~7.67）和压力（OR=4.17,95%CI：3.01~5.76）,睡眠效率与抑郁（OR=2.02,95%CI：1.53~2.68）和焦虑（OR=1.73,95%CI：1.27~2.36）,睡眠时间与抑郁（OR=1.45,95%CI：0.73~2.91）均存在正相关。抑郁（OR=1.60,95%CI：1.17~2.18）、焦虑（OR=1.74,95%CI：1.32~2.31）、压力与睡眠质量（OR=1.22,95%CI：1.15~1.28）也存在正相关。结论青年人睡眠质量与抑郁、焦虑和压力间存在双向关系,需进一步开展睡眠与心理健康关系的纵向或干预研究,综合考虑解决睡眠和心理健康问题的最合适、最经济的干预措施。

关键词: 睡眠, 心理健康, 青年人, 双向关系

Abstract: Objective To conduct a systematic review and meta-analysis on the bidirectional relationship between sleep and mental health in young adults. Methods PubMed,PsychINFO,Embase,Scopus,MEDLINE,PsycArticles,CNKI,and other databases were searched for Chinese and English literatures on the relationship between sleep and mental health of young adults from January 2012 to May 2023. Two researchers independently screened the included literatures,extracted data and evaluated their quality. Then meta-analysis was performed using Stata 14.0 software. Results A total of 36 studies were included in the meta-analysis,including 28 cross-sectional studies,4 cohort studies,and 4 intervention studies. The results showed that sleep quality was positively associated with depression（OR=2.71,95%CI：1.44-5.11）,anxiety（OR=3.73,95%CI：1.81-7.67） and stress（OR=4.17,95%CI：3.01-5.76）,sleep efficiency was positively correlated with depression（OR=2.02,95%CI：1.53-2.68） and anxiety（OR=1.73,95%CI：1.27-2.36）,sleep duration was positively correlated with depression（OR=1.45,95%CI：0.73-2.91）. The depression（OR=1.60,95%CI：1.17-2.18）,anxiety（OR=1.74,95%CI：1.32-2.31）,and stress（OR=1.22,95%CI：1.15-1.28） were positively correlated with sleep quality. Conclusion There is a bidirectional relationship between sleep quality and depression,anxiety,and stress in young adults,and it is necessary to further carry out longitudinal or intervention studies on the relationship between sleep and mental health,and comprehensively consider the most appropriate and economical interventions to address sleep and mental health problems.

Key words: Sleep, Mental health, Young adults, Bidirectional relationship

中图分类号:

R181.2

刘艳洁, 黄赞, 周玉兰. 青年人睡眠与心理健康双向关系的meta分析. [J]职业与健康, 2023, 39(24): 3432-3442.

LIU Yanjie, HUANG Zan, ZHOU Yulan. Meta-analysis of bidirectional relationship between sleep and mental health in young adults. [J]OCCUPATION AND HEALTH, 2023, 39(24): 3432-3442.

