中国老年人睡眠时长与衰弱程度的关联研究

叶梓怡; 杜雨珊; 朱小涵; 何杏; 郭超

doi:10.16462/j.cnki.zhjbkz.2025.08.006

中国老年人睡眠时长与衰弱程度的关联研究

doi: 10.16462/j.cnki.zhjbkz.2025.08.006

北京大学人口研究所，北京 100871

基金项目: 国家高层次青年人才支持计划项目

详细信息

通讯作者:
GUO Chao, 郭超，E-mail: chaoguo@pku.edu.cn

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-18
- 修回日期: 2025-05-22
- 刊出日期: 2025-08-10

Association sleep duration and different levels of frailty in Chinese older adults

Institute of Population Research, Peking University, Beijing 100871, China

Funds: Top Young Talent Project of the National Special Support Program

摘要

摘要: 目的探究老年人睡眠时长与不同衰弱程度的关联。方法采用病例对照研究设计，基于2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据，采用多分类logistic回归分析模型分析不同睡眠时长的暴露与中国老年人衰弱程度的关联。结果纳入的8 555名老年人中，衰弱前和衰弱的现患率分别为34.21%和27.64%。调整控制变量后，多分类logistic回归分析模型结果显示，夜间睡眠＞4~＜5 h与老年人衰弱前及衰弱均相关(均P＜0.05)。夜间睡眠≥9 h与衰弱相关(OR=1.80, 95% CI: 1.39~2.34)，但与衰弱前无统计学意义。此外，与午间睡眠1~＜1.5 h的老年人相比，午间睡眠≥2.5 h与老年人衰弱前相关(OR=1.63, 95% CI: 1.16~2.29)。与总睡眠时长7~＜8 h的老年人相比，总睡眠时长＞5~＜6 h与老年人衰弱前和衰弱均相关(均P＜0.05)，且总睡眠时长≥10 h与老年人衰弱相关(OR=1.64, 95% CI: 1.28~2.10)。结论睡眠时长过长或过短均与老年人整个衰弱程度相关。应向老年人普及科学的夜间睡眠和午间睡眠时长，以预防衰弱前和衰弱的发生。
- 夜间睡眠 /
- 午间睡眠 /
- 衰弱前 /
- 衰弱 /
- 老年人
Abstract: Objective To investigate the association between sleep duration and different levels of frailty among older adults. Methods A case control study design was employed, utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multinomial logistic regression models were applied to examine the association between sleep duration and frailty progression among Chinese older adults. Results Among the 8 555 older adults included in the analysis, the prevalence rates of pre-frailty and frailty were 34.21% and 27.64%, respectively. After adjusting control variables, the results of the multinomial logistic regression analysis showed that a nighttime sleep duration of > 4- < 5 hours was significantly associated with both pre-frailty and frailty (all P < 0.05). A nighttime sleep duration of more than 9 hours was significantly associated with frailty (OR=1.80, 95% CI: 1.39-2.34), but showed no statistically significant association with pre-frailty. In addition, compared with a nap duration of 1- < 1.5 hours, a nap duration of more than 2.5 hours was significantly associated with pre-frailty (OR=1.63, 95% CI: 1.16-2.29). Compared with a total sleep duration of 7- < 8 hours, a total sleep duration of > 5- < 6 hours was significantly associated with both pre-frailty and frailty (all P < 0.05), and a total sleep duration of ≥10 hours was associated with frailty (OR=1.64, 95% CI: 1.28-2.10). Conclusions Both too long and too short sleep duration are associated with different levels of frailty in the elderly. Promoting scientifically appropriate nighttime and nap durations among older adults may help prevent the onset of pre-frailty and frailty.
- Nighttime sleep /
- Sleep at noon /
- Pre-frailty /
- Frailty /
- Old adults

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图 1 研究对象筛选流程

Figure 1. Research object selection process

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表 1 老年人睡眠时长与不同衰弱程度关联的单因素分析

Table 1. Univariate analysis of the association between sleep duration and different frailty levels among the elderly

