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2019新型冠状病毒病(COVID-19)的爆发与传播,对我国居民的生命与健康造成了威胁.此次疫情是继2003年“非典”以来又一次突发性公共卫生事件.在以往的研究中,人们关注的重心多为医护人员在疫情期间睡眠的状况[1-2].此次疫情一方面构成重大情绪应激事件,增加了普通民众的抑郁、焦虑等情绪;另一方面,由于长期“禁足”在家,社会授时因子减弱,这些都大大增加了失眠的风险.本研究重点关注疫情期间普通居民的睡眠规律与身心健康.
我们选取了2020年2月17-2月27日作为调查窗口期.该时期全国确诊病例在70 548~78 497之间,疫情正处于平缓增长期.赵楠等[3]在疫情高峰期时表示,随着疫情的缓解,持续应激带来的心理健康问题在一定时期内可能越来越多地涌现出来,需要对后续长期心理援助与服务工作有所预案、逐步开展.武汉封城一个多月以来,由于各级政府防控人员和医务人员感染及呈现出的高强度工作状态,致使普通民众对新冠疫情经历了恐慌期和调整期.各地采取的封闭隔离、延迟开学等措施,以及不实消息的传播等因素导致恐惧、焦虑、抑郁和心理应激现象迅速增多[4]. Holmes等[5]将“改变个人当下持有的生活模式以适应生活环境变化的某个事件”定义为“生活事件”.新冠疫情完全符合上述特征,构成了一次重大的负性生活事件.
中国在本次疫情中采取了果断措施,限制出行,全民居家隔离.该过程正值春节假期,多数居民处于休假状态.大多数人本来就进入了晚睡晚起的度假模式,而居家隔离则进一步减弱了社会授时因子.前人研究发现,自然光暴露可以提高主观睡眠评价[6],而工作环境及相关的社会授时因子可提高人们的警觉度、认知表现和睡眠质量[7].黄庆玲等[8]研究发现,应激相关失眠易感性越高的人,更容易出现夜间觉醒等情况;常向东等[9]针对大学生群体的研究发现,睡眠质量与生活事件存在显著的正相关关系,说明个体经历的负性生活事件越多,其睡眠质量越差,即生活事件是影响大学生睡眠质量的重要因素之一.疫情这一负性生活事件势必会与居家隔离相叠加,严重影响到人们的睡眠健康.
如何针对居民个体特点进行有效的睡眠质量提升导引和睡眠障碍个性干预,是本研究的另一个目的.有研究发现,大五人格中的高神经质是睡眠不良(睡眠卫生差、睡眠质量差、嗜睡增加)的最佳预测因子[10].大五人格特质是作为稳定的心理特质对5-羟色胺起作用,以此参与调节睡眠节律[11].而疫情期间生活方式维度的变化则是非稳定的、非持久的[12].本研究要探讨这些非特质性变量在大五神经质对睡眠质量下降的直接关系中起着何种作用,从而为更有效的应对策略提供直接支持.
本研究通过问卷星平台,在全国发放问卷共1 122份. ①通过全体居民的疫情关注、情绪、饮食与睡眠等维度对生活方式进行描述性统计分析,以揭示疫情期间居民的日常作息规律. ②结合失眠的易感指标,特别对睡眠质量下降的原因进行了分析. ③发现了人格特质中的神经质和疫情期睡眠质量高度相关.进一步通过中介分析,获得了干预睡眠质量的核心变量.最后,本研究提出了一系列针对性的睡眠改善建议.