参考文献

[1] KRONHOLM E,LAATIKAINEN T,PELTONEN M,et al.Self-reported sleep duration,all-cause mortality,cardiovascular mortality and morbidity in Finland[J].Sleep Med,2011,12(3):215-221.
[2] HILDRUM B,MYKLETUN A,HOLMEN J,et al.Effect of anxiety and depression on blood pressure:11-year longitudinal population study[J].Br J Psychiatry,2008,193(2):108-113.
[3] MONTAGNI I,QCHIQACH S,PEREIRA E,et al.Sex-specific associations between sleep and mental health in university students:a large cross-sectional study[J].J Am Coll Health,2020,68(3):278-285.
[4] GLAVIN E E,MATTHEW J,SPAETH A M.Gender differences in the relationship between exercise,sleep,and mood in young adults[J].Health Educ Behav,2022,49(1):128-140.
[5] PATEL V,FLISHER A J,HETRICK S,et al.Mental health of young people:a global public-health challenge[J].Lancet,2007,369(9569):1302-1313.
[6] PAPACONSTANTINOU E A,SHEARER H,FYNN-SACKEY N,et al.The association between chronotype and mental health problems in a university population:a systematic review of the literature[J].Int J Ment Health Addiction,2018,17(3):716-730.
[7] ROBOTHAM D.Sleep as a public health concern:insomnia and mental health[J].J Public Mental Health,2011,10(4):234-237.
[8] ZOU P,WANG X,SUN L,et al.Poorer sleep quality correlated with mental health problems in college students:a longitudinal observational study among 686 males[J].J Psychosom Res,2020(136):110177.
[9] CASEMENT M D,LIVINGSTON N R,ALLEN N B,et al.Feasibility,acceptability and affective consequences of at home sleep extension in young women with depressive symptoms:a pilot study[J].J Sleep Res,2020,30(2):e13045.
[10] ZHAI K,GAO X,WANG G.The role of sleep quality in the psychological well-being of final year undergraduate students in China[J].Int J Environ Res Public Health,2018,15(12):2881.
[11] MORITA Y,SASAI-SAKUMA T,ASAOKA S,et al.The impact of a delayed sleep-wake schedule on depression is greater in women-a web-based cross-sectional study in Japanese young adults[J].Chronobiol Int,2015,32(7):1-7.
[12] RIBEIRO J D,PEASE J L,GUTIERREZ P M,et al.Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military[J].J Affect Disord,2012,136(3):743-750.
[13] LUND H G,REIDER B D,WHITING A B,et al.Sleep patterns and predictors of disturbed sleep in a large population of college students[J].J Adolesc Health,2010,46(2):124-132.
[14] AHAMMED B,JAHAN N,SEDDEQUE A,et al.Exploring the association between mental health and subjective sleep quality during the COVID-19 pandemic among Bangladeshi university students[J].Heliyon,2021,7(5):e07082.
[15] LOVELL G.A cross-sectional investigation of depressive,anxiety,and stress symptoms and health-behavior participation in Australian university students[J].Nurs Health Sci,2015,17(1):134-142.
[16] DOANE L D,THURSTON E C.Associations among sleep,daily experiences,and loneliness in adolescence:evidence of moderating and bidirectional pathways[J].J Adolesc,2014,37(2):145-154.
[17] JAE-MIN K,ROBERT S,SUNG-WAN K,et al.Insomnia,depression,and physical disorders in late life:a 2-year longitudinal community study in Koreans[J].Sleep,2009,32(9):1221-1228.
[18] ALVARO P K,ROBERTS R M,HARRIS J K.A systematic review assessing bidirectionality between sleep disturbances,anxiety,and depression[J].Sleep,2013,36(7):1059-1068.
[19] SALTZMAN J A,LIECHTY J M.Family correlates of childhood binge eating:a systematic review[J].Eat Behav.2016(22):62-71.
[20] BUYSSE D J,ANGST J,GAMMA A,et al.Prevalence,course,and comorbidity of insomnia and depression in young adults[J].Sleep,2008(31):473-480.
