医学生失眠亚型及影响因素分析

职业与健康 ›› 2024, Vol. 40 ›› Issue (14): 1960-1964.

医学生失眠亚型及影响因素分析

刘荣勋^1a, 高雨彤^1b, 孙丽君^1a, 位彦鸽², 朱丽丽^1b

1.新乡医学院 a心理学院,b护理学院,河南新乡 453000;
2.新乡医学院第二附属医院早期干预二科,河南新乡 453000

收稿日期:2023-10-22 修回日期:2023-11-18 发布日期:2026-03-17
通信作者: 朱丽丽,副教授,E-mail：lilyer2000@126.com
作者简介:刘荣勋,男,讲师,主要从事心理健康教育管理工作。
基金资助:
2021年河南省高等教育教学改革研究与实践项目（学位与研究生教育）（2021SJGLX189Y）; 河南省教育科学规划 2023 年度一般课题（2023YB0135）

Analysis on insomnia subtypes and influencing factors among medical students

LIU Rongxun^1a, GAO Yutong^1b, SUN Lijun^1a, WEI Yange², ZHU Lili^1b

1. a School of Psychology, b School of Nursing, Xinxiang Medical College, Xinxiang, Henan 453000, China;
2. Department Ⅱof Early Intervention, Second Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan 453000, China

Received:2023-10-22 Revised:2023-11-18 Published:2026-03-17
Contact: ZHU Lili,Associate professor,E-mail：lilyer2000@126.com

摘要/Abstract

摘要： 目的了解医学生失眠的潜在类别,并分析失眠亚型的相关因素。方法采用便利抽样法,2022年6—7月选取新乡市某医学院4 425名医学生为调查对象,采用一般资料调查量表、失眠严重指数问卷、抑郁筛查量表、压力知觉量表对其进行调查,使用潜在剖面分析的方法了解医学生失眠亚型,利用回归混合模型分析各类别的预测因素。结果医学生的失眠严重程度得分[M（P₂₅,P₇₅）]为1（10,4）分,失眠人数共356人（8.05%）,其中轻度失眠319人,中度失眠33人,重度失眠4人,失眠亚型分为“无失眠组”“不稳定型早醒失眠”“早醒型稳定趋势性失眠”和“入睡困难型稳定性失眠”4种潜在类别,性别、年级、年龄、专业、抑郁、压力对不同亚型均有预测作用（均P<0.05）。结论医学生失眠亚型可分为4种潜在类别,其影响因素不同,未来可根据不同亚型及其影响因素开展针对性的干预措施,减少医学生失眠问题的发生率,促进其身心健康成长。

关键词: 医学生, 失眠亚型, 潜在剖面分析, 影响因素

Abstract: Objective To understand the potential categories of insomnia among medical students,analyze the factors associated with insomnia subtypes. Methods The convenience sampling method was used to select 4 425 medical students from a medical university in Xinxiang City from June to July 2022,and they were surveyed using the general information survey scale,insomnia severity index questionnaire,depression screening scale,and stress perception scale. The latent profile analysis was used to explore the subtypes of insomnia in the medical students. The mixed regression model was used to analyze predictive factors for each category. Results The medical students' insomnia severity score of M（P₂₅,P₇₅） was 1（0,4）points. There were 356（8.05%） people with insomnia,of which 319 were mild insomnia,33 were moderate insomnia,and 4 were severe insomnia. The subtypes were divided into four potential categories,namely "no insomnia group","unstable early wakefulness insomnia","early wakefulness stable trend insomnia",and "difficulty in falling asleep stable insomnia". The gender,grade,age,major,depression,and stress had a predictive effect on the different subtypes（all P<0.05）. Conclusion The insomnia subtypes of medical students can be divided into four potential categories with different influencing factors,and targeted interventions can be carried out according to the different subtypes and their influencing factors in the future to reduce the incidence of insomnia among medical students and promote their healthy physical and mental growth.

Key words: Medical students, Insomnia subtypes, Potential profile analysis, Influencing factors

中图分类号:

R181.3⁺7

刘荣勋, 高雨彤, 孙丽君, 位彦鸽, 朱丽丽. 医学生失眠亚型及影响因素分析. [J]职业与健康, 2024, 40(14): 1960-1964.

LIU Rongxun, GAO Yutong, SUN Lijun, WEI Yange, ZHU Lili. Analysis on insomnia subtypes and influencing factors among medical students. [J]OCCUPATION AND HEALTH, 2024, 40(14): 1960-1964.

