西藏自治区藏族居民社会资本与睡眠障碍关系

付瑶; 次德吉; 尼玛曲措; 王勤俭; 余宛琪; 杨淑娟

doi:10.11847/zgggws1135906

西藏自治区藏族居民社会资本与睡眠障碍关系

doi: 10.11847/zgggws1135906

1.
四川大学华西公共卫生学院四川大学华西第四医院，四川成都 610041
2.
拉萨城关区疾病预防控制中心
3.
西藏自治区疾病预防控制中心

基金项目: 国家重点研发计划（2017YFC0907305）

详细信息

作者简介:
付瑶（1998 – ），女，辽宁沈阳人，硕士在读，研究方向：儿少卫生与妇幼保健

通讯作者:
杨淑娟，E-mail：rekiny@126.com

中图分类号: R 195.4
计量
- 文章访问数: 218
- HTML全文浏览量: 71
- PDF下载量: 24
- 被引次数: 0
出版历程
- 接收日期: 2021-06-17
- 网络出版日期: 2022-09-17
- 刊出日期: 2022-11-30

Association of social capital with sleep disorders among adult Tibetan residents in Tibet Autonomous Region, China

1.
Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China

摘要

摘要: 目的了解中国西藏自治区藏族居民社会资本对睡眠障碍的影响，为改善其睡眠质量提供依据。方法于2018年5月 — 2019年9月，采用多阶段分层整群抽样方法，抽取7 737名西藏藏族居民进行问卷调查，分析其睡眠障碍以及健康相关社会资本（家庭资本和社区/社会资本）情况，应用多因素logistic回归探究西藏藏族居民社会资本对其睡眠障碍的影响。结果西藏藏族居民睡眠障碍发生率为31.41 %（2 430/7 737），家庭社会资本和社区/社会资本得分均值分别为8.2和10.0分。在控制人口学特征及健康危险因素的情况下，家庭社会资本越多的西藏藏族居民睡眠障碍发生风险越低（OR = 0.97，95 % CI = 0.95～0.99）；社区/社会资本对睡眠障碍的影响无统计学意义（P > 0.05）。按年龄分层后， ≥ 50岁西藏藏族居民的家庭社会资本越多，睡眠障碍的发生风险越低（OR = 0.95，95 % CI = 0.92～0.99）；而 < 50岁西藏藏族居民中的家庭社会资本和社区/社会资本对睡眠障碍的影响均无统计学意义（P > 0.05）。结论西藏藏族居民的社会资本与睡眠障碍具有相关性，应增加其社会资本以改善睡眠质量。
- 社会资本 /
- 睡眠障碍 /
- 西藏
Abstract: Objective To explore the impact of social capital on sleep disorders among adult Tibetan residents in Tibet Autonomous Region (Tibet) and to provide evidences for improving sleep quality in the population. Methods Relevant data on 7 737 Tibetan community residents aged 18 – 79 years were extracted from the base line survey of The China Multi-Ethnic Cohort (CMEC) conducted in Tibet with stratified multistage cluster sampling and face-to-face questionnaire interviews from May 2018 to September 2019. Multivariate unconditional logistic regression was used to analyze the correlation of social capital with sleep disorders in the residents. Results Sleep disorders were reported by 31.41% (2430) of the residents surveyed. The residents′ mean score for family social capital and community/social capital were 8.2 and 10.0, respectively. After adjusting for demographic characteristics and health risk factors, the residents with higher family social capital were less likely to have sleep disorders (odds ratio [OR] = 0.97, 95% confidence interval [95% CI]: 0.95 – 0.99); no significant effect of community/social capital on sleep disorder was observed (P > 0.05). After stratified by age, the elder residents (≥ 50 years) with higher family social capital were less likely to have sleep disorders (OR = 0.95, 95% CI: 0.92 – 0.99); while, the impact of family social capital and community/social capital on sleep disorders was not significant for the residents under 50 years old (P > 0.05). Conclusion The social capital is related to the occurrence of sleep disorders among adult Tibetan residents in Tibet. The result should be concerned when developing interventions on sleep disorder in the population.
- social capital /
- sleep disorder /
- Tibet