[21] LI W,YIN J,CAI X,et al.Association between sleep duration and quality and depressive symptoms among university students:a cross-sectional study[J].PLoS One,2020,15(9):e0238811.
[22] LEMMA S,GELAYE B,BERHANE Y,et al.Sleep quality and its psychological correlates among university students in Ethiopia:a cross-sectional study[J].BMC Psychiatry,2012,12(1):237.
[23] HAREGU A,GELAYE B,PENSUKSAN W C,et al.Circadian rhythm characteristics,poor sleep quality,daytime sleepiness and common psychiatric disorders among Thai college students[J].Asia Pac Psychiatry 2015,7(2):182-189.
[24] WILSON K T,BOHNERT A E,AMBROSE A,et al.Social,behavioral,and sleep characteristics associated with depression symptoms among undergraduate students at a women’s college:a cross-sectional depression survey,2012[J].BMC Womens Health,2014,14(1):8.
[25] YE Y L,WANG P G,QU G C,et al.Associations between multiple health risk behaviors and mental health among Chinese college students[J].Psychol Health Med,2015,21(3):377-385.
[26] PELTZ J S,ROGGE R D,PUGACH C P,et al.Bidirectional associations between sleep and anxiety symptoms in emerging adults in a residential college setting[J].Emerging Adulthood,2016,5(3):204-215.
[27] SEUN-FADIPE C T,MOSAKU K S.Sleep quality and psychological distress among undergraduate students of a Nigerian university[J].Sleep Health,2017,3(3):190-194.
[28] ALMOJALI A I,ALMALKI S A,ALOTHMAN A S,et al.The prevalence and association of stress with sleep quality among medical students[J].J Epidemiol Glob Health,2017,7(3):169-174.
[29] HERAWATI K,GAYATRI D.The correlation between sleep quality and levels of stress among students in universitas Indonesia[J].Enfermeria clinica,2019,29(Supplement 2):357-361.
[30] LI T,XIE Y,TAO S,et al.Chronotype,sleep,and depressive symptoms among chinese college students:a cross-sectional study[J].Front Neurol,2020,11:592825.
[31] MANZAR M D,NOOHU M M,SALAHUDDIN M,et al.Insomnia symptoms and their association with anxiety and poor sleep hygiene practices among ethiopian university students[J].Nat Sci Sleep,2020(12):575-582.
[32] RAMOS J N,MURARO A P,NOGUEIRA P S,et al.Poor sleep quality,excessive daytime sleepiness and association with mental health in college students[J].Ann Hum Biol,2021,48(5):382-388.
[33] GREY I,ARORA T,SANAH A.Generalized anxiety mediates the relationship between loneliness and sleep quality amongst young adults during the covid-19 pandemic[J].Psychol Rep,2022:1-17.
[34] JACKSON M L,SZTENDUR E M,DIAMOND N T,et al.Sleep difficulties and the development of depression and anxiety:a longitudinal study of young Australian women[J].Arch Womens Ment Health,2014,17(3):189-198.
[35] MATTHEWS T,DANESE A,GREGORY AM,et al.Sleeping with one eye open:loneliness and sleep quality in young adults[J].Psychol Med.2017,47(12):2177-2186.
[36] 李俊,许韶君,侯方丽,等.高职大学生情绪症状与睡眠质量相关性分析[J].中国学校卫生,2014,35(4):537-539.
[37] 郭素然,孙文梅.大学生负性情绪在反刍思维与睡眠质量间的中介作用[J].中国健康心理学杂志,2016,24(3):151-155.
[38] 王道阳,戴丽华,殷欣.大学生的睡眠质量与抑郁、焦虑的关系[J].中国心理卫生杂志,2016,30(3):226-230.
[39] 徐妙哲,张丹丹,张红坡.大学生睡眠质量与心理健康状况的相关性[J].中国健康心理学杂志,2016,24(2):311-314.
[40] 蒋红成,毛勇,李雨晴.边疆省份医学生睡眠质量与焦虑及抑郁相关性分析[J].中国公共卫生管理,2016,32(3):305-308.
[41] 牛建梅,张研婷,强金萍,等.大学生抑郁与睡眠质量的相关性研究[J].现代预防医学,2017,44(22):4135-4138,4142.
[42] 陈江媛,吴冉.大学生的睡眠质量与抑郁,焦虑的关系[J].中国健康心理学杂志,2021,29(4):608-614.
[43] 庞亚玲,麻超,雷亮,等.大学生压力知觉对睡眠质量的影响:有调节的中介模型[J].中国特殊教育,2021(5):81-89.
[44] 吕秋玥,汤万杰,王强,等.大学生昼夜节律类型与抑郁情绪相关性的纵向研究[J].重庆医科大学学报,2021,46(10):1163-1169.
[45] 高蕾,李方明,高晓雷.西藏高原地区大学生睡眠质量与抑郁焦虑症状的关系[J].中国学校卫生,2021,42(4):593-596.
[46] 周喆林,尉力文,何秋惠,等.研究生知觉压力与心理健康的关系:睡眠质量的中介作用和社会支持的调节作用[J].中国健康心理学杂志,2022,30(5):749-752.
