Sleep Duration, Sleep Habits, and Social Jetlag From 4 to 6 years Their Impacts on Myopia Among School-Aged Children: The Ma'anshan Birth Cohort Study

4-6岁儿童的睡眠时间、睡眠习惯和社交时差对近视的影响:马鞍山出生队列研究

Authors：Meng Wang, Juan Tong, Dongqing Zhu, Kun Huang, Xiaoyan Wu, Guopeng Gao, Liu Jiang, Shuangqin Yan, Fangbiao Tao, Shuman Tao

Source：Nature And Science of Sleep

DOI: 10.2147/NSS.S500191

Abstract

Purpose: To examine the associations of sleep parameters and their trajectories at preschool age with myopia among school-aged children by using a birth cohort study design.

Patients and methods: All participants were recruited from the Ma'anshan Birth Cohort Study. Sleep duration, sleep habits, and social jetlag were collected in 4 years, 5.5 years, and 6 years. Cycloplegic refraction and ocular biometry were performed at 7 years. Key statistical analyses were performed using the latent class growth models, binary logistic regression, generalized linear models, and linear mixed models, respectively.

Results: A total of 1561 children were included in the study (mean age of 7.93 years, 52.6% boys). Social jetlag of at least 1 hour at age 4 was positively linked to an increased risk of myopia in school-age children and axial length (AL) but negatively correlated with spherical equivalent refraction (SER) (P<0.05). Inadequate sleep duration at 5.5 years was associated with an increase in AL among school-age children (β=0.16; 95% CI: 0.07-0.24). A pattern of increasing-declining social jetlag was positively correlated with AL/CR ratio (RR=1.55; 95%CI: 1.01-2.37). Poor sleep habits, higher social jetlag at age 4, and the declining-increasing trajectory of social jetlag were negatively associated with SER in school-aged children (P<0.05). Furthermore, the declining-increasing and increasing-declining trajectories of social jetlag were positively correlated with the elongation of AL.

Conclusion: The correlations between sleep parameters at preschool age and myopia in school-aged children reveal that maintaining regular sleep habits in preschool may contribute to the early prevention of myopia.

Keywords: axial length; children; cycloplegic spherical equivalent refraction; myopia; sleep.

摘要

目的：采用出生队列研究设计，检测学龄前儿童睡眠参数及其轨迹与近视的关系。

患者和方法：所有参与者均来自马鞍山出生队列研究。睡眠持续时间、睡眠习惯和社交时差分别在4年、5年半和6年收集。在7岁时进行睫状肌麻痹验光和眼部生物测量。关键统计分析分别使用潜在类别增长模型、二元逻辑回归、广义线性模型和线性混合模型进行。

结果：共有1561名儿童纳入研究(平均年龄7.93岁，52.6%为男孩)。4岁时至少1小时的社交时差与学龄儿童近视风险增加和眼轴长度(al)正相关，但与球面等效屈光(SER)负相关(P<0.05)。5.5岁时睡眠持续时间不足与学龄儿童AL增加相关(β= 0.16；95%可信区间:0.07-0.24)。社交时差的上升-下降模式与AL/CR比值呈正相关(RR = 1.5595%可信区间:1.01-2.37)。不良的睡眠习惯、4岁时较高的社交时差以及社交时差的下降-上升轨迹与学龄儿童的SER呈负相关(P<0.05)。此外，社交时差的递减-递增和递增-递减轨迹与al的延长呈正相关。

结论：学龄前睡眠参数与学龄儿童近视的相关性表明，学龄前保持规律的睡眠习惯有助于近视的早期预防。

关键词：轴向长度；儿童；睫状肌麻痹球面等效折射；近视；睡觉。