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表 1 不同年龄对象睡眠障碍单因素分析

因素	< 50岁（n = 1 185人）				≥ 50岁（n = 1 245人）
因素	睡眠障碍人数	%	χ²值	P 值	睡眠障碍人数	%	χ²值	P 值
性别			34.7	0.0000			56.5	0.0000
男性	416	35.1			404	32.4
女性	769	64.9			841	67.6
户口			54.2	0.0000			43.1	0.0000
城镇	163	13.8			256	20.6
农村	1022	86.2			989	79.4
婚姻状况			1246.4	0.0000			15.7	0.0004
未婚	141	11.9			21	1.7
分居/离异，丧偶	41	3.5			161	12.9
已婚/同居	1003	84.6			1063	85.4
教育程度			0.6	0.4300			0.2	0.6240
小学及以下	831	70.1			1157	92.9
初中及以上	354	29.9			88	7.1
家庭年收入（元）			323.2	0.0000			79.6	0.0000
< 12 000	295	24.9			337	27.1
12 000～59 999	721	60.8			682	54.8
60 000～99 999	95	8.1			114	9.2
≥ 100 000	74	6.2			111	8.9
职业			3200.4	0.0000			790.2	0.0000
农林牧渔	94	7.9			126	10.1
在业	597	50.4			185	14.9
家务及其他	483	40.8			782	62.9
离退休	11	0.9			150	12.1
是否购买商业保险			9.6	0.0020			11.1	0.0009
否	1112	93.9			1180	94.9
是	72	6.1			63	5.1
吸烟状况			2832.3	0.0000			1145.0	0.0000
从不吸烟	902	76.1			1027	82.5
既往吸烟（已戒烟）	26	2.2			74	5.9
吸烟	257	21.7			144	11.6
饮酒状况			1880.9	0.0000			1496.8	0.0000
从不饮酒	1066	90.0			1130	90.8
偶尔饮酒	55	4.6			41	3.3
饮酒	64	5.4			74	5.9
体质指数（BMI）			1199.3	0.0000			487.3	0.0000
< 24	315	33.1			266	23.8
24～27.9	476	50.1			600	53.6
≥ 28	160	16.8			253	22.6
自报高血压			6.2	0.0129			0.9	0.3500
否	1060	89.5			836	67.1
是	125	10.5			409	32.9
自报糖尿病			0.6	0.4321			0.5	0.4699
否	1169	98.6			1197	96.1
是	16	1.4			48	3.9
抑郁症状阳性			23.6	0.0000			2.4	0.1202
否	1173	99.0			1235	99.2
是	12	1.0			10	0.8
焦虑症状阳性			29.2	0.0000			6.8	0.0091
否	1171	98.8			1234	99.1
是	14	1.2			11	0.9

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表 2 家庭社会资本和社区/社会资本为主要预测变量的2组模型中影响因素与睡眠障碍的关系

