探討影響老年人睡眠障礙之因素

A study of influential factors associated with sleep disorders based on elderly in Taiwan

陳貞均(Chen-Chun Chen)

指導教授 ： 黃怡婷

國立臺北大學/商學院/統計學系/碩士(2016年)

摘要

因全球老年人口比例逐年增加，現今醫療技術快速發展，但老年人有睡眠障礙的比例卻居高不下且逐年上升。若能找出影響老年人睡眠障礙的因素，或許可減少使用的藥物，避免醫療資源濫用。
本篇論文研究採用衛生署國民健康局「2009國民健康訪問調查」問卷資料，調查期間為2009年6月至2010年2月底，有效問卷2904份，剔除問卷遺失值與干擾因素 (失智症) 後，完整資料計2703筆。 本研究以二種方式討論影響老年人睡眠障礙的因素，先運用因素分析將「困難入睡」、「維持睡眠困難，頻繁的醒來或醒來後困難再進入睡眠等特點」、「清晨很早醒來，無法再睡覺」 等三個變數整合成自覺睡眠障礙應變數、而使用「藥物治療」為另一個應變數。藉由卡方獨立性檢定與兩樣本獨立T檢定以及變異數分析 (ANOVA) 檢定來檢定與睡眠障礙有相關的自變數。再利用邏輯斯迴歸與多項式邏輯斯迴歸分別找出影響的因子，並比較兩變數之影響因素。
本研究結果發現性別、曾罹患心臟疾病或曾被醫師診斷過失眠對於使用藥物幫助入睡與自覺睡眠障礙有顯著的影響。女性老年人覺得有睡眠障礙的困擾比使用藥物治療高
(勝算比分別為1.86 與1.40)；曾經罹患過心臟疾病的老年人比較有睡眠障礙, 二個模型結果一致 (勝算比約為 1.4)；曾經被醫師診斷過失眠的老年人有睡眠障礙的勝算亦比較高 (使用藥物治療的勝算比為自覺睡眠障礙的 3 倍)。
二個模型有一致的結果，但女性卻有較高自覺睡眠障礙，而有被醫師診斷過失眠，較不會覺得有睡眠障礙，希望本研究的研究結果可以提供民眾做為提升生活品質的參考。

關鍵字

台灣老年人 ； 睡眠障礙 ； 因素分析 ； 多元邏輯斯迴歸 ； 多項式邏輯斯迴歸

並列摘要

The percent of elderly is increasing each year globally. Although the medical technics make great strides nowadays, the percent of having sleep disorder in elderly increases every year. It is then important to understand influential factors associated with sleep disorders in elderly. In turn, the elderly can avoid taking too many drugs and it might result in reducing a waste of the medical resource.
This research used data collected by Health Promotion Administration in 2009 National Health Interview Survey. 2703 eligible respondents who were aged 65 years old and over, had no missing data and didn’t have Alzheimer disease were included in this study. Two dependent variables were considered. The first variables used factor analysis to combine three questions “Difficulty with initiating sleep?”, “Difficulty with maintaining sleep?”, “Early morning awakening” and was used to measure self-reported sleep disorder and is treated as a subjective measure. The second variable used “Use any medication for sleep night?” and is treated an objective measure of sleep disorder. The chi-square test, two sample t-test and analysis of variance were used to assess the relationship between the response variables and potential influential factors. The overall association between the response variables and explanatory variables were examined through the logistic regression and proportional odds model.
The result of the study shows that the potential influential factors for the subjective and objective measures are the same. They are gender, cardiovascular disease and diagnosed of insomnia. The result indicated that the odds of having sleep disorder based on subjective and objective measures for female are 1.403 and 1.857 higher than those for male. The odds of having sleep disorder for respondents who had cardiovascular disease are about the same for both measures. However, the odds of having sleep disorder for respondents who diagnosed of insomnia is 3 times higher when using a direct measure (OR=22.756) as compared to an indirect measure (OR=7.404).
Although the findings from the subjective and objective measures are consistent, female elderly tends to feel they have sleep disorders but does not take sleeping pill and for those who were diagnosed with insomnia, they do not feel they have sleep disorder when respondents take sleeping pills. The finding of this research may provide some guidance for the publics to improve their quality of life.

並列關鍵字

Elderly in Taiwan ； Sleeping Disorder ； Factor Analysis ； Logistic Regression ； Proportional Odds Model

參考文獻

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