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第五届肥胖症年度研讨会 Fifth Annual Obesity Symposium
睡眠 压力和肥胖 Sleep, Stress and Obesity
一个沉重的问题 A Weighty Issue
睡眠和肥胖症的流行病学研究 Epidemiology of Sleep and Obesity
美国人口中 Comorbidity with Medical and Mental Disorders
生理失调和精神失调的共病现象 in the U.S. Population
我很荣幸的向大家介绍 So it's my great pleasure to introduce
斯坦福大学的莫里斯欧哈杨 Maurice M. Ohayon from Stanford University
他是斯坦福大学精神病学 He is a psychiatrist in the Department of Psychiatry
和行为科学系的 and Behavioral Sciences
一名精神病学专家 at Stanford University
也是斯坦福流行病研究中心的主任 And he is the Director of Stanford Epidemiologic Research Center
他的学科背景很不寻常 He has an unusual background
他是生物学的博士 He has a PhD in biology
但他也同时获得了数学和计算机科学的博士学位 but he also has doctors in mathematics as well as computer sciences
大约在15年前 And he really joined forces with this sleep community
他开始从事睡眠方面的研究 about 15 years ago
当时他的研究方向着重于 where his research began to focus on epidemiology
普通人群的睡眠和精神失调情况 of sleep and mental disorders in the general population
从我所开展的所有研究来看 And I know from all the research that I do
如果你正在完成国家健康研究所的研究项目 if you are in the mode of writing an NIH grants
你就必须要谈到你的研究意义 and you have to talk about the significance of your research
及其对一般人群产生的影响 and the impact on the population
欧哈杨博士为我们提供了所需的参考数据 Dr. Ohayon has really given us the references that we need
这些数据在对这些问题的研究过程中 the data we need to talk about
非常的重要 the significance of the problem
所以如果你需要一些流行数据 So if you need any prevalence data
像是我需要的关于性别差异的数据 on gender differences like I do
或者年龄差异的数据 or age differences
那么我们都会引用到他的成果 we are always citing his wonderful work
因此他加入睡眠研究学术界 So fortunate for this sleep research community
是我们的荣幸 he has joined us
今天他演讲的主题是 and today he is going to talk about
睡眠和肥胖症的流行病学研究 epidemiology of sleep and obesity
我们真的非常感谢 We really owe a great deal of appreciation to him
他为睡眠研究领域所做出的贡献 for his contributions to sleep research
下面请和我一起欢迎欧哈杨博士 So join me in a warm welcome for Dr. Ohayon
谢谢你的介绍 Thank you very much for this introduction
我将会给大家看一些可能会有趣的数据 I will say that I'm bringing you maybe some interesting data
我是这样希望的 但我们是流行病学家 I hope, but like all the epidemiologists
我们都是乏味的人 we are boring people
因为我们只和数字打交道 because we are coming with a lot of numbers
而我可能是流行病学家中最乏味的 And I'm probably one of the worst
因为我讨厌对数据做出诠释 because I hate to give interpretation of my data
我只看事实 I stay on the fact
可视的就是简单的 Visibility is easy
之所以简单 第一个重要原因是 It's very easy for one big reason
数字非常的... is that the number are so...