变量	参照	家庭社会资本作为主要预测变量				社区/社会资本作为主要预测变量
		< 50岁		≥ 50岁		< 50岁		≥ 50岁
		OR 值	95 % CI	OR 值	95 % CI	OR 值	95 % CI	OR 值	95 % CI
家庭社会资本		0.99	0.95～1.02	0.95	0.92～0.99 ^a
社区/社会资本						1.00	0.96～1.04	0.98	0.94～1.02
性别
女性	男性	0.46	0.36～0.59 ^b	0.73	0.56～0.96 ^b	0.46	0.36～0.59 ^b	0.73	0.56～0.96 ^b
户口
农村	城镇	1.48	1.19～1.84 ^b	1.56	1.28～1.90 ^a	1.48	1.19～1.84 ^b	1.56	1.28～1.90 ^a
婚姻状况
分居/离异，丧偶	未婚	1.19	0.72～1.97	3.09	1.65～5.78 ^b	1.20	0.72～1.98	2.98	1.60～5.57 ^b
已婚/同居		1.21	0.93～1.58	2.66	1.48～4.76 ^b	1.21	0.93～1.58	2.56	1.43～4.57 ^b
教育程度
小学	小学及以下	0.84	0.69～1.01	0.79	0.66～0.95 ^a	0.83	0.69～1.00	0.79	0.66～0.95 ^a
初中及以上		0.92	0.75～1.14	0.76	0.54～1.07	0.92	0.75～1.13	0.76	0.54～1.07
家庭年收入（元）
12000～59999	< 12000	0.74	0.61～0.90 ^b	0.82	0.68～1.00	0.74	0.61～0.90 ^b	0.82	0.68～0.99
60000～99999		0.84	0.61～1.15	0.90	0.65～1.24	0.83	0.61～1.14	0.90	0.65～1.24
≥ 100000		0.63	0.44～0.91 ^a	0.89	0.63～1.25	0.62	0.43～0.90 ^a	0.90	0.63～1.27
职业
在业	农林牧渔	1.10	0.83～1.48	1.02	0.74～1.41	1.11	0.83～1.48	1.03	0.74～1.42
家务及其他		1.35	1.01～1.80 ^b	0.92	0.70～1.20	1.35	1.01～1.80 ^a	0.92	0.71～1.20
离退休		2.18	0.75～6.32	1.49	0.98～2.27	2.19	0.75～6.34	1.50	0.99～2.29
是否购买商业医疗保险
是	否	1.68	1.19～2.38	1.72	1.13～2.61 ^a	1.66	1.18～2.35 ^b	1.70	1.12～2.58 ^a
吸烟状况
既往吸烟（已戒烟）	从不吸烟	0.87	0.53～1.42	0.97	0.69～1.36	0.87	0.53～1.43	0.98	0.70～1.38
吸烟		0.86	0.68～1.10	0.74	0.57～0.96 ^a	0.86	0.68～1.10 ^b	0.75	0.58～0.97 ^a
饮酒状况
偶尔饮酒	从不饮酒	1.80	1.20～2.70 ^b	1.07	0.67～1.72	1.79	1.19～2.69	1.08	0.67～1.73
饮酒		1.28	0.89～1.85	0.74	0.55～1.02	1.28	0.89～1.85	0.75	0.55～1.02
焦虑症状阳性
是	否	6.27	0.60～65.31	4.81	1.27～18.18 ^a	6.35	0.61～66.31	5.01	1.32～19.04 ^a
注：a P < 0.05，b P < 0.01。

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参考文献(53)

