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Article(id=1325502161068622247, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025131, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1741622400000, receivedDateStr=2025-03-11, revisedDate=1743523200000, revisedDateStr=2025-04-02, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953941838, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953941838, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953941838, creator=13701087609, updateTime=1793953941838, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=548, endPage=551, ext={EN=ArticleExt(id=1325502162008146344, articleId=1325502161068622247, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Correlation between bedtime screen use behavior and sleep health among fourth- and fifth-grade primary school students, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association between bedtime screen use and sleep health among fourth- and fifth-grade primary school students, so as to provide evidence to support interventions for improving sleep quality.

Methods

From April to June 2024, a survey was conducted among 4 232 fourth- and fifth-grade students from nine primary schools in a district of Beijing. A self-designed questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations.

Results

Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to non-users, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P < 0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P < 0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P < 0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P < 0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P < 0.01).

Conclusions

Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

, authors=Guiyin ZHU, Fan ZHU, Tiantian QI, Shihao GUO, Shuang YANG, Yinghua MA*, authorsList=Guiyin ZHU, Fan ZHU, Tiantian QI, Shihao GUO, Shuang YANG, Yinghua MA, authorCompany=null, correspAuthors=Yinghua MA, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325502165757854122, articleId=1325502161068622247, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=四五年级小学生睡前视屏行为与睡眠健康的相关性, columnId=1259565858817491410, journalTitle=中国学校卫生, columnName=心理卫生, runingTitle=null, highlight=null, articleAbstract=
目的

探究四五年级小学生睡前视屏行为与睡眠健康之间的关系，为促进小学生睡眠健康提供参考依据。

方法

2024年4—6月在北京市某区9所小学4 232名四五年级小学生中开展调查，使用自编问卷调查小学生的睡前视屏行为与睡眠情况，采用广义线性模型和Logistic回归分析小学生睡前视屏行为与睡眠健康的相关性。

结果

28.3%的小学生报告存在睡前视屏行为，上学日和周末每天睡眠时长分别为(9.31±0.90)(10.08±1.36)h；报告存在睡前视屏行为的小学生，上学日和周末的就寝时间每天分别推迟10.18(95%CI=6.88~13.47)和22.09(95%CI=17.33~26.85)min，周末晨起时间推迟7.97(95%CI=1.78~14.16)min，上学日和周末的睡眠时长每天分别减少9.82(95%CI=-13.62~-6.03)和14.12(95%CI=-20.24~-8.00)min(P值均 < 0.05)；周末-上学日就寝时间差更大[β值(95%CI)=1.15(1.08~1.23), P < 0.01]；入睡时间≤20 min、日间保持清醒警觉和主观睡眠满意的可能性更低[OR值(95%CI)分别为0.62(0.54~0.72)、0.66(0.56~0.77)和0.57(0.49~0.66), P值均 < 0.01]。

结论

睡前视屏行为可对小学生多维度睡眠健康造成负面影响，减少睡前视屏行为可能有助于促进小学生睡眠健康。

, authors=朱桂因, 朱璠, 祁甜甜, 郭世豪, 杨爽, 马迎华*, authorsList=朱桂因, 朱璠, 祁甜甜, 郭世豪, 杨爽, 马迎华, authorCompany=null, correspAuthors=马迎华, authorNote=

朱桂因(1998-)，女，广东佛山人，在读博士，主要研究方向为儿童青少年生长发育及其影响因素

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马迎华，E-mail:
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朱桂因(1998-)，女，广东佛山人，在读博士，主要研究方向为儿童青少年生长发育及其影响因素

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Sleep Med Rev, 2022, 63: 101626., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325502186272195042, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, awardId=null, language=CN, fundingSource=中国教育学会教育科研重点规划课题(202416305735A), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325502169570476459, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, xref=null, ext=[AuthorCompanyExt(id=1325502169926992300, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, companyId=1325502169570476459, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Child and Adolescent Health/School of Public Health, Peking University, Beijing (100191), China), AuthorCompanyExt(id=1325502169960546733, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, companyId=1325502169570476459, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=北京大学公共卫生学院/儿童青少年卫生研究所，北京 100191)])], figs=[ArticleFig(id=1325502182996443609, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=EN, label=Tab.1, caption=

Comparison of the reporting rate of bedtime screen use behavior among primary school students in different groups