[47] WALLACE D D,BOYNTON M H,LYTLE L A.Multilevel analysis exploring the links between stress,depression,and sleep problems among two-year college students[J].J Am Coll Health,2017,65(3):187-196.
[48] FREEMAN D,SHEAVES B,GOODWIN G M,et al.The effects of improving sleep on mental health (OASIS):a randomised controlled trial with mediation analysis[J].Lancet Psychiatry,2017,4(10):749-758.
[49] UBARA A,TANIZAWA N,HARATA M,et al.How does e-mail-delivered cognitive behavioral therapy work for young adults(18-28 years) with insomnia? mediators of changes in insomnia,depression,anxiety,and stress[J].Int J Environ Res Public Health,2022,19(8):4423.
[50] HETLAND J,BAKKER AB,ESPEVIK R,et al.Daily work pressure and task performance:the moderating role of recovery and sleep[J].Front Psychol,2022,13:857318.
[51] KONJARSKI M,MURRAY G,LEE V V,et al.Reciprocal relationships between daily sleep and mood:a systematic review of naturalistic prospective studies[J].Sleep Med Rev,2018(42):47-58.
[52] GOLUB A,JOHNSON B D,LABOUVIE E.On correcting biases in self-reports of age at first substance use with repeated cross-section analysis[J].J Quant Criminol,2000,16(1):45-68.
[53] KANEITA Y,YOKOYAMA E,HARANO S,et al.Associations between sleep disturbance and mental health status:a longitudinal study of Japanese junior high school students[J].Sleep Med,2009,10(7):780-786.
[54] IRWIN M.Effects of sleep and sleep loss on immunity and cytokines[J].Brain Behav Immun,2002,16(5):503-512.
[55] MIEKO S,HIROYUKI S,MICHIKAZU S,et al.Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders:a prospective analysis[J].Biosci Trends,2016,10(1):34-41.
[56] SHARKEY K M,PEARLSTEIN T B,CARSKADON M A.Circadian phase shifts and mood across the perinatal period in women with a history of major depressive disorder:a preliminary communication[J].J Affect Disord,2013,150(3):1103-1108.
[57] DOWLATI Y,HERRMANN N,SWARDFAGER W,et al.A meta-analysis of cytokines in major depression[J].Biol Psychiatry,2010,67(5):446-457.
[58] MENKE A.Is the HPA axis as target for depression outdated,or is there a new hope[J].Front Psychiatry,2019(10):101.
[59] BAKOTIC M,RADOSEVIC-VIDACEK B,BJELAJAC A K.Morningness-eveningness and daytime functioning in university students:the mediating role of sleep characteristics[J].J Sleep Res,2017,26(2):210-218.
[60] CHARRIER A,OLLIAC B,ROUBERTOUX P,et al.Clock genes and altered sleep-wake rhythms:their role in the development of psychiatric disorders[J].Int J Mol Sci,2017,18(5):938.
[61] HASLER B P,ALLEN J J B,SBARRA D A,et al.Morningness-eveningness and depression:preliminary evidence for the role of the behavioral activation system and positive affect[J].Psychiatry Res,2010,176(2-3):166-173.
[62] PERLIS M L,GILES D E,MENDELSON WB,et al.Psychophysiological insomnia:the behavioural model and a neurocognitive perspective[J].J Sleep Res,1997,6(3):179-188.
[63] ESPIE C A,BROOMFIELD N M,MACMAHON K M A,et al.The attention-intention-effort pathway in the development of psychophysiologic insomnia:a theoretical review[J].Sleep Med Rev,2006,10(4):215-245.
[64] 赵颖,江敏敏,王静,等.抑郁对大学生自伤行为的影响:睡眠质量的中介作用及性别的调节作用[J].中国健康心理学杂志,2021,29(6):922-926.
[65] NESTLER E J,CARLEZON W A.The mesolimbic dopamine reward circuit in depression[J].Biol Psychiatry,2006,59:1151-1159.
[66] LESCH K P,BENGEL D,HEILS A,et al.Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region[J].Science,1996(274):1527-1531.
[67] KANEITA Y,YOKOYAMA E,HARANO S,et al.Associations between sleep disturbance and mental health status:a longitudinal study of Japanese junior high school students[J].Sleep Med,2009,10(7):780-786.