[1]	Sun XY, Zheng B, Lv J, et al. Sleep behavior and depression: findings from the China Kadoorie Biobank of 0.5 million Chinese adults[J]. Journal of Affective Disorders, 2018, 229: 120 – 124. doi: 10.1016/j.jad.2017.12.058
[2]	Wang DM, Li WZ, Cui XQ, et al. Sleep duration and risk of coronary heart disease: a systematic review and meta - analysis of prospective cohort studies[J]. International Journal of Cardiology, 2016, 219: 231 – 239. doi: 10.1016/j.ijcard.2016.06.027
[3]	Watling J, Pawlik B, Scott K, et al. Sleep loss and affective functioning: more than just mood[J]. Behavioral Sleep Medicine, 2017, 15(5): 394 – 409. doi: 10.1080/15402002.2016.1141770
[4]	McMullan CJ, Curhan GC, Forman JP. Association of short sleep duration and rapid decline in renal function[J]. Kidney International, 2016, 89(6): 1324 – 1330. doi: 10.1016/j.kint.2015.12.048
[5]	Hayley AC, Williams LJ, Venugopal K, et al. The relationships between insomnia, sleep apnoea and depression: findings from the American National Health and Nutrition Examination Survey, 2005 – 2008[J]. Australian and New Zealand Journal of Psychiatry, 2015, 49(2): 156 – 170. doi: 10.1177/0004867414546700
[6]	Grandner MA. Sleep, health, and society[J]. Sleep Medicine Clinics, 2017, 12(1): 1 – 22. doi: 10.1016/j.jsmc.2016.10.012
[7]	Vyncke V, Hardyns W, Peersman W, et al. How equal is the relationship between individual social capital and psychological distress? A gendered analysis using cross - sectional data from Ghent (Belgium)[J]. BMC Public Health, 2014, 14: 960. doi: 10.1186/1471-2458-14-960
[8]	Guglielmi O, Lanteri P, Garbarino S. Association between socioeconomic status, belonging to an ethnic minority and obstructive sleep apnea: a systematic review of the literature[J]. Sleep Medicine, 2019, 57: 100 – 106. doi: 10.1016/j.sleep.2019.01.042
[9]	Poscia A, Stojanovic J, La Milia DI, et al. Interventions target-ing loneliness and social isolation among the older people: an update systematic review[J]. Experimental Gerontology, 2018, 102: 133 – 144. doi: 10.1016/j.exger.2017.11.017
[10]	Nicholson Jr NR, Shellman J. Decreasing social isolation in older adults: effects of an empowerment intervention offered through the CARELINK program[J]. Research in Gerontological Nursing, 2013, 6(2): 89 – 97. doi: 10.3928/19404921-20130110-01
[11]	Garbarino S, Lanteri P, Durando P, et al. Co - morbidity, mortality, quality of life and the healthcare/welfare/social costs of disordered sleep: a rapid review[J]. International Journal of Environmental Research and Public Health, 2016, 13(8): 831. doi: 10.3390/ijerph13080831
[12]	Chirico F, Heponiemi T, Pavlova M, et al. Psychosocial risk prevention in a global occupational health perspective. A descrip-tive analysis[J]. International Journal of Environmental Research and Public Health, 2019, 16(14): 2470. doi: 10.3390/ijerph16142470
[13]	中商情报网. 2019年全国31省GDP数据出炉: 西藏GDP增速排名全国第一[EB/OL]. (2020 – 01 – 23) [2021 – 06 – 07]. https://baijiahao.baidu.com/s?id=1656502640941147933&wfr=spider&for=pc&isFailFlag=1.
[14]	趣财经. 2020年中国各省人均预期寿命一览表[EB/OL]. (2019 – 02 – 20). https://m.qcaijing.com/industry/20190220/3200.html.
[15]	人民网. 西藏人均预期寿命70.6岁[EB/OL]. (2019 – 05 – 24). http://health.people.com.cn/GB/n1/2019/0524/c14739-31101199.html.
