| Objective:To explore the status quo of insomnia,Sedentary Behavior(SEB)and Physical Activity(PA)in older women in community,and to deeply study the joint effects of SEB and PA patterns and their dose-effect relationship with insomnia.An isochronous substitution model was used to explore the association between absolute time redistribution of SEB,LPA,MVPA and insomnia status.At the same time,the optimal cut-off value of SEB and PA to distinguish insomnia from non-insomnia was discussed,which laid a foundation for preventing and improving insomnia in older women in community,and provided a theoretical basis for the development of physical activity guidelines for older women in community and the realization of healthy aging.Methods:A cross-sectional study was used.1370 older women in Yantai were randomly selected to carry out the investigation.Questionnaires were collected face-to-face.The questionnaire consisted of three parts:general data questionnaire,Athens Insomnia Scale and Mini-mental State Examination.Objective PA and SEB data were measured using an Actigraph wGT3X-BT accelerometer.ActiLife software was used to input data,and StataMP14(64-bit)software was used for statistical analysis.Descriptive analysis was performed for general demographic characteristics,insomnia,sedentary behavior,and physical activity status of the subjects,with mean± standard deviation(SD)for continuous variables and frequency(percentage)for categorical variables.Continuous variables were evaluated by Chi-square test,and multicategory variables were analyzed by Jonckheere-Terpstra trend Chi-square test.The Fisher Exact test is used to test the theoretical frequency T<5.The theoretical frequency T>5 was analyzed by Chi-square test.Spearman correlation coefficient method was used for correlation analysis,and Logistic regression analysis was used for multivariate analysis.ROC analysis was performed using MedCAL 19.1 to explore the optimal time cutoff values of SEB and PA in insomnia.The association between absolute time redistribution of SEB,LPA,MVPA and insomnia was studied using the Isotemporal Substitution Model(ISM).Results:1.1126 older community women(64.9±2.8 years old)were included in the survey,10.5%of whom had insomnia and 89.5%of whom had no insomnia.Single factor analysis of insomnia in older women in community showed that there were no significant differences in age,BMI,monthly income and other demographic variables in insomnia(P>0.05).Compared with non-insomnia group,total sitting time,l0min-Bouted SEB(single sitting session≥10 minutes)and 30min-Bouted SEB(single sitting session≥30 minutes)were significantly higher in insomnia group(P<0.05).The levels of total LPA,Bouted LPA(A single LPA≥10 minutes),and Sporadic MVPA(a single MVPA<10 minutes)were significantly lower(P<0.05).2.Spearman correlation analysis showed that sedentary behavior patterns(total sedentary time,10min-Bouted SEB,30min-Bouted SEB)were positively correlated with insomnia scores(P<0.05).In the physical activity,total LPA time,Bouted LPA,Sporadic MVPA,and number of steps were negatively correlated with insomnia score(P<0.05).3.Logistic regression analysis showed that in model 2,sedentary behavior patterns(total sedentary time,10min-Bouted SEB,30min-Bouted SEB)were significantly positively correlated with insomnia after MVPA adjustment(P<0.05).Their OR values were 1.27(1.06-1.53),1.21(1.05-1.38)and 1.21(1.04-1.40),respectively.The adjusted OR value of Sporadic LPA(A single<10-minute LPA)was 0.89(0.81-0.97)after joining the total MVPA.The adjusted OR value of Bouted LPA was 0.91(0.84-0.99)after joining the total MVPA,and 0.88(0.81-0.97)after joining the Sporadic LPA.The correlation of other physical activity patterns disappeared after adjustment(P>0.05).4.The combined effect of SEB and PA was analyzed by three-by-three classification.Logistic regression analysis showed that,compared with high MVPA and low MVPA,only the combination of high MVPA and low MVPA had significant correlation with insomnia(P<0.05),and only high MVPA could offset the effect of high sedentary.5.In the isochronous replacement model,there was a significant negative correlation between 30 minutes of SEB replaced by 30 minutes of LPA per day and insomnia(P<0.05).There was also a significant positive correlation between 30 minutes of LPA and 30 minutes of SEB per day(P<0.01).There was no significant correlation between replacing 30 min SEB with 30 min DAILY MVPA or 30 min LPA(P>0.05).In addition,there was no correlation when 30 minutes of MVPA was replaced by 30 minutes of SEB or LPA per day(P>0.05).6.The optimal truncation values of total sedentary time,10min-Bouted SEB and 30min-Bouted SEB were 536.2 min/day,314.1 min/day and 162.9 min/day,respectively.The optimal total LPA time and Bouted LPA cutoff values for distinguishing insomnia from non-insomnia were 353.2 minutes/day and 234.3 minutes/day,respectively.Conclusion:1.There was a significant positive correlation between sedentary behavior pattern and insomnia in older women in community.The longer the total sedentary time,the higher the insomnia level.The longer the single sedentary time,especially the longer the sedentary time lasting more than 30 minutes,the higher the insomnia level,the optimal truncation value of sedentary time lasting more than 10 minutes was 314.1 min/day,and the optimal truncation value of sedentary time lasting more than 30 minutes was 162.9 min/day.2.Among physical activity,only total LPA and Bouted LPA were associated with decreased insomnia levels,and active participation in LPA for more than 10 minutes was beneficial to improve insomnia.LPA of 353 minutes per day was associated with improved insomnia,with an optimal truncation value of LPA with a single duration of more than 10 minutes was 234.3 minutes/day.3.High levels of MVP A in older women can offset the effects of high sedentary insomnia.4.Replacing SEB with 30 minutes of daily LPA was effective in improving insomnia.Replacing LPA with 30 minutes of daily SEB was associated with increased levels of insomnia. |
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