我不会提到什么内部消息 so have nothing to disclose
我支持国家健康研究所的决策 I'm supporting...supporter chosen by the NIH
我和别人没有任何的利益冲突 and I have no other conflict of interest
所以我这里的目标是 So my goal here would be
研究肥胖问题 to examine how obesity is related
如何与一般人群的睡眠长度联系起来的 with sleep duration in the general population
我想强调的是"一般人群" I want to underline the fact that is the "general population"
因为这类人群 This is totally different of
与实验室的试验参与者完全不同 what you can have in the clinical population
一般人群肯定包括了"正常人群" The general population is for sure including the "normal population"
这里涉及到了各种情况 但也有局限 And here, it's all the interests, but a sort of limitation
因为这意味着这中间的人有的并没有生病 It means that these people are not sick also
或者所有人都包括在内 or you have all the people
病人和非病人都包括在一般人群中 patients, non-patients, inside of the general population
第二 The second thing is
研究肥胖在精神和生理疾病中的重要性 to examine the importance of obesity in mental and medical disorders
常识总是说 Look, the common sense is saying always that
如果你有精神疾病 那么你会变得肥胖 if you have mental disorder, you can become obese
如果你有生理疾病 and if you have a medical disorder
你的体重肯定会减轻 for sure you can lose weight
但一开始 在疾病刚出现的时候 but you can in the first time, in the first movement
你可能会变得肥胖 have problem of obesity
所以这研究起来会很有意思 So it's interesting to look at that
因此我选取了一个样本 So I have a sample
这个样本实际是一个纵向样本 This sample is in fact a longitudinal sample
数据采集活动从2003年开始一直到今天 that was collected since 2003 until now
我现在给大家展示的 And here I will present
只是最后一批统计的数据 only the result on the last wave we have done
所以是第四批 So that is the fourth wave
这只是横向研究的数据 It's only resulted at that cross-section
为什么只是横向研究的数据呢? Why only these cross-sectional data?
一个重要原因是 For one big reason is that
我很难用口头描述 it is too much complicated
如此复杂的纵向数据 to present longitudinal data orally
我们必须花时间去看 I think that we must have time to look
总之 And anyway
关于肥胖症的数据大得惊人 the data are so spectacular for obesity
确实需要进行纵向分析 that it does need a longitudinal analysis to report
我们的实际样本为2万名成年人 So we have a sample of practically 20,000 adult individuals
参与率为... with participation rate...
我希望大家注意这个数字 I'll try to add attention on
我们的参与率为83.2% that of 83.2% participation rate
作为流行病学家 我认为这个参与率已经"充分" I am an epidemiologist that we say things all full
如果 If you are with...
当你看到一篇文章的 when you see a paper
样本参与率不足60%时 with less than 60% of participation rate
你就不用再读下去了 don't read it
不要浪费你的时间 Don't lose your time
把它扔到垃圾桶里 Put it in the trash
不管它声称自己多么具有原创性 Or so if it is totally original...no meaning
你拿出一枚硬币 You take a piece of money
扔到半空中 you toss it in the air
正面反面的几率各占一半 you have exactly the same result
不要和这样的文章较劲 Don't play with that
我认为在流行病学研究中 I think that it must be a limit
存在一定的拒绝参与率是合理的 of what is acceptable and is not acceptable
但什么比例可以被接受 to have too much refusal rate in the study
什么不能被接受 这是有一个限度的 in the epidemiologic study
我理解 首先局限性是存在的 I understand that the first is a kind of limitation
但你必须知道这点 but you must know that
其次你必须关注 The second thing is that you must look
这个一般性人群是否具有代表性 if what is saying like general population is truly representative
我们的样本选择了美国15个州 很有代表性 You know, it's representative of 15 states in America
所以一共涉及到1.38亿人口 We...so 138 millions
这个数据得到了美国官方审查数据的证实 and this was verified with official censors of America
每个人都是真实的 one by one individual
所以我告诉你们这点很重要 So I am telling you this is probably crucial
年龄从18岁到102岁不等 The age range is between 18 and 102 years
我不打算详细讲解研究方法的问题 I don't go in the details of methodology
你们可以从发表的文章上找到相关信息 You can find it inside of the publication
那么我们收集了哪些信息呢? So what is the information that we are collecting?