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组别选项人数睡前视屏行为χ2值P值
性别男2 159633(29.3)2.330.13
女2 073564(27.2)
年级四2 541635(25.0)34.02< 0.01
五1 691562(33.2)
父亲文化水平高中及以下699223(31.9)5.400.02
大专及以上3 533974(27.6)
母亲文化水平高中及以下524146(27.9)0.050.82
大专及以上3 7081 051(28.3)
父亲就寝时间22:00及以前1 115306(27.4)0.530.47
22:00以后3 117891(28.6)
母亲就寝时间22:00及以前1 714467(27.2)1.530.22
22:00以后2 518730(29.0)
自评学习负担轻1 120227(20.3)106.60< 0.01
一般2 550721(28.3)
重562249(44.3)
每天视屏时长/h≤12 840577(20.3)270.22< 0.01
>11 392620(44.5)
每天午睡时长/01 224468(38.2)103.50< 0.01
  min1~301 463409(28.0)
>301 545320(20.7)
每天户外活动< 22 636860(32.6)64.93< 0.01
  时长/h≥21 596337(21.1)
), ArticleFig(id=1325502183319405019, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=CN, label=表1, caption=

不同组别小学生睡前视屏行为报告率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项人数睡前视屏行为χ2值P值
性别男2 159633(29.3)2.330.13
女2 073564(27.2)
年级四2 541635(25.0)34.02< 0.01
五1 691562(33.2)
父亲文化水平高中及以下699223(31.9)5.400.02
大专及以上3 533974(27.6)
母亲文化水平高中及以下524146(27.9)0.050.82
大专及以上3 7081 051(28.3)
父亲就寝时间22:00及以前1 115306(27.4)0.530.47
22:00以后3 117891(28.6)
母亲就寝时间22:00及以前1 714467(27.2)1.530.22
22:00以后2 518730(29.0)
自评学习负担轻1 120227(20.3)106.60< 0.01
一般2 550721(28.3)
重562249(44.3)
每天视屏时长/h≤12 840577(20.3)270.22< 0.01
>11 392620(44.5)
每天午睡时长/01 224468(38.2)103.50< 0.01
  min1~301 463409(28.0)
>301 545320(20.7)
每天户外活动< 22 636860(32.6)64.93< 0.01
  时长/h≥21 596337(21.1)
), ArticleFig(id=1325502183432651228, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=EN, label=Tab.2, caption=

Comparison of bedtime screen use behavior and sleep indicators among primary school students

, figureFileSmall=null, figureFileBig=null, tableContent=
睡前视屏行为人数睡眠时点a每天睡眠时长a睡眠相关行为b
上学日就寝时间周末就寝时间上学日晨起时间周末晨起时间上学日睡眠时长/min周末睡眠时长/min|周末-上学日就寝时间差|/min|周末-上学日晨起时间差|/min社会时差/min
有1 19721:47±0.8322:31±1.256:53±0.578:23±1.57545.72±56.29591.47±89.8240(20, 65)80(50, 130)60(32, 95)
无3 03521:30±0.7321:56±1.026:54±0.608:07±1.28563.76±52.47610.26±77.4430(15, 60)65(30, 110)45(22, 75)
总体4 23221:35±0.7722:06±1.126:54±0.588:11±1.38558.66±54.18604.94±81.5630(15, 60)70(40, 120)50(25, 80)
t/H值10.4014.28-0.655.22-9.57-6.3671.1565.90102.09
P值< 0.01< 0.010.51< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325502183776584158, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=CN, label=表2, caption=

有无睡前视屏行为小学生各项睡眠指标比较

, figureFileSmall=null, figureFileBig=null, tableContent=
睡前视屏行为人数睡眠时点a每天睡眠时长a睡眠相关行为b
上学日就寝时间周末就寝时间上学日晨起时间周末晨起时间上学日睡眠时长/min周末睡眠时长/min|周末-上学日就寝时间差|/min|周末-上学日晨起时间差|/min社会时差/min
有1 19721:47±0.8322:31±1.256:53±0.578:23±1.57545.72±56.29591.47±89.8240(20, 65)80(50, 130)60(32, 95)
无3 03521:30±0.7321:56±1.026:54±0.608:07±1.28563.76±52.47610.26±77.4430(15, 60)65(30, 110)45(22, 75)
总体4 23221:35±0.7722:06±1.126:54±0.588:11±1.38558.66±54.18604.94±81.5630(15, 60)70(40, 120)50(25, 80)
t/H值10.4014.28-0.655.22-9.57-6.3671.1565.90102.09
P值< 0.01< 0.010.51< 0.01< 0.01< 0.01< 0.01< 0.01< 0.01
), ArticleFig(id=1325502185492054495, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=EN, label=Tab.3, caption=