参考文献

[1] PATEL D,STEINBERG J,PATEL P.Insomnia in the Elderly:A Review[J].J Clin Sleep Med,2018,4(6):1017-1024.
[2] NICHOLSON R,MACKENZIE C,AFIFI T O,et al.An examination of comorbid psychiatric disorders in disordered gamblers versus other substance-related disorders[J].J Gambl Stud,2019,35(3):829-847.
[3] MORIN C M,BJORVATN B,CHUNG F,et al.Insomnia,anxiety,and depression during the COVID-19 pandemic:an international collaborative study[J].Sleep Med,2021,87:38-45.
[4] GARDANI M,BRADFORD D R R,RUSSELL K,et al.A systematic review and meta-analysis of poor sleep,insomnia symptoms and stress in undergraduate students[J].Sleep Med Rev,2022,61:101565.
[5] ALRASHED F A,SATTAR K,AHMAD T,et al.Prevalence of insomnia and related psychological factors with coping strategies among medical students in clinical years during the COVID-19 pandemic[J].Saudi J Biol Sci,2021,28(11):6508-6514.
[6] ZHANG M,QIN L,ZHANG D,et al.Prevalence and factors associated with insomnia among medical students in China during the COVID-19 pandemic:Characterization and associated factors[J].BMC Psychiatry,2023,23(1):140.
[7] WU T T,ZOU Y L,XU K D,et al.Insomnia and multiple health outcomes:Umbrella review of meta-analyses of prospective cohort studies[J].Public Health,2023,215:66-74.
[8] ALQUDAH M,BALOUSHA S A M,AL-SHBOUL O,et al.Insomnia among medical and paramedical students in Jordan:Impact on academic performance[J].Biomed Res Int,2019,2019:7136906.
[9] PILLAI V,ROTH T,DRAKE C L.The nature of stable insomnia phenotypes[J].Sleep,2015,38(1):127-138.
[10] CRAWFORD M R,CHIRINOS D A,IURCOTTA T,et al.Characterization of patients who present with insomnia:Is there room for a symptom cluster-based approach[J].J Clin Sleep Med,2017,13(7):911-921.
[11] CARPI M,MARQUES D R,MILANESE A,et al.Sleep quality and insomnia severity among italian university students:A latent profile analysis[J].J Clin Med,2022,11(14):4069.
[12] 王孟成. 潜变量建模与Mplus应用-进阶篇[M].重庆:重庆大学出版社,2018:13-15.
[13] MANZAR M D,JAHRAMI H A,BAHAMMAM A S.Structural validity of the Insomnia Severity Index:A systematic review and meta-analysis[J].Sleep Med Rev,2021,60:101531.
[14] COSTANTINI L,PASQUARELLA C,ODONE A,et al.Screening for depression in primary care with Patient Health Questionnaire-9(PHQ-9):A systematic review[J].J Affect Disord,2021,279:473-483.
[15] 李亚杰,李咸志,李剑波,等.中文版压力知觉量表在代表性社区成人群体中的应用[J].中国心理卫生杂志,2021,35(1):67-72.
[16] TOUBASI A A,KHRAISAT B R,ABUANZEH R B,et al.A cross sectional study:The association between sleeping quality and stress among second and third medical students at the University of Jordan[J].Int J Psychiatry Med,2022,57(2):134-152.
[17] NSENGIMANA A,MUGABO E,NIYONSENGA J,et al.Sleep quality among undergraduate medical students in Rwanda:A comparative study[J].Sci Rep,2023,13(1):265.
[18] SIDDIQUI A F,AL-MUSA H,AL-AMRI H,et al.Sleep patterns and predictors of poor sleep quality among medical studentsin King Khalid University,Saudi Arabia[J].Malays J Med Sci,2016,23(6):94-102.
[19] CARDOSO G M D S,DA SILVA M P F N,CORRÊA C C,et al.Insomnia and excessive daytime sleepiness in medical students:Consequences of the use of technologies[J].Sleep Sci,2022,15(1):116-119.
[20] BRAUTSCH L A,LUND L,ANDERSEN M M,et al.Digital media use and sleep in late adolescence and young adulthood:A systematic review[J].Sleep Med Rev,2023,68:101742.
[21] 邓丽雅,李厚源,唐银霜,等.青少年睡眠时型与生活质量关联性的系统评价[J].中国循证医学杂志,2023,23(3):346-350.
[22] 林荣茂,沈逸琳,林楠,等.青少年睡眠质量的异质性:基于潜在剖面分析[J].中国临床心理学杂志,2023(2):442-446.
[23] 齐苗. 针灸治疗失眠症的临床效果研究[J].中国全科医学,2019,22(S1):185-187.
[24] ZHOU Y,BO S,RUAN S,et al.Deteriorated sleep quality and influencing factors among undergraduates in northern Guizhou,China[J].Peer J,2022,10:e13833.
[25] BELINGHERI M,PELLEGRINI A,FACCHETTI R,et al.Self-reported prevalence of sleep disorders among medical and nursing students[J].Occup Med(Lond),2020,70(2):127-130.
[26] MIRCHANDANEY R,BARETE R,ASARNOW L D.Moderators of cognitive behavioral treatment for insomnia on depression and anxiety outcomes[J].Curr Psychiatry Rep,2022,24(2):121-128.
[27] ZHANG D,QU Y,ZHAI S,et al.Association between healthy sleep patterns and depressive trajectories among college students:A prospective cohort study[J].BMC Psychiatry,2023,23(1):182.