Abstract: Objective To analyze the correlations of sleep timing and sleep patterns with the risk of allergic rhinitis in Chinese adolescents, in order to provide scientific reference for understanding the health effect of sleep. Methods A stratified cluster sampling method was used to perform a cross-sectional survey among 4 932 middle school students in six administrative districts of Shanghai in 2009. The Modified Version of the Adolescent Sleep Hygiene Scale (M-ASHS) was applied to evaluate sleep-related indicators. Adolescent Behavior and Health Questionnaire was used to evaluate allergic diseases, basic personal information and environmental exposure. Logistic multivariate regression was adopted to analyze the correlations of sleep timing, sleep patterns with allergic rhinitis in adolescents. Results The overall prevalence rate of allergic rhinitis was 17.5%, of which 19.2% for males and 15.8% for females (P=0.002). After controlling for basic social-demographic characteristics, maternal variables and chronic health-behavioral problems, Logistic regression analysis showed that bedtime and sleep patterns were associated with the risk of allergic rhinitis. The risk of allergic rhinitis was increased by 30% (OR= 1.30, 95%CI: 1.06 - 1.60, P=0.013) and 28% (OR=1.28, 95%CI: 1.07 - 1.78, P=0.014) with late bedtime and late bed/late wake-up sleep pattern, respectively. After further adjustment for nocturnal sleep duration, the above effects remained significant (OR=1.40,95%CI: 1.12 - 1.75, P=0.003; OR=1.44, 95%CI: 1.11 - 1.86, P=0.006), respectively. Conclusion Late bedtime and late bed/late wake-up sleep pattern are associated with a higher risk of allergic rhinitis in adolescents, suggesting that sleep management is of great significance in the prevention and treatment of allergic diseases.

Key words: adolescents, sleep duration, sleep patterns, allergic rhinitis

摘要： 目的 分析青少年就寝时间、晨起时间及睡眠节律模式与过敏性鼻炎的相关性,为深入理解睡眠的健康效应及预防和干预过敏性疾病提供理论依据。方法 于2009年使用分层整群抽样方法对上海6个行政区4 932名在校中学生进行流行病学现况调查,采用《青少年睡眠卫生评估量表修订版》(M-ASHS) 进行睡眠评估,采用青少年行为与健康问卷对过敏性疾病、个人基本信息、环境暴露等信息进行评估。使用多因素Logistic回归模型分析就寝时间、晨起时间、睡眠节律模式与过敏性鼻炎的相关性。结果 青少年过敏性鼻炎总体患病率为17.5%,其中男性为19.2%,女性为15.8%(χ²=9.473,P=0.002)。控制社会人口学基本特征,母亲孕产情况及儿童慢性健康-行为问题后,Logistic回归分析显示就寝时间和睡眠节律模式与过敏性鼻炎的发病风险存在相关性,就寝时间晚和晚睡晚起型睡眠节律模式可分别使过敏性鼻炎的发生风险提高30%(OR= 1.30, 95% CI: 1.06~1.60, P=0.013)和28%(OR=1.28, 95% CI: 1.07~1.78, P=0.014);对夜间睡眠时长进行进一步校正后,二者的显著性依然存在,OR值分别为1.40(95%CI: 1.12~1.75, P=0.003)和1.44(95% CI:1.11~1.86, P=0.006)。结论 就寝时间较晚及晚睡晚起型睡眠节律模式与青少年过敏性鼻炎患病高风险相关,提示睡眠问题的管理在过敏性疾病的防治中具有重要意义。

关键词: 青少年, 睡眠时间, 睡眠节律模式, 过敏性鼻炎