Generalized linear models analysis of bedtime screen use behavior and sleep indicators among primary school students (n=4 232)

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自变量睡眠指标β值(95%CI)P值
睡眠时点上学日就寝时间10.18(6.88~13.47)< 0.01
周末就寝时间22.09(17.33~26.85)< 0.01
上学日晨起时间0.35(-2.17~2.88)0.79
周末晨起时间7.97(1.78~14.16)0.01
睡眠时长/上学日睡眠时长-9.82(-13.62~-6.03)< 0.01
  min周末睡眠时长-14.12(-20.24~-8.00)< 0.01
睡眠相关周末-上学日就寝时间a1.15(1.08~1.23)< 0.01
  行为/min周末-上学日晨起时间a1.12(1.06~1.19)< 0.01
社会时差a1.17(1.11~1.24)< 0.01
), ArticleFig(id=1325502185856958945, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502161068622247, language=CN, label=表3, caption=

小学生睡前视屏行为与各项睡眠指标的广义线性模型分析(n=4 232)

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自变量睡眠指标β值(95%CI)P值
睡眠时点上学日就寝时间10.18(6.88~13.47)< 0.01
周末就寝时间22.09(17.33~26.85)< 0.01
上学日晨起时间0.35(-2.17~2.88)0.79
周末晨起时间7.97(1.78~14.16)0.01
睡眠时长/上学日睡眠时长-9.82(-13.62~-6.03)< 0.01
  min周末睡眠时长-14.12(-20.24~-8.00)< 0.01
睡眠相关周末-上学日就寝时间a1.15(1.08~1.23)< 0.01
  行为/min周末-上学日晨起时间a1.12(1.06~1.19)< 0.01
社会时差a1.17(1.11~1.24)< 0.01
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四五年级小学生睡前视屏行为与睡眠健康的相关性
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朱桂因 , 朱璠 , 祁甜甜 , 郭世豪 , 杨爽 , 马迎华 *
中国学校卫生 | 心理卫生 2025,46(4): 548-551
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中国学校卫生 |心理卫生 2025 , 46 (4) : 548 -551
四五年级小学生睡前视屏行为与睡眠健康的相关性
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朱桂因(1998-)，女，广东佛山人，在读博士，主要研究方向为儿童青少年生长发育及其影响因素

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朱桂因, 朱璠, 祁甜甜, 郭世豪, 杨爽, 马迎华*
作者信息
  • 北京大学公共卫生学院/儿童青少年卫生研究所，北京 100191
通讯作者:
马迎华，E-mail:
作者简介:

朱桂因(1998-)，女，广东佛山人，在读博士，主要研究方向为儿童青少年生长发育及其影响因素

Correlation between bedtime screen use behavior and sleep health among fourth- and fifth-grade primary school students
Guiyin ZHU, Fan ZHU, Tiantian QI, Shihao GUO, Shuang YANG, Yinghua MA*
Affiliations
  • Institute of Child and Adolescent Health/School of Public Health, Peking University, Beijing (100191), China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025131
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摘要
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目的

探究四五年级小学生睡前视屏行为与睡眠健康之间的关系，为促进小学生睡眠健康提供参考依据。

方法

2024年4—6月在北京市某区9所小学4 232名四五年级小学生中开展调查，使用自编问卷调查小学生的睡前视屏行为与睡眠情况，采用广义线性模型和Logistic回归分析小学生睡前视屏行为与睡眠健康的相关性。

结果

28.3%的小学生报告存在睡前视屏行为，上学日和周末每天睡眠时长分别为(9.31±0.90)(10.08±1.36)h；报告存在睡前视屏行为的小学生，上学日和周末的就寝时间每天分别推迟10.18(95%CI=6.88~13.47)和22.09(95%CI=17.33~26.85)min，周末晨起时间推迟7.97(95%CI=1.78~14.16)min，上学日和周末的睡眠时长每天分别减少9.82(95%CI=-13.62~-6.03)和14.12(95%CI=-20.24~-8.00)min(P值均 < 0.05)；周末-上学日就寝时间差更大[β值(95%CI)=1.15(1.08~1.23), P < 0.01]；入睡时间≤20 min、日间保持清醒警觉和主观睡眠满意的可能性更低[OR值(95%CI)分别为0.62(0.54~0.72)、0.66(0.56~0.77)和0.57(0.49~0.66), P值均 < 0.01]。

结论

睡前视屏行为可对小学生多维度睡眠健康造成负面影响，减少睡前视屏行为可能有助于促进小学生睡眠健康。

注视，眼  /  行为  /  睡眠  /  精神卫生  /  回归分析  /  学生
Objective

To investigate the association between bedtime screen use and sleep health among fourth- and fifth-grade primary school students, so as to provide evidence to support interventions for improving sleep quality.