[16]	Chen YS, Williams M. Subjective well - being in the new China: religion, social capital, and social status[J]. The British Journal of Sociology, 2016, 67(4): 719 – 746. doi: 10.1111/1468-4446.12232
[17]	班班多杰. 也谈藏传佛教与藏族文化的关系[J]. 青海民族学院学报(社会科学版), 2004, 30(4): 52 – 56.
[18]	Ciren W, Yu WQ, Nima Q, et al. Social capital and sleep disorders in Tibet, China[J]. BMC Public Health, 2021, 21(1): 591. doi: 10.1186/s12889-021-10626-x
[19]	Zhao X, Hong F, Yin JZ, et al. Cohort profile: the China multi-ethnic cohort (CMEC) study[J]. International Journal of Epidemi-ology, 2021, 50(3): 721. doi: 10.1093/ije/dyaa185
[20]	张明园, 何燕玲. 精神科评定量表手册[M]. 长沙: 湖南科技出版社, 2015: 142 – 202.
[21]	Han JY, Jia P, Huang YL, et al. Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV - Infected Cohort Study (SOHICS)[J]. BMC Public Health, 2020, 20(1): 581. doi: 10.1186/s12889-020-08705-6
[22]	Yang SF, Gao B, Gu J, et al. Relationship between social capital and heroin use behaviors among patients in methadone main-tenance treatment in Sichuan Province, China: a cross - sectional study[J]. Medicine, 2020, 99(24): e19963. doi: 10.1097/MD.0000000000019963
[23]	Koyanagi A, Garin N, Olaya B, et al. Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi - country study[J]. PLoS One, 2014, 9(12): e114742. doi: 10.1371/journal.pone.0114742
[24]	张清华, 蒋知新, 孙宇, 等. 北京市城区18997名中老年男性睡眠状况及其影响因素调查[J]. 中国临床康复, 2005, 9(31): 1 – 3.
[25]	Haseli-Mashhadi N, Dadd T, Pan A, et al. Sleep quality in middle - aged and elderly Chinese: distribution, associated factors and associations with cardio - metabolic risk factors[J]. BMC Public Health, 2009, 9: 130. doi: 10.1186/1471-2458-9-130
[26]	李鹏姬, 高晓雷, 马海林. 西藏孤寡老人睡眠质量及其与心理健康关系[J]. 中国公共卫生, 2021, 37(1): 36 – 39. doi: 10.11847/zgggws1124929
[27]	姚雪梅, 成伟兵, 肖辉. 846例50岁以上中老年人睡眠质量及影响因素分析[J]. 新疆医科大学学报, 2018, 41(7): 889 – 892. doi: 10.3969/j.issn.1009-5551.2018.07.021
[28]	廖佩花, 关玉梅, 刘来新, 等. 新疆5个慢性病监测点50岁以上人群健康问题调查分析[J]. 疾病预防控制通报, 2013, 28(4): 8 – 9, 23.
[29]	郝丽娟, 任雨青, 杨雅迪, 等. 青海地区不同海拔高度人群睡眠情况调查分析[J]. 高原医学杂志, 2011, 21(3): 51 – 54. doi: 10.3969/j.issn.1007-3809.2011.03.023
[30]	Ma GY, Cai L, Fan LM, et al. Association of socioeconomic factors and prevalence of hypertension with sleep disorder among the elderly in rural southwest China[J]. Sleep Medicine, 2020, 71: 106 – 110. doi: 10.1016/j.sleep.2020.03.006
[31]	Mingji C, Onakpoya IJ, Perera R, et al. Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review[J]. Heart, 2015, 101(13): 1054 – 1060. doi: 10.1136/heartjnl-2014-307158
[32]	Burtscher M. Effects of living at higher altitudes on mortality: a narrative review[J]. Aging and Disease, 2014, 5(4): 274 – 280.
[33]	Driver HS, Taylor SR. Exercise and sleep[J]. Sleep Medicine Reviews, 2000, 4(4): 387 – 402. doi: 10.1053/smrv.2000.0110
[34]	Antillón M, Lauderdale DS, Mullahy J. Sleep behavior and unemployment conditions[J]. Economics and Human Biology, 2014, 14: 22 – 32. doi: 10.1016/j.ehb.2014.03.003
[35]	Wu WW, Wang WR, Dong ZZ, et al. Sleep quality and its associated factors among low-income adults in a rural area of China: a population - based study[J]. International Journal of Environ-mental Research and Public Health, 2018, 15(9): 2055. doi: 10.3390/ijerph15092055