我很快的讲一遍 Very quickly
根据DSM-IV-TR和ICSD-2 sleep disorder diagnoses
收集到他们的睡眠失调诊断报告 according to DSM-IV-TR and ICSD-2
根据DSM-IV-TR We were collecting those mental disorder diagnoses
收集到精神疾病的诊断报告 according to the DSM-IV-TR
然后根据ICD-10 And we were collecting the organic diseases
收集到器质性疾病的诊断报告 according to the ICD-10
所有的诊断报告 All the diagnoses
最后 And to finish
我们还根据药品化合物登记册 we were collecting all the psychotropic consumption
收集到了所有的精神病药物的服用情况 according to the roster of pharmacological compounds
然后我们还加上了 And I add that we have all the information
有关他们服用的其他药物的所有信息 on the other medication that we are taking
对于市面上的非处方药的使用情况 Also over-the-counter drugs we are taking into account
我们也予以重视 in all the logistical operations that we see
我们把这些非处方药考虑进来 We were taking into account these over-the-counter drugs
大家知道 and you know that
这些药物会对整体体重产生巨大的影响 they have a big influence on the overall weight
那么肥胖的流行情况如何呢 So prevalence of obesity
在讲解研究结论之前 Let me explain you
我先做一些说明 before to go with a result how I did that
这里显示的是百分比 Here you have the percentage
这里是身体质量指数(BMI) Here you have the BMI
小于18.5 You see inferior to 18.5
18.5到24.9 我认为属于"正常人群" 18.5 to 24.9, I would say "normal population"
25到29.9属于"超重人群" 25 to 29.9, I would say "overweighted"
30以上属于"肥胖人群" And more than 30, I would say "obese"
如果大家同意我的看法 If you agree
那么我接下来给你们看看结果 I'll go with the result here
不同年龄组的肥胖症比例是很重要的数据 You have the age relation that is very important
18到24岁 18 to 24
我不会以10年为分界 I won't go in by 10
我喜欢这么划分 我是数学家 I like that. I'm a mathematician
我喜欢直接区分 I prefer to cut directly wrong
我们讲的是 If you are...
美国15个州 we are speaking the obesity
肥胖的流行情况 in the America in 15 states of America
所以2亿人非常具有代表性 so it's still representative of the 200 million in fact
这是正常人群 This is the normal population
你们看到他们的体重很正常 and you see they have a normal weight
很低 这是正常体重 is very low, so normal weight
各个年龄段肥胖比例都很低 In all the category of age, very low
现在大家坐稳了 Now, sit down tight
BMI指数在18.5到24.9的人群中 Between 18.5-24.9
18到24岁年龄段 you see 43% between
只有43%的人体重正常 18 and 24 of the normal weight
这太糟糕了 It's very bad
18到24岁只有43%的人体重正常 Only 43% when you are between 18 and 24
这就有问题了 we have a problem
我不打算对此进行解释 I will not interpret that
我说我们出问题了 I would say we have a problem
过了一般年龄 After the usual age
65岁以上的人当中 you see you have still 30% of the people more than 65
体重正常的人仍然有30% that are of normal weight
25%的人体重正常 You have 25%
但这意味着其他人的体重都不正常 but it means that all the rest is not within normal weight
我现在给大家讲讲详细信息 So I look now more in detail
我告诉大家我们的体重出问题了 We have a problem, I told you
而且还不是小问题 and it is not a little problem
超重的问题 The problem here for the overweight
这些是超重人群 This is overweight people
大家可以看到 18到24岁之间 and you see, ok, for 18-24
超重人数不多 但还是有35% not so many but still 35%
我的天 这个比例太高了 My gosh, it is a big number
35岁到44岁为42% 42% here, 35-44
所以人到了中年后 So people in the middle age
他们就会出现超重 they are with this kind of weight, overweighted
在欧洲 you know that in Europe
BMI指数达到27就算肥胖了 27, you are considered like obese
所以这个比例是很大的 So it's very big
最糟糕的是下面 And now the worst is there
肥胖人群 The obese people
这个比例真的很高 and you see it's something overwhelming
不光老年人的肥胖比例高 not for the people that are old
我不关心老年人的体重 I don't care
这样说很我很抱歉 Excuse me to say that
我也是老年人 我不关心他们 I'm old, so...I don't take care of them
我关心的是这个 18到24岁年龄组 But this one, 18 to 24
比例令人震惊 this is compelling
他们的未来在哪里? What is their future?
