- 學位論文
學齡期兒童睡眠型態與過重及肥胖之相關性研究
The Relationship between Sleep Patterns and Adiposity in School-Age Children
摘要
近幾十年來兒童過重及肥胖的盛行率大幅增加，睡眠時數逐漸減少且睡眠型態改變，關於過重肥胖兒童與睡眠時數、就寢時間的關係，許多研究已證實較晚的就寢時間與較少的睡眠時數會使體重增加，但睡眠品質與過重及肥胖間的研究結論並不一致，因此本研究探討學齡期兒童睡眠型態與過重及肥胖間之關係與相關因素，研究目的：(一)描述過重及肥胖學齡期兒童之睡眠型態；(二)分析學齡期兒童睡眠型態與過重及肥胖程度之關係；(三)分析睡眠問題與過重及肥胖程度間關係；(四)探討學齡期兒童睡眠型態影響過重及肥胖程度之相關因素。本橫斷式研究於台北市及新北市調查6-9歲過重及肥胖學齡期兒童，共有69位過重及肥胖兒童完成配戴活動紀錄器，其主要照顧者及父母運用行動裝置上的應用程式與網頁完成基本資料表、兒童睡眠習慣問卷(Children`s Sleep Habits Questionnaire, CSHQ)及睡眠日誌。研究結果發現過重及肥胖兒童夜間睡眠時數為7.02±1.05小時，夜間睡眠效率<85%有47人(68.1%)，入睡後清醒時間為59.78±22.49分鐘，CSHQ平均總分為48.09±7.70，顯示有中度的睡眠問題；相關性分析發現身體質量指數Z-score與較長的夜間睡眠潛伏期、夜間睡眠效率變異性高呈現正相關(r=0.20，p=0.04；r=0.22，p=0.03)，睡眠中有打鼾兒童睡眠時數、睡眠效率與整日睡眠時數較睡眠中無打鼾兒童少(p=0.01；p<0.01；p<0.01)，且入睡後清醒時間較睡眠中無打鼾情形兒童長 (p<0.01)，每日觀看3C產品時間與睡前一小時使用3C產品時間與身體質量指數Z-score呈現正相關(r=0.31，p<0.01；r=0.26，p=0.03)，且觀看3C產品時間亦與體脂率呈正相關(r=0.25，p=0.03)；經多元回歸分析男性、每日觀看3C產品時間、年齡及睡眠效率變異性為身體質量指數Z-score的重要預測因素，解釋量為23.7％(F=6.27，p<0.001)，年齡與每日觀看3C產品時間為體脂率的重要預測因素，解釋量為33.4％(F=18.03，p<0.01)；總結本研究結果學齡期兒童睡眠型態與過重及肥胖具有相關，期望研究結果能增加對學齡期兒童睡眠型態及過重及肥胖認識，以提供未來學齡期兒童睡眠教育、生活型態改變介入措施之參考。
並列摘要
The prevalence of overweight and obesity in children has increased significantly while the sleep duration has decreased and the sleep patterns have changed in recent decades. Many studies have confirmed the relationships between sleep duration, bedtime and overweight and obese children, such as later bedtimes and fewer hours of sleep will put on weight. However, the research conclusions between sleep quality and overweight and obesity are not consistent. This study aimed to examine the association between sleep patterns and related factors of overweight and obesity in school-age children. The research objectives were to: (1) describe sleep patterns in school-age children with overweight and obesity, (2) analyze the correlation between sleep patterns and adiposity in school-age children with overweight and obesity, (3) analyze the correlation between sleep problem and adiposity in school-age children with overweight and obesity, and (4) investigate correlated factors and the extent of the influence of sleep patterns on overweight and obesity in school-age children. Participants for this cross-section study were recruited in Taipei City and New Taipei City, Taiwan, and a total of 69 participants aged 6-9 years with overweight and obesity wore actigraph during the research period. The primary caregivers and parents of these children used mobile devices or web pages to complete the demographic background questionnaire, Children's Sleep Habits Questionnaire (CSHQ) and a sleep diary. The results showed that the hours of sleep of children with overweight and obesity were 7.02±1.05 hours at night, among the participants, 47children (68.1%) had a sleep efficiency of less than 85%. The awake time after sleep was 59.78±22.49 minutes. The average total score of CSHQ was 48.09±7.70 which indicated moderate sleep problems. Correlation analysis found that body mass index z-scores was positively correlated with longer sleep latency and higher sleep efficiency variability (r = 0.20, p = 0.04; r = 0.22, p = 0.03). Sleep duration, sleep efficiency and hours of sleep of children who snored while sleeping were less than those who did not snore (p = 0.01; p < 0.01; p < 0.01), and their awake time after sleep also longer than children without snoring during sleep (p < 0.01). The amount of time spent using electronic entertainment and communication devices per day, as well as using digital devices in the last hour before bedtime, were both positively correlated with body mass index z-scores (r = 0.31, p < 0.01; r = 0.26, p = 0.03). Additionally, daily time spend on digital devices was positively correlated with body fat (r = 0.25, p = 0.03). The multiple regression analysis indicated male, average daily time spent on digital devices, age and variability of sleep efficiency as the most predictive variables to predict body mass index z-scores, F = 6.2, p < 0.001, accounting for 23.7% of the variance. In addition, the analysis result showed age and average daily time spent on digital devices as the strong predictive variables to predict body fat, F = 18.03, p < 0.01, explaining for 33.4% of the variance. Overall, the results of this study showed significant correlations between sleep patterns and overweight and obesity in school-age children. It is expected that the findings of this study will increase the understanding of sleep patterns about children with overweight and obesity. Most of all, this study can provide useful reference for early intervention measures of sleep education and lifestyle change in school-age children.
參考文獻
延伸閱讀
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