Methods

From April to June 2024, a survey was conducted among 4 232 fourth- and fifth-grade students from nine primary schools in a district of Beijing. A self-designed questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations.

Results

Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to non-users, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P < 0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P < 0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P < 0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P < 0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P < 0.01).

Conclusions

Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

Fixation, ocular  /  Behavior  /  Sleep  /  Mental health  /  Regression analysis  /  Students
朱桂因, 朱璠, 祁甜甜, 郭世豪, 杨爽, 马迎华. 四五年级小学生睡前视屏行为与睡眠健康的相关性. 中国学校卫生, 2025 , 46 (4) : 548 -551 . DOI: 10.16835/j.cnki.1000-9817.2025131
Guiyin ZHU, Fan ZHU, Tiantian QI, Shihao GUO, Shuang YANG, Yinghua MA. Correlation between bedtime screen use behavior and sleep health among fourth- and fifth-grade primary school students[J]. Chinese Journal of School Health, 2025 , 46 (4) : 548 -551 . DOI: 10.16835/j.cnki.1000-9817.2025131
正文
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睡眠对于儿童身心发育与健康成长至关重要，然而睡眠时长不足、睡眠质量不佳、就寝-晨起时间不规律在学龄儿童中比较普遍[1-2]，其中使用电子设备是影响儿童睡眠的常见因素之一[3]。既往文献综述报道了视屏行为对儿童睡眠的负面影响，包括推迟就寝时间、缩短睡眠时长、延长入睡时间、睡眠质量不佳等[4-6]，而睡前视屏行为往往对睡眠的影响更为显著[4]。本研究利用横断面调查数据，旨在对四五年级小学生睡前视屏行为与睡眠健康的关系进行初步探索，结果如下。
1　对象与方法
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1.1　对象
于2024年4—6月在北京市某区方便选取9所小学，面向全体四五年级小学生及其家长开展电子问卷调查。发放学生问卷和家长问卷各5 157份，有4 434名学生及其家长均提交问卷，回收率为86.0%。排除家长报告既往诊断患有睡眠障碍或发育行为障碍、正在服用助眠药物或精神类药物的学生93名，剔除问卷中就寝时间和/或晨起时间出现极端值者109名(超出对应变量均值±3个标准差范围的报告值定义为极端值)，最终共纳入4 232名小学生，问卷有效率为95.4%。其中男生2 159名(51.0%)，女生2 073名(49.0%)；四年级学生2 541名(60.0%)，五年级1 691名(40.0%)。平均年龄(10.60±0.64)岁。本调查已获得所有调查对象及其家长的知情同意，并通过北京大学生物医学伦理委员会审查(批号：IRB00001052-24182)。
1.2　方法
1.2.1　睡眠情况