变量 Variable	总样本 Total^① (n=8 555)	衰弱程度Frailty levels^①			χ²值 value	P值 value
变量 Variable	总样本 Total^① (n=8 555)	非衰弱 Non-frailty (n=3 263)	衰弱前 Pre-frailty (n=2 927)	衰弱 Frailty (n=2 365)	χ²值 value	P值 value
年龄组/岁Age group/ years					410.124	< 0.001
60~＜70	5 094(59.54)	2 262(69.32)	1 755(59.96)	1 077(45.54)
70~＜80	2 564(29.97)	811(24.86)	906(30.95)	847(35.81)
80~95	897(10.49)	190(5.82)	266(9.09)	441(18.65)
性别Gender					228.761	< 0.001
男Male	3 927(45.90)	1 811(55.50)	1 274(43.53)	842(35.60)
女Female	4 628(54.10)	1 452(44.50)	1 653(56.47)	1 523(64.40)
受教育程度Education level					401.326	< 0.001
文盲Illiteracy	2 775(32.44)	774(23.72)	934(31.91)	1 067(45.12)
小学Elementary school	3 793(44.34)	1 457(44.65)	1 354(46.26)	982(41.52)
初中及以上Middle school or above	1 987(23.22)	1 032(31.63)	639(21.83)	316(13.36)
城乡类别Residence					96.568	< 0.001
城镇Urban	1 530(17.88)	737(22.59)	496(16.95)	297(12.56)
农村Rural	7 025(82.12)	2 526(77.41)	2 431(83.05)	2 068(87.44)
婚姻状况Martial status					162.823	< 0.001
已婚Married	6 689(78.19)	2 742(84.03)	2 296(78.44)	1 651(69.81)
其他Others	1 866(21.81)	521(15.97)	631(21.56)	714(30.19)
与子女同住Living with child					9.241	0.010
否No	5 389(62.99)	2 014(61.72)	1 908(65.19)	1 467(62.03)
是Yes	3 166(37.01)	1 249(38.28)	1 019(34.81)	898(37.97)
吸烟或饮酒Smoking or drinking					1.231	0.541
否No	2 316(27.07)	870(26.66)	814(27.81)	632(26.72)
是Yes	6 239(72.93)	2 393(73.34)	2 113(72.19)	1 733(73.28)
锻炼Exercise					558.612	< 0.001
否No	1 179(13.78)	220(6.74)	301(10.28)	658(27.82)
是Yes	7 376(86.22)	3 043(93.26)	2 626(89.72)	1 707(72.18)
跌倒Fall					447.352	< 0.001
否No	6 529(76.32)	2 816(86.30)	2 246(76.73)	1 467(62.03)
是Yes	2 026(23.68)	447(13.70)	681(23.27)	898(37.97)
身体疼痛Pain in body					879.644	< 0.001
否No	2 917(34.10)	1 732(53.08)	755(25.79)	430(18.18)
是Yes	5 638(65.90)	1 531(46.92)	2 172(74.21)	1 935(81.82)
夜间睡眠Nighttime sleep /h					528.627	< 0.001
≤4	1 949(22.78)	418(12.81)	685(23.40)	846(35.77)
＞4~＜5	1 257(14.69)	448(13.73)	453(15.48)	356(15.05)
5~＜6	1 658(19.38)	733(22.46)	580(19.82)	345(14.59)
6~＜7	1 270(14.85)	639(19.58)	415(14.18)	216(9.13)
7~＜8	1 454(17.00)	667(20.44)	485(16.57)	302(12.77)
8~＜9	48(0.56)	22(0.67)	19(0.65)	7(0.30)
≥9	919(10.74)	336(10.31)	290(9.90)	293(12.39)
午间睡眠Midday sleep /h					30.588	0.002
0	3 150(36.82)	1 179(36.13)	1 095(37.41)	876(37.04)
＞0~＜0.5	1 450(16.95)	562(17.22)	471(16.09)	417(17.63)
0.5~＜1	127(1.48)	61(1.87)	42(1.43)	24(1.01)
1~＜1.5	2 043(23.88)	817(25.04)	690(23.57)	536(22.66)
1.5~＜2	393(4.59)	145(4.44)	149(5.09)	99(4.19)
2~＜2.5	1 127(13.17)	427(13.09)	380(12.98)	320(13.53)
≥2.5	265(3.11)	72(2.21)	100(3.43)	93(3.94)
总睡眠时长Total sleep duration /h					403.024	< 0.001
≤5	2 309(26.99)	571(17.50)	814(27.81)	924(39.07)
＞5~＜6	1 276(14.92)	501(15.35)	449(15.34)	326(13.78)
6~＜7	1 365(15.96)	606(18.57)	476(16.26)	283(11.97)
7~＜8	1 361(15.91)	668(20.47)	438(14.96)	255(10.78)
8~＜9	1 017(11.89)	448(13.73)	362(12.37)	207(8.75)
9~＜10	184(2.15)	83(2.54)	59(2.02)	42(1.78)
≥10	1 043(12.18)	386(11.84)	329(11.24)	328(13.87)
注：①以人数(占比/%)表示。 Note: ① Number of people (proportion/%).