[36]	Xiao H, Zhang Y, Kong DS, et al. Social capital and sleep quality in individuals who self - isolated for 14 days during the coronavirus disease 2019 (COVID - 19) outbreak in January 2020 in China[J]. Medical Science Monitor, 2020, 26: e923921.
[37]	Win T, Yamazaki T, Kanda K, et al. Neighborhood social capital and sleep duration: a population based cross - sectional study in a rural Japanese town[J]. BMC Public Health, 2018, 18: 343. doi: 10.1186/s12889-018-5204-4
[38]	Robbins R, Jean-Louis G, Gallagher RA, et al. Examining social capital in relation to sleep duration, insomnia, and daytime sleepiness[J]. Sleep Medicine, 2019, 60: 165 – 172. doi: 10.1016/j.sleep.2019.03.019
[39]	Chen ZH, Salam MT, Toledo-Corral C, et al. Ambient air pollutants have adverse effects on insulin and glucose homeostasis in Mexican Americans[J]. Diabetes Care, 2016, 39(4): 547 – 554. doi: 10.2337/dc15-1795
[40]	Lu T, Wu N, Luo P. Sedentarization of Tibetan nomads[J]. Conser-vation Biology, 2009, 23(5): 1074. doi: 10.1111/j.1523-1739.2009.01312.x
[41]	罗意. “游牧 — 定居”连续统: 一种游牧社会变迁的人类学研究范式[J]. 青海民族研究, 2014, 25(1): 37 – 41. doi: 10.3969/j.issn.1005-5681.2014.01.006
[42]	Hu CY, Gao X, Fang Y, et al. Human epidemiological evidence about the association between air pollution exposure and gestational diabetes mellitus: systematic review and meta - analysis[J]. Environmental Research, 2020, 180: 108843. doi: 10.1016/j.envres.2019.108843
[43]	Khazaeian S, Kariman N, Ebadi A, et al. The impact of social capital and social support on the health of female - headed households: a systematic review[J]. Electronic Physician, 2017, 9(12): 6027 – 6034. doi: 10.19082/6027
[44]	闫平. 西藏日喀则城市老年人社会支持研究[D]. 北京: 中央民族大学, 2010.
[45]	Blackman MR. Age - related alterations in sleep quality and neuroendocrine function: interrelationships and implications[J]. JAMA, 2000, 284(7): 879 – 881. doi: 10.1001/jama.284.7.879
[46]	Nyqvist F, Forsman AK, Giuntoli G, et al. Social capital as a resource for mental well - being in older people: a systematic review[J]. Aging and Mental Health, 2013, 17(4): 394 – 410. doi: 10.1080/13607863.2012.742490
[47]	Crowley K. Sleep and sleep disorders in older adults[J]. Neuropsy-chology Review, 2011, 21(1): 41 – 53. doi: 10.1007/s11065-010-9154-6
[48]	方乐琴, 许晓珩, 林晓敏, 等. 手机依赖性使用与睡眠和饮食行为相关: 基于2 122名大学生问卷调查[J]. 南方医科大学学报, 2019, 39(12): 1500 – 1505.
[49]	Han KS, Kim L, Shim I. Stress and sleep disorder[J]. Experimental Neurobiology, 2012, 21(4): 141 – 150. doi: 10.5607/en.2012.21.4.141
[50]	Jia P. Spatial lifecourse epidemiology[J]. The Lancet Planetary Health, 2019, 3(2): e57 – e59. doi: 10.1016/S2542-5196(18)30245-6
[51]	Jia P, Lakerveld J, Wu JG, et al. Top 10 research priorities in spatial lifecourse epidemiology[J]. Environmental Health Perspec-tives, 2019, 127(7): 074501. doi: 10.1289/EHP4868
[52]	Jia P, Yu C, Remais JV, et al. Spatial lifecourse epidemiology reporting standards (ISLE - ReSt) statement[J]. Health and Place, 2020, 61: 102243. doi: 10.1016/j.healthplace.2019.102243
[53]	Jia P, Stein A. Using remote sensing technology to measure environmental determinants of non - communicable diseases[J]. International Journal of Epidemiology, 2017, 46(4): 1343 – 1344. doi: 10.1093/ije/dyw365