我们必须做点什么 We must do something
这里 大家看到了一些可怕的数字 And here, you see the awesome number
我说这是正常现象 I would say that it is normal
随着年龄的增长 人们的体重会增加 With age, we take weight
我们都知道这一点 We know that
我们为了减肥而奋斗 We fight
在加州 In California
人们为了减肥而在大街上跑步 they are all running in the streets to avoid that
好极了 我双手赞成 Perfect. I applause with my two hands
那么肥胖症的流行比例如何呢? Now, what is the prevalence?
仅仅对我们所看到的进行一个总结 Only to do a summary of what we saw
三分之一的美国人属于肥胖人群 Nearly 1/3 of the American population is obese
其实是28.5% 28.5% is only a fact
数据要精确 Keep it exact
45到64岁人群中肥胖的比例最高 The peak at age 45 to 64
我们已经知道这些了 no, that we were knowing
但我们不知道三分之一的人属于肥胖人群 but we were not knowing that 1/3 were obese
三分之一的人超重 More than 1/3 is overweighted
在我的国家 也就是美国 In my country that is America
超过三分之一的人... plus 1/3 is doing...
三分之二的人要么超重 要么肥胖 2/3 are overweight or obese
人数太多了 太多了 Too much. Too much
每个人都在说这个问题 So everyone was saying
而且我们最近几年都看见了 and I saw that in the past years
哈 这个问题太严重了 Ha, big problem
然后是睡眠时间与肥胖 Sleep duration and obesity
我要证明这个问题 So I want to verify that
看看我们是如何做到 What I did
纵轴显示的是睡眠小时数 Here I put the hours of sleep
横轴显示的是年龄组 here I put the age group
而这里 Here you have...
绿色的表示正常体重 in green you will have sort of normal weight
然后是超重 Overweight
肥胖用红色表示 and obese in red
橙色是超重 in the orange overweight
我们开始 So we go
首先 First of one
首先 这让睡眠专家们大吃一惊 First, something astound in the field of the sleep specialists
但我发表这篇文章已经有10年了 but that is practically 10 years I published on that
研究显示 我们的睡眠时间不是8小时 it's not 8 hours that we are sleeping
是错的 我们睡了7小时 It's wrong. It's 7 hours
我将8小时睡眠理论称为"传说" From where I'm calling this legend, 8 hours
是的 我们都需要8小时睡眠 Yes, we want all to sleep 8 hours
你试一试在一个星期里每天睡9个小时 Try to sleep 9 hours per night during one week
然后再来找我 and come to see me
这样我就会很看重你 because I must regard you
第二件事是 如果人们的体重增加一些 The second thing is now if I put some body of our weight
我们的人群增加一些体重 my population of their weight
大家看到 其实变化并不是很大 You see, it's not so much variation, not so much
在这个年龄段是重合的 Here, yes, for the age
但你们看到 but you see
超重人群的变化趋势和正常人群一样 it is the same variation that in normal one
下面是肥胖人群 Now the obese
但让人吃惊的不是这里 but surprise is not here
而是这个年龄段 it is here and here
年轻人的睡眠时间很短 It's low for the young people
而且只有年轻人短 and only for them
其他年龄组的人群都不短 not for the rest of the population
事实上 给我一些解释 Again, in the fact, give me the explanation
你们给我解释 I will leave you that
所以 我们得出了什么结论? So, what we can see?