Sleep Patterns and Physical and Mental Health of Residents During the COVID-19: Susceptibility Factors and Coping Strategies
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摘要: 新型冠状病毒病疫情发生后,我国迅速采取了“禁足”在家的隔离措施,这对居民日常生活和作息产生了多方面的影响.为全面了解疫情对居民日常起居、睡眠和生活习惯的影响程度,该研究于2020年2月17-2月27日,即疫情的平缓增长期对全国发放问卷共1 122份,旨在通过全体居民的疫情关注、情绪、饮食与睡眠等维度对生活方式进行描述性统计分析,揭示疫情期间居民的日常作息规律.结合失眠易感指标,我们特别对睡眠质量下降的原因进行了分析.分析结果显示:疫情发生后,居民普遍存在晚睡晚起的现象,平均滞后近1 h,平均多睡近0.5 h,但睡眠质量反而有下降.睡眠障碍明显,50%以上的居民存在入睡困难、维持困难或主观睡眠质量下降.人格特质中的神经质和疫情期睡眠质量高度相关.进一步中介分析发现,负性情绪、网络疫情关注在神经质和睡眠质量的关系中存在显著的中介作用.基于以上结果,提出减少对疫情相关新闻的关注,进行规律性体育锻炼和按时用餐,合理控制情绪等有助于改善睡眠的建议.Abstract: After the outbreak of the COVID-19, China quickly adopted measures for isolation at home, which has affected the residents of the country in many ways. In order to comprehensively understand the changes in residents' daily living, sleep and living habits caused by the epidemic, a study was conducted in which we distributed 1128 questionnaires in the period of gentle growth of the epidemic from February 17 to 27, 2020. A descriptive statistical analysis of the dimensions of attention, mood, diet and sleep of all residents was made to reveal their daily routine during the epidemic and, combined with the susceptibility indicators of insomnia, we specifically analyzed the reasons for the decline in sleep quality. The results showed that during the epidemic, residents generally slept later and woke up later, their sleep period delayed nearly one hour and slept half an hour more on the average, but their sleep quality generally deteriorated. The residents showed obvious sleep disturbance, and more than 50% of them had difficulty in falling asleep and maintaining sleep or sleep quality decline. Neuroticism in personality traits ware shown to be in highly significantly correlation with sleep quality during the epidemic. Further mediation analysis found that negative emotions and cyber epidemic concerns had significant mediating effects in the relationship between neuroticism and sleep quality. Based on the above results, this study offers suggestions to reduce the attention to news related to the epidemic, do regular physical exercise and take meals on time, and reasonably control emotions to improve sleep.
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Key words:
- COVID-19 epidemic /
- life style /
- sleep pattern /
- regular work and rest .
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表 1 食物获取困难度与出入小区次数的相关性和情绪性进食与睡眠情况的相关性
能买到想吃的食物 食物获得的困难程度 出入小区次数 生活满意度 能买到想吃的食物 1 食物获得的困难程度 -0.525*** 1 出入小区次数 -0.119*** 0.131*** 1 生活满意度 -0.257*** 0.226*** 0.052 1 情绪不好渴望吃东西 情绪很好渴望吃东西 做和疫情相关噩梦 睡眠问题影响日间功能 对睡眠问题的担忧程度 情绪不好时,你渴望吃东西 1 情绪很好时,你渴望吃东西 0.707*** 1 做和疫情相关噩梦 0.120*** 0.113*** 1 睡眠问题影响日间功能 0.127*** 0.117*** 0.215*** 1 对睡眠问题的担忧 0.161*** 0.137*** 0.247*** 0.638*** 1 注:***表示p=0.001级别(双尾)具有统计学意义. 表 2 睡眠质量下降人群疫情期前后睡眠指标变化
指标 疫情前 疫情后 改变情况 t p 入睡时间 23:44 00:11 延后27 min -7.752 < 0.001 入睡潜伏期 22 min 46 min 延后10 min -8.573 < 0.001 起床时间 8:30 9:55 延后85 min -11.379 < 0.001 午睡时长 49 min 69 min 多睡20 min -4.382 < 0.001 睡眠效率 0.95 0.91 降低0.04 7.666 < 0.001 睡眠总时长 581 min 604 min 多睡23 min -2.189 0.029 睡眠中点 4:04 5:26 延后55 min -13.734 < 0.001 -
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