大学生考试周与非考试周睡眠行为差异及其与学业成绩的关系OA

Objective To investigate the association between sleep behaviors(including bedtime,sleep quality,and nap duration)and academic performance among college students,as well as the regulatory effect of test anxiety and ex-ercise habit on the association between sleep and academic performance.Methods A questionnaire survey was con-ducted to collect data.The grade of compulsory courses(with higher grades indicating better academic performance)was used as an ordinal dependent variable.All independent variables were coded by levels:for bedtime during exam and non-exam periods,higher levels indicated later bedtimes;for anxiety during the exam period,higher levels indicated more se-vere anxiety;for sleep quality during both exam and non-exam periods,higher levels indicated better sleep quality;for nap duration,higher levels indicated longer naps.Exercise habit was treated as a binary variable(yes/no).Ordinal logis-tic regression(proportional odds model)was used for multivariable analysis,and OR and 95%CIwere calculated.In addi-tion,sex-stratified models were established to investigate sex differences in the associations between these factors and aca-demic performance.Results A total of 1 221 college students were included,among whom male students accounted for 33.7%.After controlling for confounding factors,bedtime during the exam period was significantly positively associated with the grade of compulsory courses,indicating that later bedtime was associated with a greater likelihood of achieving a higher grade(OR=1.32,95%CI 1.08 ‒ 1.62,P=0.007).Sex was also an independent predictive factor,and the OR of achieving a higher grade in female students was 2.4 times that in male students(OR=2.41,95%CI 1.90‒3.06,P<0.001).Sleep quality during the exam pe-riod(OR=1.18,95%CI 0.99 ‒ 1.42,P=0.070)and exercise habit(OR=1.24,95%CI 0.99 ‒ 1.55,P=0.064)showed marginally significant associations with grade.In contrast,bedtime during the non-exam period,nap duration,anxiety during the exam period,and self-rated sleep quality during the non-exam period showed no statistical significance(all P>0.05).Sex-stratified analysis showed that among the male students,later bedtime during the exam period was associated with a greater likelihood of achieving a higher grade(OR=1.48,95%CI 1.05‒2.09,P=0.025),whereas higher anxiety during the exam period was associated with a lower likelihood(OR=0.79,95%CI 0.63‒0.98,P=0.032);among the female students,better sleep quality during the exam period was associated with a greater likelihood of achieving a higher grade(OR=1.27,95%CI 1.02‒1.57,P=0.033),and bedtime during the exam period showed a positive association with academic performance,but without statistical significance(OR=1.25,95%CI 0.96 ‒ 1.62,P=0.091).Conclusion The association be-tween sleep behaviors and academic performance among college students varies with academic period and sex.Later bed-time during the exam period is associated with better academic performance,but this effect is observed only among male students.In addition,the academic performance of male students is negatively affected by test anxiety,whereas the aca-demic performance of female students is positively associated with subjective sleep quality.Future interventions aimed at improving academic health should consider sex-specific strategies.