总体上来说 肥胖人群的睡眠时间 Overall, obese individuals have shorter sleep duration
低于体重正常的人群 than those with normal weight
只在45岁以下人群中 The difference in sleep duration
睡眠时间显示出显著差异 is significant only in individuals younger than 45 years
记住这点 一会儿我还会回来 Keep that, I will come back in one moment
我刚才说了 我选择的是一般人群 Now I was saying, I am with the general population
也许我还应该看看这些人的健康状况 Maybe, I must look at the health status of these people
决定人们健康状况的是 The health status of the people is determined
你的生理状况和精神状况 by your medical condition and your psychiatry condition
因为从心理学角度来说 because for sure, psychologically
如果你心理失常 if you are disturbed
你的体重就会增加 you can have an issue of weight
所以我想看看是不是这么回事 So I want to see that
这里显示的是百分比 I put here, the percentage
而这里我也对年龄进行了分组 Here I put the category
18到24岁 健康的人群 18 to 24, they are healthy people
健康人群 他们没有任何生理问题 Healthy people, they have no medical condition
或精神失常 完全没有 no mental disorder, zero
我也没看出 Nor I see
他们存在生理疾病或精神疾病 they have a medical condition or a mental and/or a mental disorder
然后我对每个年龄组进行了测试 And I did that for each category
还是10年为一个阶段 Again, 10 by 10
首先来看18到24岁年龄组 So I look at the first 18 to 24
你们得跟着我一起这样做 and here you must do something like me
这样更便于理解 like that we understand more quickly
38%加20% 38 plus 20
也就是超重人群的比例加上肥胖人群比例 overweight plus obese
好吗 记住了吗? Ok? Remember
超重加肥胖 Overweight, obese
这样就是58% We have 58
然后和非健康人群进行比较 I will compare now when they are not healthy
差别不大 56% 并不是很显著 Not a big variation, 56, not significant
然后再来看42%和25%的超重和肥胖人群 I look now, 42, 25
差别大吗? do we have a big variation?
也不是很大 No, not really
非健康人群超重和肥胖比例为65% 65, 65, ok
健康人群为67% 差别也不大 with 67, not so big
而且也不显著 and it's not significant anyway
35到44岁年龄组 35-44 of age
我做一个比较 I compare
健康人群中超重比例为46% 肥胖26% So 46, 26 for the healthy
而非健康人群分别为38%和31% 38, 31, a variation
差别也不大 不显著 but no so big, not significant
下面看看45到54岁年龄组 Now, 45-54
健康人群中超重和肥胖比例分别为42%和27% 42, 27
非健康人群分别为36%和37% and 36, 37
大家可以看到生理状况和精神失调 You see the medical condition
开始影响体重了 mental disorder are playing
下面我很快的讲一下其他年龄组的情况 Now I can look more quickly for the other category of age
遗憾的是 随着年龄的增长 With age unfortunately
人们患生理疾病和精神疾病的可能性 you have more chance to be with a medical condition
变得越来越大 or with a psychiatry condition
大家可以看到 And you see
健康和非健康人群的体重差异 the bigger the difference is
65岁时达到最高 when you are more than 65
我由此得出了什么结论呢? So what I will say about that?
