Emergence of Sex Differences in Insomnia Symptoms in Adolescents: A Large-Scale School-Based Study
Emergence of Sex Differences in Insomnia Symptoms in Adolescents: A Large-Scale School-Based Study
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DOI：
10.5665/sleep.6022
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发表时间：
2016-08-01
期刊：
影响因子：
5.6
通讯作者：
Wing, Yun-Kwok
中科院分区：
文献类型：
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作者：
Zhang, Jihui;Chan, Ngan Yin;Wing, Yun-Kwok
研究目的：本研究旨在探讨青春期状态对失眠症状发生率的性别差异的调节及其与健康的相关性。方法：共招募了来自 31 所中小学的 7,507 名 6-17 岁儿童和青少年（女性加权百分比：48.5%）。过去一个月每周出现入睡困难 (DIS)、维持睡眠困难 (DMS) 和/或早醒 (EMA) ≥ 3 次的参与者被视为有失眠症状。失眠的严重程度通过失眠严重指数（ISI）来衡量。结果：从 Tanner 1 期到 5 期，女孩失眠症状的患病率从 3.4% 增加到 12.2%（3.6 倍），男孩从 4.3% 增加到 9.1%（2.1 倍）。在失眠患病率方面，性别和 Tanner 分期之间存在显着的交互作用（P < 0.001）。即使在控制了年龄、家庭收入和上学时间之后，坦纳第四阶段仍出现了女性优势。在 DIS、DMS 和 ISI 总分中发现了类似的性别-Tanner 阶段交互作用，但在 EMA 中没有发现。无论男女，失眠症状都与行为问题、心理健康状况不佳和总体健康状况不佳密切相关。患有失眠的男孩会报告更多不适应的生活方式（吸烟、饮酒和能量饮料），而患有失眠的女孩更容易出现情绪和人际关系困难。结论：青春期成熟与失眠症状患病率逐渐增加有关，青春期后期失眠症状的患病率和严重程度均以女性为主。
Study Objectives: This study aimed to explore the moderation of pubertal status on the onset of sex differences in the prevalence of insomnia symptoms and their health correlates.Methods: A total of 7,507 children and adolescents (weighted percentage of female: 48.5%) aged between 6-17 y were recruited from thirty-one primary and secondary schools. Participants with difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and/or early morning awakening (EMA) >= 3 times/week in the past month were considered as having insomnia symptoms. The severity of insomnia was measured by the Insomnia Severity Index (ISI).Results: The prevalence of insomnia symptoms increased from 3.4% to 12.2% in girls (3.6-fold) and from 4.3% to 9.1% in boys (2.1-fold) from Tanner stage 1 to 5. There was a significant interaction between sex and Tanner stage in the prevalence of insomnia (P < 0.001) with an emergence of female preponderance at Tanner stage 4 even after controlling for age, family income, and school start time. Similar sex-Tanner stage interactions were found in DIS, DMS, and ISI total score but not EMA. Insomnia symptoms were strongly associated with behavioral problems, poor mental health, and poor general health in both sexes. Boys with insomnia would report more maladaptive lifestyles (smoking, alcohol, and energy drinks) whereas girls with insomnia were more susceptible to emotional and relationship difficulties.Conclusions: Pubertal maturation was associated with a progressive increase in the prevalence of insomnia symptoms with the emergence of female preponderance in both the prevalence and severity of insomnia symptoms at late puberty.