摘要
目的探讨儿童多维睡眠指标与龋病新发风险间的前瞻性关联,为儿童口腔健康相关的睡眠行为干预提供参考。方法2021年10月(T1),采用整群抽样方法选取安徽省蚌埠市2所小学1417名一至四年级6~11岁小学生为调查对象,分别在2022年11月(T2)、2023年5月(T3)、2023年11月(T4)进行随访,包括父母问卷和儿童睡眠习惯问卷分别调查儿童睡眠信息和睡眠习惯(基线)、口腔健康及生长发育检查,并评价儿童龋齿和睡眠状况,其中睡眠指标包括就寝时间、睡眠时长、睡眠中点、社会时差、周末补觉及睡眠习惯。采用多因素Cox比例风险回归模型分析多维度睡眠指标与学龄儿童2年后新发龋齿之间的关联。结果T1儿童龋齿患病率为65.1%,2年随访结束时,龋齿新发病率为59.0%。多因素Cox比例风险回归模型分析结果显示,儿童睡眠阻碍、睡中觉醒、睡眠伴随障碍和日间困倦评分每增加1分,新发龋齿风险分别增加12%(HR=1.12,95%CI=1.08~1.15)、22%(HR=1.22,95%CI=1.15~1.29)、12%(HR=1.12,95%CI=1.08~1.17)和15%(HR=1.15,95%CI=1.12~1.19);周末补觉时长每增加1 h,新发龋齿的风险增加23%(HR=1.23,95%CI=1.14~1.33);与上学日就寝时间早于21:00的儿童相比,就寝时间晚于22:00的儿童新发龋齿风险增加57%(HR=1.57,95%CI=1.22~2.03);与睡眠充足(≥9 h/d)的儿童相比,睡眠不足的儿童新发龋齿风险增加67%(HR=1.67,95%CI=1.43~1.95)(P值均<0.01)。结论睡眠行为及睡眠障碍与儿童龋齿发生发展存在关联。在龋病预防以及高危儿童口腔健康管理中,优化睡眠行为与睡眠质量可能是改善儿童口腔健康的有效干预措施之一。
Objective To explore the prospective association between multidimensional sleep indicators and the risk of newly-onset dental caries,providing a reference for children's oral health-related sleep intervention.Methods In October 2021,1417 students in grades 1 to 4(aged 6 to 11)from two elementary schools in Bengbu,Anhui Province,were selected by cluster sampling method.Surveys and follow-up visits were conducted at baseline(T1),November 2022(T2),May 2023(T3),and November 2023(T4),respectively,including parental questionnaires,oral health and physical examination.Bedtime,sleep duration,sleep midpoint,social jet lag,weekend catch-up sleep,and sleep habits were collected and calculated.A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newly-onset caries in school-aged children after 2 years.Results The prevalence of dental caries in children was 65.1%at baseline,and the prevalence was 59.0%at the end of the 2-year follow-up.Cox proportional risk regression model showed that for every 1-point increase in the children's bedtime resistance,nocturnal awakenings,parasomnias,and daytime sleepiness scores,the risk of newly-onset caries increased by 12%(HR=1.12,95%CI=1.08-1.15),22%(HR=1.22,95%CI=1.15-1.29),12%(HR=1.12,95%CI=1.08-1.17),and 15%(HR=1.15,95%CI=1.12-1.19),respectively;the risk of newly-onset caries increased by 23%for each 1 h increase in the length of weekend catch-up sleep(HR=1.23,95%CI=1.14-1.33);compared with children who went to bed before 21:00 on school days,those who went to bed later than 22:00 had a 57%higher risk of newly-onset caries(HR=1.57,95%CI=1.22-2.03).Compared to children who slept adequately(≥9 h/d),those with insufficient sleep had a 67%higher risk of new caries(HR=1.67,95%CI=1.43-1.95)(P<0.01).Conclusions These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries.Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance children's oral health outcomes.
作者
鲁秀真
黄传龙
李扬
左敏
孙莹
陈新
LU Xiuzhen;HUANG Chuanlong;LI Yang;ZUO Min;SUN Ying;CHEN Xin(College&Hospital of Stomatology,Anhui Medical University/Key Lab.of Oral Diseases Research of Anhui Province,Hefei(230032),Anhui Province,China;不详)
出处
《中国学校卫生》
北大核心
2025年第4期579-583,共5页
Chinese Journal of School Health
基金
国家自然科学基金项目(82373591)
安徽医科大学口腔医学院学科建设项目(2023xkfyts07)。
关键词
龋齿
睡眠
随访研究
风险
儿童
Dental caries
Sleep
Follow-up studies
Risk
Child