患有生理或精神疾病的人 That individuals with medical/mental disorders
比健康人群更容易肥胖 are more often obese than these healthy individuals
这种差异在35岁及以上的参与者身上显现出来 difference seen in participants 35 years or older
健康人群比患有生理或精神疾病的人 Healthy individuals are significantly more often overweight
更容易超重 than those with medical/mental disorders
我讲完了简单的部分 Ok, with that, I have finished with the easy part
现在我们来看看维恩图告诉我们些什么 Now I want to look with the Diagram of Venn
我喜欢维恩图 I like Diagram of Venn
因为它能够给我们解题的钥匙 It's giving you the key
而且非常的直观 and it is very visual
这里我做了个奇妙的设计 Here I did something curious
由于一般来讲 I took all, because all what...generally speaking
这是能力比例 is the ratio of ability
睡眠不足的人 People that are deprived
存在失眠 疼痛和肥胖的情况 have a problem with insomnia, pain and obesity
那么被诊断为抑郁的人群 How in the population of people with diagnosis of depression
如何看待他们的重度抑郁症呢 measure of the perceived disorder, MDD
应该如何描述这些人的状况呢 How these people can be described
我很简单的讲一讲 so very quickly
对于慢性疼痛来说 we have that, and that for chronic pain
在参与调查的人中占到63.7% you have inside of the family the 63.7%
8年前 或者更早 9年前 8 years ago, or add a little more, 9 years ago
我们和肖斯伯尔共同发表了第一篇论文 with Shallsbral, we were publishing the first paper
证明重度抑郁症和慢性疼痛之间存在联系 showing the link between MDD and chronic pain
相信我 两者完全重合的 完全重合 And believe me, it's totally overlapping, totally
所以63%的比例并不令人吃惊 So 63.7% is not a surprise
失眠症状和重度抑郁症的联系也很大 Insomnia symptoms and MDD is very very more
为62.1% 62.1%
与肥胖的联系 37.9% And obesity, 37.9
那么它们的重合情况呢? now how they are overlapping?
你们还记得维恩图的原理吗 You remember that for the Diagram of Venn
它并不显示出数值的比例 nothing is proportional in their figure
你们看到24.3%发生了重合 You see 24.3
这并非完全是比例百分比 this is not sheer face that is proportional to the percentage
所以你会看到非常有趣的结论 So you have something very interesting
这是失眠 It is that insomnia
你们可以看到 和慢性疼痛的重合比例为24.2% as you see, has 24.2% sharing with chronic pain
但和肥胖的重合比例只有8.5% but only 8.5% with obesity
任何一个方向去看都是这样的 And it is true in the two directions
肥胖人群的失眠情况 If you are obese with insomnia
零 Zero
8.5%不是零 8.5 is not 0
这一点很重要 It's important
但和你想象的数字是不一样的 but not so...not the number that you can expect
而失眠人群肥胖的比例为8.5% And insomnia in the direction of obesity, 8.5
那么我们得出了什么结论呢? so what we can say about that?
重度抑郁症患者的肥胖比例要高出1.5倍 Obesity rate in MDD is 1.5 times higher
在没有失眠或疼痛的情况下 is present in 4% of MDD
4%的重度抑郁症患者属于肥胖人群 in the absence of insomnia or pain
重度抑郁症患者中只有8.4%的肥胖人群 is associated with pain
会出现疼痛 only in 8.4% of MDD
这一点非常重要 That is something very important
因为这一关系和我们实验室得到的结果不同 because it is not going in the direction of what we have clinic
也就是在睡眠实验室的结果不同 in the clinic of sleep
我们知道存在这样的差别 we have noted that existing like that
但毫无疑问 我们的试验是有偏倚的 But for sure, that we have a bias
因为试验参与者到实验室接受试验 because if they come into the sleep clinic for one big reason
一个大的原因是他们的睡眠存在问题 is it because they have a problem of sleep
存在健康问题的人群中 associated with both pain and insomnia
17%的人既有疼痛又有失眠情况 in 17% of much of the perceived disorders
但你会说 But you would say
好吧 失眠的症状 ok, so insomnia symptoms
3个月以上 每周有3晚睡不着觉 3 nights per week for more than 3 months
