台灣兒童睡眠障礙與其行為及學習成績之研究

The Research of Taiwanese Children’s Problem Behavior and Academic Performance with Sleep Disorders

吳敏華(Min-Hua Wu)

指導教授 ： 王理

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2008年)

https://doi.org/10.6834/CSMU.2008.00043

摘要

本研究探討台灣兒童因睡眠呼吸障礙引起的行為及學習成績問題，選取台中市兩所國民小學的兒童為樣本，對兒童家長及教師進行睡眠呼吸障礙教育，由兒童家長及班級導師分別填寫兒童行為量表(Child Behavior Checklist, CBCL)、兒童睡眠狀況量表(sleep state checklist)及教師報告量表(Teacher’s Report Form, TRF)，評估兒童睡眠狀況、兒童行為及學習成績表現。由兒童家長自行決定是否參加與臨床睡眠呼吸障礙檢查，在臨床上以睡眠呼吸多項生理儀器(Polysomnographic)監測睡眠狀況，所到的睡眠檢查資料與兒童行為做一比較。
本研究共收集1677份由家長填寫的兒童行為量表(CBCL)，1757份睡眠狀況量表及1831份教師報告量表(TRF)之有效問卷。比較兒童行為問卷的兒童行為分數前四分之ㄧ及後四分之ㄧ兒童與睡眠狀態量表的睡眠呼吸問題、打鼾、磨牙、翻滾、夢遊、尖叫、早晨頭痛及白天打瞌睡有關。臨床檢查部份，有138名兒童至台灣中部某睡眠醫學中心接受睡眠呼吸中止症檢查，發現兒童有較高的呼吸中止及淺呼吸指標(AHI)相較有較低的呼吸中止與淺呼吸指標(AHI)者會有較差的睡眠第三階段、慢波睡眠、肢體移動障礙及血氧飽和濃度；臨床上比較兒童患有中重度睡眠呼吸障礙較無睡眠呼吸障礙的兒童，會有退縮行為、身體抱怨、焦慮憂鬱、人際問題、注意力問題及內化行為等行為問題。比較兒童學習成績及學習表現分數前四分之一及後四分之一的兒童與打鼾，發現兒童打鼾相較沒有打鼾的兒童在社會及自然生活與科技達統計顯著。
本研究發現兒童睡眠呼吸障礙會與行為表現有關，但與學習成績表現無關，期望藉由本研究能使社會及學校重視兒童睡眠呼吸障礙，讓罹患睡眠呼吸障礙兒童能得到適時幫助。

關鍵字

睡眠呼吸障礙 ； 兒童行為量表 ； 教師報告量表

並列摘要

This research focuses on exploring the relationship between children with sleep disorders and its relevant behavior and academic performance problems. Participants of this study were selected from 2 elementary schools in Taichung city. In these two schools, sleep specialist gave a lecture course on sleep disorder health education for schoolteachers and parents. Parents of theses children were filling in the child behavior checklists and the children’s sleep state checklist, and the checklist of Teacher’s report form were being done by the children’s home room teachers. The purpose for filling these checklists were to understand children’s sleep statement, behavior and academic performance. Parental informed consent to participant the sleep examination, and these data which collected by polysomngraphic were compared with children’s behavior.
In this study, 1757 were returned the child sleep state checklist, 1677 were returned the child behavior checklist by parents and 1831 were returned the teacher’s report form by children’s home room teachers. Comparison between the before one-first and after one-first score showed significant difference in children’s sleep breathing problems, snoring, bruxism, roll, sleepwalking, scream, morning headache and daytime sleepiness. In clinic, 138 voluntary children come to the sleep center for an overnight polysomngraphic assessment in a central Taiwan university affiliate hospital. Compared with the non-sleep disordered breathing (SDB)(AHI≦5) and moderate/ sever SDB (AHI≧15) showed significant difference in sleep stage 3 of total sleep times, slow wave sleep, leg movement index (LMI) and desaturation index (DI). Children with moderate/ sever SDB compared non-SDB, the result showed significant difference in withdraw behavior, somatic complain, anxiety/depression, social problem, attention problem and internal behavior. Comparison with forward part of the four-first and posterior part of the four-first child’s academic performance score and snoring, we find that children’s sleep snoring are in association with their society and nature and science technology academic performance.
This research result show that SDB and children’s behavior are in positive correlation but no significant difference in children’s academic performance. For this reason, we hope the findings of this study will promote society and relevant units at schools concerned these problems and get proper treatment.

並列關鍵字

Sleep Disordered Breathing ； Child Behavior Checklist ； Teacher’s Report Form

參考文獻

3. 李美枝(1998)。中國人親子關係的內涵與功能: 以大學生為例。本土心理學研究，9，3-52。

4. 林俊賢、蔡東鍾(2007)。台東縣國中學生補習教育與心理幸福關聯性研究。台東大學教育學報，18(1)，73-106。

5. 胡昆宜、周正修 顏銘傭 周稚傑(2007)。惱人的磨牙。基層醫學，22(9)，327-330。

12. 蘇秀枝（2005）。國小學童課後托育、補習才藝與學業成就、行為適應之關係以台中縣大?堨型馬牷C朝陽人文社會學刊，3（1），173-223。

31. Chang ET, Shiao GM (2007). Relationship of sleepiness, neck circumference and body mass index to the respiratory disturbance index among Taiwanese. Thorac Med., 22, 79-85.