中国公共卫生

目的 探讨睡眠时间和睡眠质量与中国老年人慢性病及慢性病共病患病的关系，为制定我国老年人慢性病防控策略提供参考依据。方法 收集中国老年健康影响因素追踪调查（CLHLS）2018年中23个省（自治区、直辖市）11 529名≥60岁老年人的相关数据，分析我国老年人睡眠时间和睡眠质量与慢性病及慢性病共病患病的关系。结果 中国11 529名≥60岁老年人中，睡眠时间<6、6～8和> 8 h/d者分别为2 115人（18.35%）、6 362人（55.18%）和3 052人（26.47%），睡眠质量好、睡眠质量一般和睡眠质量差者分别为6 201人（53.78%）、3 629人（31.48%）和1 699人（14.74%）；患慢性病和慢性病共病者分别为6 457例和2 682例，慢性病和慢性病共病患病率分别为56.01%和23.26%。在调整了性别、年龄、婚姻状况、吸烟情况、饮酒情况和体质指数等混杂因素后，多因素非条件logistic回归分析结果显示，睡眠时间<6 h/d中国老年人慢性病患病风险为睡眠时间6～8 h/d中国老年人的1.25倍（OR=1.25,95%CI=1.13～1.39），睡眠质量好和一般中国老年人慢性病患病风险分别为睡眠质量差中国老年人的0.62倍（OR=0.62,95%CI=0.55～0.70）和0.72倍（OR=0.72,95%CI=0.64～0.81）；睡眠时间<6 h/d中国老年人慢性病共病患病风险为睡眠时间6～8 h/d中国老年人的1.34倍（OR=1.34,95%CI=1.19～1.51），睡眠质量好和一般中国老年人慢性病共病患病风险分别为睡眠质量差中国老年人的0.54倍（OR=0.54,95%CI=0.48～0.62）和0.65倍（OR=0.65,95%CI=0.57～0.74）。结论 睡眠时间短可增加中国老年人慢性病及慢性病共病的患病风险，而睡眠质量较好则可降低中国老年人慢性病及慢性病共病的患病风险。

Objective To investigate the association of sleep duration and sleep quality with chronic disease and comorbidity among the elderly in China, providing a reference for developing chronic disease prevention and control strategies for the elderly population in China. Methods Data on 11 529 the elderly aged ≥ 60 years old from 23provinces(autonomous regions and municipalities) across China were collected from the Chinese Longitudinal Healthy Longevity Survey(CLHLS) in 2018. The association of sleep duration and sleep quality with chronic disease and comorbidity among the elderly in China was analyzed. Results Among the 11 529 the elderly aged ≥ 60 years in China,2 115(18.35%), 6 362(55.18%), and 3 052(26.47%) had a sleep duration of < 6 h/d, 6 – 8 h/d, and >8 h/d, respectively;6 201(53.78%), 3 629(31.48%), and 1 699(14.74%) had good, fair, and poor sleep quality, respectively. There were 6 457cases of chronic disease and 2 682 cases of chronic disease comorbidity, with prevalence rates of 56.01% and 23.26%,respectively. After adjusting for confounding factors such as gender, age, marital status, smoking status, drinking status,and body mass index, multivariate unconditional logistic regression analysis showed that the risk of chronic disease in Chinese the elderly with a sleep duration of < 6 h/d was 1.25 times that of those with a sleep duration of 6 – 8 h/d(OR =1.25, 95%CI: 1.13 – 1.39). The risk of chronic disease in Chinese the elderly with good and fair sleep quality was 0.62times(OR = 0.62, 95%CI: 0.55 – 0.70) and 0.72 times(OR = 0.72, 95%CI: 0.64 – 0.81) that of those with poor sleep quality, respectively. The risk of chronic disease comorbidity in Chinese the elderly with a sleep duration of < 6 h/d was1.34 times that of those with a sleep duration of 6 – 8 h/d(OR = 1.34, 95%CI: 1.19 – 1.51). The risk of chronic disease comorbidity in Chinese the elderly with good and fair sleep quality was 0.54 times(OR = 0.54, 95%CI: 0.48 – 0.62) and0.65 times(OR = 0.65, 95%CI: 0.57 – 0.74) that of those with poor sleep quality, respectively. Conclusion Short sleep duration can increase the risk of chronic disease and comorbidity in Chinese the elderly, while better sleep quality can reduce the risk of chronic disease and comorbidity in Chinese the elderly.