参照儿童睡眠健康的6个维度[7-8]，采用自编睡眠情况问卷调查学生过去1个月各维度的睡眠指标，由学生自己报告。(1)睡眠时点：上学日和周末的就寝时间、晨起时间。(2)睡眠时长：根据晨起时间和就寝时间的差值分别计算上学日和周末睡眠时长。(3)睡眠效率：入睡的难易程度，将报告入睡时间≤20 min定义为睡眠效率高[9]。(4)警觉性：日间保持清醒和警觉的能力，本研究将报告上课、写作业时感到困倦的频率(通常/有时/偶尔)为偶尔(0~1 d/周)的定义为日间能够保持清醒和警觉[10]。(5)睡眠满意度：对睡眠质量好坏的主观评价，将报告早上醒来后感觉睡得好的频率(通常/有时/偶尔)为通常(5~7 d/周)的定义为主观睡眠满意。(6)睡眠相关行为：健康的睡眠相关行为包括规律的睡眠时间安排和良好的就寝习惯等，本研究以以下3个指标来反映睡眠时间安排规律性，根据周末和上学日之间睡眠时点差异，分别计算|周末-上学日就寝时间差|、|周末-上学日晨起时间差|、社会时差(社会时差=|周末睡眠中点-上学日睡眠中点|，睡眠中点=晨起时间-睡眠时长/2)，差值越大表示就寝-晨起时间越不规律[11]；反映就寝习惯的指标为上学日主动就寝行为、周末主动就寝行为，分别定义为报告上学日/周末通常做到主动上床睡觉。
1.2.2　睡前视屏行为
参考《青少年睡眠卫生量表》(Adolescent Sleep Hygiene Scale)[12]的条目，采用自编问卷调查睡前视屏行为，本研究将睡前视屏行为定义为就寝时间前1 h看手机、电脑、电视等电子屏幕，学生报告“通常”或“有时”定义为“有睡前视屏行为”，报告“很少”者定义为“无睡前视屏行为”。
1.2.3　基本信息与协变量
采用自编问卷收集人口学特征与协变量信息，参照既往文献选择调整的协变量[13]。学生报告性别、年级、自评学习负担(轻/一般/重)、每天平均视屏时长(≤1，>1 h)、每天平均午睡时长(0，1~30，>30 min)、每天平均户外活动时长(< 2，≥2 h)，家长报告父母亲文化水平(高中及以下/大专及以上)、孩子睡眠障碍或发育行为障碍疾病史(有/无)、孩子助眠药物或精神类药物用药史(有/无)、父母亲就寝时间(22:00及以前或22:00以后)。
1.3　质量控制
学校统一组织学生在电脑机房填写电子版问卷，由统一培训的调查员向学生说明调查目的和填写说明，班主任和任课教师回避。通过班级微信群向家长发放问卷二维码及问卷说明。调查结束后，由团队成员检查删除重复值后进行匹配和数据清洗工作，整理形成数据库。
1.4　统计学分析使用SPSS
26.0软件进行数据分析。周末-上学日就寝时间差、周末-上学日晨起时间差、社会时差呈右偏态分布，以M(P25, P75)描述，组间比较采用Kruskal-Wallis检验；其余定量资料近似正态分布，以($\bar{x} \pm s$)描述，组间比较采用独立样本t检验。定性资料以频数和构成比描述，组间比较采用χ2检验。采用广义线性模型分析有无睡前视屏行为分别与上学日和周末的就寝时间/晨起时间/睡眠时长、周末-上学日就寝时间差/晨起时间差、社会时差的关系，采用Logistic回归分析有无睡前视屏行为与入睡时间是否≤20 min、日间是否保持清醒和警觉、是否主观睡眠满意、上学日是否主动就寝、周末是否主动就寝的关系；以睡前视屏行为作为自变量(无睡前视屏行为作为参照)，睡眠指标为因变量，其中偏态分布的因变量进行对数转换后再纳入回归分析，调整性别、年级、父母亲文化水平、父母亲就寝时间、自评学习负担、每天视屏时长、每天午睡时长、每天户外活动时长等协变量。使用双侧检验，检验水准α=0.05。
2　结果
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2.1　小学生睡前视屏行为
见表1。
调查的小学生中有1 197名(28.3%)自我报告存在睡前视屏行为。不同年级、父亲文化水平、自评学习负担、每天视屏时长、每天午睡时长、每天户外活动时长的小学生睡前视屏行为报告率差异均有统计学意义(P值均 < 0.05)。
2.2　有无睡前视屏行为小学生各项睡眠指标的比较
小学生上学日和周末睡眠时长每天分别为(9.31±0.90)和(10.08±1.36)h，上学日和周末睡眠时长≥10 h的分别有1 000(23.6%)和2 527名(59.7%)。在睡眠效率方面，有无睡前视屏行为小学生入睡时间≤20 min的报告率分别为21.9%(534名)和78.1%(1 904名)；在警觉性方面，有无睡前视屏行为小学生日间保持清醒和警觉的报告率分别为23.5%(726名)和76.5%(2 369名)；在睡眠满意度方面，有无睡前视屏行为小学生主观睡眠满意的报告率分别为21.7%(591名)和78.3%(2 137名)；在睡眠相关行为的就寝习惯方面，有无睡前视屏行为小学生上学日主动就寝的报告率分别为17.8%(563名)和82.2%(2 592名)，周末主动就寝的报告率分别为14.5%(422名)和85.5%(2 480名)，组间差异均有统计学意义(χ2值分别为115.46，132.34，165.86，666.12，859.77，P值均 < 0.01)，无睡前视屏行为组的睡眠指标水平更好。除了上学日晨起时间以外，其他各项睡眠指标在有无睡前视屏行为小学生间差异均有统计学意义(P值均 < 0.01)。见表2。
2.3　小学生睡前视屏行为与各项睡眠指标的回归分析