现在这个已经被加入了DSM-V now it would be inside of the DSM-V
这种情况在重度抑郁症患者中间很常见 are highly prevalent in MDD
比例高达62.1% 62.1%
而且这些患者都没有疼痛或肥胖的情况 and this is occurring in the absence of pain and obesity
重度抑郁症患者中有24.3%的人存在慢性疼痛 and are associated with chronic pain in 24.3% of MDD
所谓慢性疼痛 Chronic pain, you see
指的是3个月以上每周疼痛3天以上的时间 more than 3 days per week for more than 3 months
这种情况在重度抑郁症患者中间也很常见 is also highly prevalent in MDD
我把这个提出来 I put that to show you
说明这些都是非常严重的症状 that I was taking only these serious symptoms
不是那种只在和医生交谈时 not something that was only symptomatic
才出现的症状 at the moment of the interview
没有失眠和肥胖的重度抑郁症患者中 And occur in the absence of insomnia and obesity
14%的人患有慢性疼痛 in 14% of MDD
还记得吗 正常情况只有8.5% Remember, 8.5% in the usual case
你可以说可能是嗜睡 Now you can say, maybe somnolence
我在这里可能出错了 I did a mistake
我觉得不是失眠 而是嗜睡 I don't think that is insomnia. It's somnolence
所以我又选择了908名重度抑郁症患者 So I took my people that are in the MDD that 908
看了他们的困倦状况 and I looked at somnolence
慢性疼痛是一样的 So chronic pain is a the same
肥胖 Obesity
这次 这里是嗜睡 And this time, here, we have somnolence
然后我们研究了三者的互动关系 And we look at their interactions
似乎这个比例没有达到8.5% and look it shows that it's less than 8.5%
但仍然有6% but still is 6% there
所以嗜睡实际发挥的影响 So somnolence is playing practically
与失眠是一个水平的 at the same level that insomnia
这是个有趣的地方 And that is also very interesting
我希望你们自己找到解释方法 I leave you for the interpretation
困倦症状 Somnolence symptoms
也就是睡眠过度 so excessive amount of sleep
我告诉大家我是如何计算嗜睡 I am telling you how I was taking somnolence
睡眠量以及过度困倦的比例的 the amount of sleep, excessive sleepiness
重度抑郁症患者中间 are highly prevalent
这种情况的比例高达49.9% in MDD for 49.9%
这里我稍微讲快一点 So I will go faster there
三角关系 The triple association
14%的抑郁症患者存在嗜睡 疼痛和肥胖的情况 somnolence, pain and obesity was found in 14% of the cases
现在你可以说 不光是抑郁症 Now you can say, ok, not only the depression
焦虑症患者是什么情况呢 I want anxiety
我们的焦虑症患者样本人数更多 So with anxiety, we have more people
我这里的"N"为4272人 4272 is my "N"
焦虑的发病率为26.8% so the prevalence is 26.8%
那么焦虑如何与失眠 疼痛和肥胖发生关系的呢? how this is interacting with insomnia, pain and obesity?
完全一样 So is it exactly the same thing
大家可以看到 焦虑症患者中 and you see insomnia, obesity here
只有3.9%的人存在失眠和肥胖 in this population of anxiety disorder, only 3.9%
所以压力本身是否造成失眠和肥胖 so the stress by itself
你还需要打一个问号 You can put a question mark
可能有其他的解释方法 Maybe it's other interpretation there that we can have
所以在没有失眠和疼痛的病例中 So it's present in 10.1% of anxiety
焦虑患者的肥胖率为10.1% in the absence of insomnia or pain
大家可以看到 You see that
焦虑患者中只有7.4%的人有疼痛症状 Associated with pain only in 7.4% of anxiety
9%的焦虑症患者同时存在疼痛和失眠情况 and associated with both pain and insomnia in 9% of anxiety
所以这个结果实际上是相同的 So this is practically the same
我评估的依据是症状 I was looking by symptoms
我可以告诉大家 and I can tell you
这些是关于慢性疼痛的可靠结果 this is the solid results also for the chronic pain
大家看到慢性疼痛的发病率为49.5% And you see the chronic pain has a prevalence of 49.5%
从纵向统计数据来看 and in the longitudinal data that we have
我们发现焦虑和睡眠失调 we see that the this anxiety and the sleep disorder
都是慢性疼痛的结果 are all consequences of this chronic pain
