问题库/身体与体检
常年上夜班、白天睡不好,怎么补
先算自己上了几年夜班,按每5年一档:上夜班的人心血管病比不上夜班的多约13%、心血管死亡多约27%,每多上5年心血管病再多约7%,能转岗就趁早。同时把血压、体重、吸烟这几项列出来先改能改的,把充电器挪出卧室、手机放客厅,给最容易刷的两个应用设时长上限,定一个上床点。
这里不保证什么
夜班致癌的证据软得多,干满20年那一档在影响分析后就不显著了;连续几个月睡不好别靠保健品,去做失眠的认知行为治疗。
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上夜班干得越久心血管风险越高,能转岗就趁早转
上夜班的人,心血管病比不上夜班的人多约 13%,心血管死亡多约 27%。而且干得越久越多:每多上 5 年夜班,心血管病再多约 7%。所以这笔账按年数算,能转岗就趁早。
- 算清自己上了几年夜班,按每 5 年一档算风险增量
- 同时把血压、体重、吸烟这几项列出来,先改能改的
- 看内部有没有白班岗位,问清转岗的薪资和期限再决定
坑这条按心血管算账,不按癌症:夜班致癌的证据软得多,干满 20 年那一档在影响分析后就不显著了。
成本:转岗或换工作可能少拿钱,夜班津贴也没了。找工作要花时间,下决心也难。如果是挑工作的时候把这笔账算进去,成本是零。第 2 节 · 不要慢慢死
出处
Xi J, Ma W, Tao Y, 等 (2025). Association between night shift work and cardiovascular disease: a systematic review and dose-response meta-analysis. Frontiers in Public Health. <https://doi.org/10.3389/fpubh.2025.1668848>;Esposito G, Bravi F, Santucci C, 等 (2025). Night shift work and breast cancer risk in healthcare workers: a systematic review and meta-analysis. Occupational Medicine. <https://doi.org/10.1093/occmed/kqaf040>;Shen QM, Li ZY, Tan YT, 等 (2026). Night shift work and risk of total and site-specific cancer: results from a prospective cohort study among Chinese men. Scandinavian Journal of Work, Environment & Health. <https://doi.org/10.5271/sjweh.4290>;Czeisler CA, Johnson MP, Duffy JF, 等 (1990). Exposure to bright light and darkness to treat physiologic maladaptation to night work. New England Journal of Medicine, 322(18), 1253-1259. <https://doi.org/10.1056/NEJM199005033221801>;Eastman CI, Stewart KT, Mahoney MP, Liu L, Fogg LF (1994). Dark goggles and bright light improve circadian rhythm adaptation to night-shift work. Sleep, 17(6), 535-543:「Both bright light and goggles were significant factors for producing circadian rhythm phase shifts. The combination of bright light plus goggles was the most effective」「Goggles were necessary for producing phase delays」. <https://doi.org/10.1093/sleep/17.6.535>;Crowley SJ, Lee C, Tseng CY, Fogg LF, Eastman CI (2003). Combinations of bright light, scheduled dark, sunglasses, and melatonin to facilitate circadian entrainment to night shift work. Journal of Biological Rhythms, 18(6), 513-523:「With bright light during the night shift, almost all of the earlier participants achieved complete re-entrainment, and the phase delay shift was so large that darker sunglasses and melatonin could not increase its magnitude」. <https://doi.org/10.1177/0748730403258422>
到点就睡,不为游戏、短视频、色情内容熬夜
2025 年中国人夜里平均睡 6.97 小时,平均 0:10 才入睡。在孩子和青少年里,睡前用手机、平板的人,睡不够的概率是两倍多,白天犯困的概率是 2.7 倍。设备只是放在卧室里不用,数字也差不多。所以最省事的办法是手机不进卧室。
- 把充电器挪出卧室,手机睡前放到客厅,闹钟另买一个
- 给最容易刷的两个应用设每天时长上限,到点自动锁
- 定一个上床点,到点关灯;想再看一集时先起身喝口水
坑这一条有争议:色情内容对精力的影响没有可靠证据说得清,这里只管它挤占睡眠时间这一点。
成本:不花钱。难在长期对抗「再看一集」的惯性。手机不进卧室最省力。第 3 节 · 不要浪费精力
出处
