中国上海社区卫生服务中心就诊成年人中自我报告的习惯性打鼾与健康相关生活质量：一项横断面研究

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中文摘要

背景： 习惯性打鼾是初级保健中的常见症状，但常被视为小问题而被忽视。尽管睡眠呼吸障碍与不良健康结局相关，但在中国社区卫生服务中心就诊的成年人中，自我报告的习惯性打鼾与健康相关生活质量（HRQoL）之间的关联仍未被充分描述。本研究探讨了该人群中习惯性打鼾与躯体和心理HRQoL的关联。
方法： 我们在中国上海社区卫生服务中心招募的2,312名成年人中进行了一项横断面研究。习惯性打鼾定义为自我报告每周至少3晚打鼾。HRQoL采用12项简短健康调查量表（SF-12）评估，并由此得出躯体健康总评（PCS）和心理健康总评（MCS）评分。PCS和MCS评分<50被归类为低于常模，但不作为诊断界值解读。在调整社会人口学特征、健康行为、BMI和慢性疾病后，采用多变量logistic回归模型检验习惯性打鼾与低于常模HRQoL的关联。作为敏感性分析，还采用多变量线性回归模型将PCS和MCS作为连续结局进行分析。
结果： 在2,312名参与者中（平均年龄44.4岁；63%为女性），36.9%报告习惯性打鼾（每周≥3晚）。与非打鼾者相比，习惯性打鼾者在躯体健康总评（PCS：42.9 vs. 46.0，P < 0.001）和心理健康总评（MCS：49.9 vs. 50.8，P = 0.023）上的评分均显著较低。多变量调整后，习惯性打鼾与低于常模的躯体HRQoL（ORm = 1.590，95% CI：1.291-1.957）和心理HRQoL（ORm = 1.250，95% CI：1.047-1.493）的较高比值比相关。在敏感性分析中，习惯性打鼾仍与较低的PCS（β = -2.38，95% CI：-3.00至-1.75）和较低的MCS（β = -1.21，95% CI：-2.04至-0.38）显著相关。
结论： 习惯性打鼾在上海社区卫生服务中心就诊的成年人中很常见，并与较低的躯体和心理HRQoL相关，尤其是躯体HRQoL。这些发现支持在社区医疗中更加重视基于症状的简单打鼾筛查，这可能有助于识别可从进一步睡眠相关评估和健康管理中获益的个体。

英文摘要

BACKGROUND: Habitual snoring is a common symptom in primary care but is often overlooked as a minor nuisance. Although sleep-disordered breathing has been associated with adverse health outcomes, the association between self-reported habitual snoring and health-related quality of life (HRQoL) remains insufficiently characterized among adults attending community health centers in China. This study examined the association of habitual snoring with physical and mental HRQoL in this setting.
METHODS: We conducted a cross-sectional study among 2,312 adults recruited from community health centers in Shanghai, China. Habitual snoring was defined as self-reported snoring on at least 3 nights per week. HRQoL was assessed using the 12-item Short Form Health Survey (SF-12), from which the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were derived. PCS and MCS scores < 50 were classified as below norm and were not interpreted as diagnostic cutoffs. Multivariable logistic regression models were used to examine the associations of habitual snoring with below-norm HRQoL after adjustment for sociodemographic characteristics, health behaviors, BMI, and chronic disease. As a sensitivity analysis, PCS and MCS were additionally analyzed as continuous outcomes using multivariable linear regression models.
RESULTS: Of the 2,312 participants (mean age 44.4 years; 63% female), 36.9% reported habitual snoring (≥3 nights/week). Habitual snorers had significantly lower scores on both the Physical Component Summary (PCS: 42.9 vs. 46.0, P < 0.001) and the Mental Component Summary (MCS: 49.9 vs. 50.8, P = 0.023) compared to non-snorers. After multivariable adjustment, habitual snoring was associated with higher odds of below-norm physical HRQoL (ORm = 1.590, 95% CI: 1.291-1.957) and mental HRQoL (ORm = 1.250, 95% CI: 1.047-1.493). In sensitivity analyses, habitual snoring remained significantly associated with lower PCS (β = -2.38, 95% CI: -3.00 to -1.75) and lower MCS (β = -1.21, 95% CI: -2.04 to -0.38).
CONCLUSION: Habitual snoring was common among adults attending community health centers in Shanghai and was associated with lower physical and mental HRQoL, particularly physical HRQoL. These findings support greater attention to simple symptom-based screening for snoring in community care, where it may help identify individuals who may benefit from further sleep-related evaluation and health management.