而睡眠失调并非肥胖的结果 and not...the sleep is not the consequence for obesity
因此总体上来说 So generally speaking
当我们研究肥胖问题时 when you look at obesity
我们必须考虑到疼痛 you must always look to pain
否则你将忽略一个重大的容易混淆的因素 or you miss a big factor, confounding factor
嗜睡也一样 The same for somnolence
慢性疼痛患者中 Chronic pain, 21
嗜睡比例为21% you see, somnolence
然后再看看它们的重合情况 And when we look at the interaction
大家可以看到是2.9% you see, 2.9
所以这个比例基本上是一样的 so it's practically the same range
有趣的是 在两种疾病中 So what is very interesting is that in the two cases
焦虑和抑郁 for anxiety disorder and for depression disorder
都会影响到睡眠 we have an influence on some sleep
但失眠和嗜睡的几率是一样高的 but it's equal between insomnia and excessive somnolence
我对这两者采用了完全相同的分析方法 I did exactly the same kind of analysis
这并不重要 It's not important
下面讲最后一个问题 I am coming on the last point that I want to do
生理疾病 So medical conditions
因为问题不仅在于精神疾病 Because the question could be, it's not only a psychiatry condition
不光是睡眠的问题 only the condition of sleep
还可能是生理疾病 it could be a medical condition
那么生理疾病 So with medical condition
如何影响了失眠 疼痛和肥胖呢 how this is going insomnia, pain and obesity
我告诉大家 我对分析结果感到很吃惊 And here I can tell you I was very surprised
因为相互影响的程度是一样的 We are again in the same range
肥胖和睡眠的影响仍然继续 So the story of obesity and sleep is working
但睡眠失调 失眠或嗜睡之间 but the direction of the sleep disorder, insomnia or somnolence
相互影响的趋势是相同的 is equal between...
这是事实 that is the fact
这意味着什么 Now what it means
为什么会得出这样的结论 and why we have this kind of thing
我对此做了一些宏观分析 I have some micro analysis
我后面会讲到 but I will discuss that later
患有生理疾病的病人的肥胖率 So again, obesity rate in medical conditions is
是其他没有生理疾病的参与者的1.5倍 1.6 times higher than among participants without medical conditions
我们发现这是事实 And so we find exactly
因此你看到失眠的发生率为36.5% So the prevalence you see of insomnia symptoms is 36.5%
这里还有一点... here also it is something that when you do...
当你对自己的数据进行分析时 it means that when you do some analysis in your own data
或者对实验室数据进行分析时 or so for the clinical data
你必须考虑到这个问题 you must take that in account
生理疾病在我们的样本人群中 The medical conditions
成为了主要的影响因素 are playing fully inside of your samples
而嗜睡情况也完全一样 Somnolence, we have exactly the same results
下面我很快的总结一下 So I'll go very fast
肥胖和嗜睡的重合率为4.6% You see, 4.6% in the overlapping between obesity and somnolence
基本上和失眠的重合率一致 Exactly the same
下面是我的总结 We have...so I am at my conclusion
对不起 我讲得太多了 Sorry to be long
参与测试的人当中 Shorter sleep duration is associated with obesity
只有年轻人的睡眠长短与肥胖有关 only among the younger participants
这是我们对样本人群进行了研究的结论 That is what we've found inside of our sample
参与测试的人当中 The presence of a medical and/or a mental disorder
又只有年轻人的生理和/或精神疾病 is associated with a shorter sleep duration
与睡眠长短有关 again only among the younger participants
肥胖会增加患抑郁和生理疾病的可能性 Obesity increases the likelihood of depression and medical conditions
但却不会导致焦虑症的增加 but not anxiety disorders
这是一个很新的发现 And that also is very new
最后 And finally
对于患有生理和/或心理疾病的患者来说 in medical and/or mental disorders
肥胖常常与失眠 obesity is most often associated with insomnia
极度嗜睡和慢性疼痛有关 hypersomnolence and chronic pain
谢谢大家 Thank you very much