Objective: To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality. Method: Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children's personal and family information was obtained by Shanghai Children's Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children's sleep duration and quality were analyzed by multivariate analysis of variance. Result: The children's average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night' than those who 'never' had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01). Conclusion: The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.
目的： 了解我国婴幼儿就寝习惯现状，并探索其与睡眠时间及质量的剂量依赖关系。 方法： 采用多中心横断面研究，于2012至2013年按照"省→市→县→医院"的抽样技术路线，抽取全国8个省市0～35月龄足月、健康婴幼儿作为研究对象。通过家长填写"简明婴儿睡眠问卷"评估婴幼儿睡眠情况；同时家长完成"儿童个人及家庭社会环境问卷"了解儿童详细的背景资料。采用多因素方差分析法，分析就寝习惯对婴幼儿睡眠时间及睡眠质量的影响。 结果： 入选1 304名婴幼儿平均(12±10)月龄，其中男689名，占总人数52.8%。48.5%(632/1 304)的家长报告婴幼儿没有形成每晚规律就寝习惯。就寝习惯与夜间睡眠时间及所有睡眠质量相关指标存在显著剂量依赖关系(P均<0.05)。就寝习惯越规律，夜间睡眠时间越长、就寝时间越早、入睡潜伏期越短、夜醒次数越少以及夜醒持续时间越短，如每晚保持规律就寝的婴幼儿夜间睡眠时间明显长于无任何一天规律就寝婴幼儿[9.5(95%CI: 9.4～9.6)比8.9(95%CI: 8.6～9.3)h，t＝3.345, P＝0.001，CI：可信区间]。每晚规律就寝组与每晚从不规律就寝组比较，夜醒次数少[1.3( 95%CI: 1.2～1.4)比2.4 (95%CI: 2.0～2.9)次，t＝3.182, P＝0.001]，且夜醒持续时间也少[16.6(95%CI: 14.6～18.8)比59.2(95%CI: 47.0～72.7)min，t＝6.383, P<0.01]。 结论： 我国婴幼儿规律就寝习惯比例较低。规律就寝习惯与婴幼儿良好的睡眠结果尤其是睡眠质量密切相关，并存在剂量依赖关系。就寝习惯越规律，婴幼儿睡眠质量越好。.
Keywords: Bedtime routine; Child; Infant; Sleep.