- 學位論文
應用睡眠紡錘波分析評估睡眠障礙之治療
Sleep Spindle Analysis for Assessment of Behavior Therapy for Sleep Disorder
摘要
近幾年來社會急速發展，人們生活步調日趨繁忙，在這背後隱藏不少問題，壓力導致精神上障礙，與睡眠障礙問題。因此睡眠障礙的評估與治療日益重要。本研究與新光醫院睡眠中心合作，建立一套藉由睡眠紡錘波去判斷睡眠障礙的人，經由認知行為治療前後，是否有差異。藉由睡眠紡錘波判斷，提供醫護人員臨床決策輔助之參考。 本研究是以睡眠第二期中，一個重要的特徵波-睡眠紡錘波，為主要對象，藉由判斷睡眠紡錘波密度，藉以評估經由認知行為治療前後，睡眠紡錘波是否有增加，做為臨床上的一個參考指標；分析睡眠紡錘波的演算法，利用的是均方根法(Root Mean Square, RMS)，此方法好處是經由濾波的腦波，經由此法則運算，搭配人工定義一個判斷值(threshold)，即可找出睡眠紡錘波，跟其他演算法比較，不用大量複雜運算，其正確率也在可接受的範圍，故選用此法則。 結果顯示不論是治療效果好或不好的患者，經由認知行為治療後，整晚的睡眠紡錘波密度以及stage2睡眠紡錘波密度，均有顯著;此外，應用整晚睡眠紡錘波密度以及stage2睡眠紡錘波密度去評估治療好壞並無顯著，所以應用睡眠紡錘波密度評估失眠患者治療之好壞，似乎仍稍嫌不足。無論如何，本研究是一個開端，希望透過量化腦波資訊，提供失眠治療的評估。
關鍵字
睡眠紡錘波；均方根；認知行為治療並列摘要
In recent years, the busy and high-pressure life style cause some problems like psychiatry disorder and sleep disorder with people. Hence, the importance of the assessment and therapy for sleep disorder is rising. This research cooperates with sleep center in Shin-Kong Hospital. We attempted to develop an EEG analysis method to help the assessment of cognitive behavior therapy (CBT) for sleep disorder. Sleep spindle is one of the most important waveform features in sleep stage2. Sleep spindle density is expected as the indicator for assessing sleep disorder. The algorithm for automatic spindle detection we choose is the root mean square (RMS). The advantages of RMS are easy to understand and implement. After 10-15Hz band-pass filtering, the RMS in 100ms window was calculated. Then a threshold was determined by manual setting to detected spindle signal. Finally, the spindle densities in whole night and stage2 were acquired. Fourteen patients undergone CBT were enrolled in this study: Eight patients with good therapy and six patients without good therapy. The result showed that there was no difference of sleep spindle density between the groups with and without good therapy. But it is significantly different in sleep spindle densities before and after CBT in both groups. In conclusion, this study showed it is not sufficient to use sleep spindle density to assess CBT for sleep disorder. However, this study is a pilot research for using quantitative EEG information for sleep disorder assessment and therapy.