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表 2 老年人睡眠时长与不同衰弱程度关联的多分类logistic回归分析

Table 2. Multinomial logistic regression analysis of the association between sleep duration and different frailty levels in the elderly

变量Variable	衰弱前Pre-frailty		衰弱Frailty
变量Variable	aOR值value(95% CI)^①	P值value	aOR值value(95% CI)^①	P值value
夜间睡眠Nighttime sleep /h
≤4	1.91(1.59~2.29)	< 0.001	3.82(3.05~4.78)	< 0.001
＞4~＜5	1.32(1.09~1.59)	0.005	1.91(1.50~2.44)	< 0.001
5~＜6	1.16(0.97~1.38)	0.104	1.30(1.03~1.65)	0.027
6~＜7	1.00		1.00
7~＜8	1.07(0.90~1.29)	0.434	1.29(1.01~1.64)	0.038
8~＜9	1.39(0.72~2.69)	0.323	0.98(0.35~2.71)	0.966
≥9	1.10(0.89~1.37)	0.363	1.80(1.39~2.34)	< 0.001
午间睡眠Midday sleep /h
0	1.01(0.88~1.16)	0.924	0.94(0.80~1.12)	0.505
＞0~＜0.5	0.97(0.82~1.15)	0.717	1.14(0.93~1.40)	0.204
0.5~＜1	0.84(0.55~1.29)	0.428	0.75(0.42~1.32)	0.312
1~＜1.5	1.00		1.00
1.5~＜2	1.32(1.01~1.73)	0.039	1.19(0.85~1.68)	0.306
2~＜2.5	1.01(0.84~1.22)	0.876	1.04(0.83~1.30)	0.727
≥2.5	1.63(1.16~2.29)	0.005	1.44(0.96 ~2.14)	0.076
总睡眠时长Total sleep duration /h
≤5	1.69(1.42~2.00)	< 0.001	2.74(2.22~3.38)	< 0.001
＞5~＜6	1.26(1.05~1.52)	0.015	1.46(1.15~1.85)	0.002
6~＜7	1.20(1.00~1.44)	0.049	1.15(0.91~1.46)	0.248
7~＜8	1.00		1.00
8~＜9	1.18(0.97~1.43)	0.105	1.09(0.84~1.42)	0.502
9~＜10	1.10(0.75~1.61)	0.612	1.14(0.71~1.84)	0.591
≥10	1.15(0.94~1.42)	0.167	1.64(1.28~2.10)	< 0.001
注：①在模型中，aOR值为调整了年龄、性别、受教育程度、婚姻状况、城乡类别、与子女同住、锻炼、跌倒、身体疼痛变量后的比值比。 Note: ① In the model, the aOR value is the ratio after adjusting for variables such as age, gender, education level, marital status, residence, living with children, exercise, falls, and physical pain.

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