基于STRAW+10分期女性睡眠健康研究

Sleep health in women across reproductive aging:a STRAW+10-based study

摘要

目的 研究我国不同生殖衰老分期女性睡眠问题的发生特征及变化趋势。方法 本研究为一项全国大型横断面调查,采用多阶段分层随机抽样方法,于2023年9月至2024年2月期间在全国12个省、26个区县招募了35~60岁女性共49 890人。研究通过电子化信息调查系统收集数据,并使用匹兹堡睡眠质量指数(PSQI)评估受试者的睡眠状况。将所有调查对象依据生殖衰老分期(STRAW)+10标准进行分组,比较不同分期女性总体睡眠问题的发生率及各维度睡眠问题的分布特征,并分析睡眠时间与入睡时间在不同分期的变化趋势。结果 所有调查女性中总体睡眠问题发生率为37.51%,其中睡眠效率低(47.55%)和入睡时间延长(36.64%)最为常见。不同STRAW+10分期女性的睡眠问题发生率存在显著差异(P<0.001)。其中,绝经过渡期(-1)和绝经早期(+1a)睡眠问题最为突出,发生率分别为42.64%和42.82%;生育晚期(-3)女性的发生率最低,为35.93%。总体及各维度睡眠问题的发生率均随生殖衰老进程逐渐升高,在绝经过渡期(-1)达到峰值,随后下降并趋于稳定。睡眠问题以复杂的共病/共现网络形式表现。结论 女性睡眠问题在生殖衰老过程中呈先升后降趋势,绝经过渡期和绝经早期是高风险阶段。应加强围绝经期女性的睡眠健康管理,通过早期筛查与个体化干预,预防睡眠障碍的持续或加重。

Abstract

Objective To investigate the occurrence characteristics and changing trends of sleep problems among women at different stages of reproductive aging in China. Methods This nationwide cross-sectional study employed a multistage stratified random sampling method to recruit women aged 35-60 years from 12 provinces and 26 districts/counties across China.Data were collected via an electronic survey system,and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).Participants were categorized according to the STRAW +10 criteria for reproductive aging.The overall prevalence of sleep problems and the distribution of specific sleep dimensions were compared across reproductive stages.Trends in sleep duration and sleep onset latency across stages were analyzed. Results The overall prevalence of sleep problems was 37.51%,with low sleep efficiency (47.55%) and prolonged sleep onset latency (36.64%) being the most common issues.Sleep problems were most prevalent during the late menopausal transition (-1 stage,42.64%) and early postmenopause (+1a stage,42.82%),while the lowest prevalence was observed in late reproductive stage (-3 stage) women (35.93%).Both overall and dimension-specific sleep problems increased progressively with reproductive aging,peaking during the late menopausal transition (-1 stage),followed by a decline and stabilization.Sleep problems manifested as a complex comorbidity/co-occurrence network across multiple dimensions. Conclusion Sleep disturbances among women exhibit an increasing-then-decreasing pattern during reproductive aging,with the late menopausal transition and early postmenopause representing high-risk periods.Prolonged sleep onset and reduced sleep efficiency are the primary manifestations.Perimenopausal women should be prioritized in sleep health management,and early identification with targeted interventions is recommended.

关键词

女性 / 睡眠问题 / STRAW分期 / 匹兹堡睡眠质量指数 / 分布特征

Key words

woman / sleep disorder / STRAW staging / women's health / pittsburgh sleep quality index / distribution characteristic

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基金资助

国家重点研发计划--中国女性绝经状况的流行病学调查研究(2022YFC2703801)

国家重点研发计划--建议中国育龄期女性生殖内分泌激素临床适用标准(2023YFC2705501)