Carter et al. (2016). Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes. JAMA Pediatrics. <https://doi.org/10.1001/jamapediatrics.2016.2341>;Exelmans & Van den Bulck (2016). Bedtime mobile phone use and sleep in adults. Social Science & Medicine. <https://doi.org/10.1016/j.socscimed.2015.11.037>;中国睡眠研究会 (2026). 2026 中国睡眠健康研究白皮书(福建省卫健委转载健康报报道). <https://wjw.fujian.gov.cn/jggk/csxx/xcc/mtbd/202603/t20260323_7114382.htm>;Grubbs JB 等 (2018). Pornography Problems Due to Moral Incongruence: An Integrative Model with a Systematic Review and Meta-Analysis. Archives of Sexual Behavior. <https://doi.org/10.1007/s10508-018-1248-x>(备注里的争议方之一);Prause N, Pfaus J (2015). Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction. Sexual Medicine. <https://doi.org/10.1002/sm2.58>(备注里的争议方之二)
长期失眠(一周三晚以上、拖了三个月以上)先做失眠的认知行为治疗,别一上来就长期吃安眠药
做完这套治疗,入睡平均快约 19 分钟,半夜醒着的时间少约 26 分钟。效果会慢慢变弱,但 12 个月后还在。网上的自助课程和当面做的效果差不多。安眠药对 60 岁以上的人帮助小,每 6 人吃药就有 1 人出副作用,每 13 人才有 1 人睡好。
- 先自己试刺激控制:困了才上床,躺一阵睡不着就起来
- 床只用来睡觉,每天同一时间起床,白天不打盹
- 按 6 到 8 周去睡眠门诊或网上的自助课程做完一整套
坑睡眠限制那一步要把躺床时间压短,头几周白天会更困,开车和操作机器的人要慎用,最好在医生跟进下做。
成本:去医院的睡眠门诊、精神科或心理科做,要花挂号费和治疗费。网上的自助课程便宜得多。一个疗程一般 6 到 8 周,每天要记睡眠日记。自己就能先做的是刺激控制:困了才上床,躺着睡不着就起床。床只用来睡觉和性生活,每天同一时间起床,白天不打盹。难在睡眠限制那一步:头几周要把躺床时间压短,白天会更困。第 3 节 · 不要浪费精力
出处
国家卫生健康委办公厅 (2020). 关于印发精神障碍诊疗规范(2020 年版)的通知(国卫办医函〔2020〕945 号),附件第十二章第二节「失眠障碍」. <https://www.nhc.gov.cn/yzygj/c100068/202012/b4305ace9e14440792eb76d29602c88a.shtml>;Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD; Clinical Guidelines Committee of the American College of Physicians (2016). Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 165(2):125-133. <https://doi.org/10.7326/M15-2175>;Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D (2015). Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 163(3):191-204. <https://doi.org/10.7326/M14-2841>;van der Zweerde T, Bisdounis L, Kyle SD, Lancee J, van Straten A (2019). Cognitive behavioral therapy for insomnia: A meta-analysis of long-term effects in controlled studies. Sleep Medicine Reviews, 48:101208. <https://doi.org/10.1016/j.smrv.2019.08.002>;Zachariae R, Lyby MS, Ritterband LM, O'Toole MS (2016). Efficacy of internet-delivered cognitive-behavioral therapy for insomnia - A systematic review and meta-analysis of randomized controlled trials. Sleep Medicine Reviews, 30:1-10. <https://doi.org/10.1016/j.smrv.2015.10.004>;Espie CA, Emsley R, Kyle SD, 等 (2019). Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial. JAMA Psychiatry, 76(1):21-30. <https://doi.org/10.1001/jamapsychiatry.2018.2745>;Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE (2005). Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ, 331(7526):1169. <https://doi.org/10.1136/bmj.38623.768588.47>;Edinger JD, Arnedt JT, Bertisch SM, 等 (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2):255-262. <https://doi.org/10.5664/jcsm.8986>
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