广义线性模型分析结果显示，调整协变量后，相比于报告无睡前视屏行为的小学生，报告有睡前视屏行为的小学生上学日和周末的就寝时间分别推迟10.18和22.09 min，周末晨起时间推迟7.97 min，上学日和周末的睡眠时长分别减少9.82和14.12 min(P值均 < 0.05)；周末-上学日就寝时间差、周末-上学日晨起时间差和社会时差更大[β值(95%CI)分别为1.15(1.08~1.23)，1.12(1.06~1.19)，1.17(1.11~1.24)，P值均 < 0.01]。见表3。
Logistic回归模型分析结果显示，调整协变量后，报告有睡前视屏行为的小学生入睡时间≤20 min、日间保持清醒警觉和主观睡眠满意的可能性更低[OR值(95%CI)分别为0.62(0.54~0.72)、0.66(0.56~0.77)和0.57(0.49~0.66)，P值均 < 0.01]；做到上学日和周末主动就寝的可能性也更低[OR值(95%CI)分别为0.19(0.17~0.23)和0.15(0.13~0.18)，P值均 < 0.01]。
3　讨论
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本研究结果显示，28.3%的调查学生报告存在睡前视屏行为。睡前视屏行为与小学的6个睡眠维度指标均存在相关性，存在睡前视屏行为的小学生上学日和周末的就寝时间分别推迟10.18和22.09 min，周末晨起时间推迟7.97 min，上学日和周末的睡眠时长分别减少9.82和14.12 min。与此同时，上述小学生入睡时间更长、日间更难保持清醒和警觉、主观睡眠满意度更低，周末-上学日就寝和晨起时间差更大，也更难做到主动就寝。提示睡前视屏行为可能对小学生多个维度睡眠健康造成负面影响。
来自美国、芬兰、瑞典的多项横断面调查结果显示，儿童青少年夜晚或睡前使用电子设备与自我报告更晚的就寝时间、更短的睡眠时长、入睡困难、日间疲劳、周末-上学日就寝时间和晨起时间不一致有关[13-16]。在我国广州、深圳、上海等城市也有调查发现，每天总体视屏时间与儿童青少年自我报告或家长报告的就寝时间和晨起时间推迟、睡眠时长缩短、就寝习惯不良有关[17-19]。本研究未发现睡前视屏行为与上学日晨起时间的相关性，可能是由于学校统一的上学时间导致学生形成相对固定的晨起时间，即使存在睡前视屏行为，也难以改变已养成固定的起床模式。
现有研究表明，有多种机制可解释睡前视屏行为对睡眠的影响，本研究的结果部分支持以下机制：(1)睡前使用电子设备占用原本用于睡眠的时间，引起就寝时间推迟和睡眠时长不足；(2)电子屏幕的内容往往容易引起大脑兴奋，使个体难以放松进入睡眠；(3)屏幕发出的蓝光会抑制褪黑素分泌，引起入睡时间延长、睡眠质量降低[5]。长期睡前视屏可能会进一步引起上学日睡眠时长不足、周末推迟就寝时间和晨起时间进行补觉，从而造成更为不规律的就寝-晨起习惯。由于儿童青少年普遍对电子设备的使用缺乏控制，并且进入青少年时期睡前视屏行为可能更为普遍[20]，需要及时关注，并适当干预儿童青少年的睡前视屏行为，以保证其充足良好的睡眠。
本研究也存在一定的局限性：首先，本研究为横断面设计，可能存在尚未控制的混杂因素，结论仍需纵向研究和实验性研究进一步验证；其次，本研究的睡眠和视屏信息均由学生自我报告，缺少睡前视屏时间、视屏内容等精确信息，可能存在回忆偏倚和测量偏倚；最后，本研究的样本仅限于北京市某区的小学生，结论的外推性尚待验证。未来需要进一步开展前瞻性研究，结合客观记录的睡眠健康指标(如睡眠监测设备)和更精确的视屏使用数据，对研究结论进行更深入的论证。
基金
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  • 中国教育学会教育科研重点规划课题(202416305735A)
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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025131
  • 接收时间：2025-03-11
  • 首发时间：2026-11-06
  • 出版时间：2025-04-25
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  • 收稿日期：2025-03-11
  • 修回日期：2025-04-02
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中国教育学会教育科研重点规划课题(202416305735A)
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    北京大学公共卫生学院/儿童青少年卫生研究所，北京 100191

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马迎华，E-mail:
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
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