懷孕婦女睡眠型態與孕期血壓相關性之初探

Associations of Sleep Patterns with Blood Pressures in Pregnant Women

林玟利(Wen-Li Lin)

指導教授 ： 蔡劭瑜

國立臺灣大學/醫學院/護理學研究所/碩士(2013年)

https://doi.org/10.6342/NTU.2013.10984

摘要

婦女懷孕期間經歷複雜的身體型態及生理改變，使孕婦有較差的睡眠及較多的睡眠困擾，影響孕婦與胎兒之健康。睡眠型態與血壓的相關性在少數成人研究中曾被報導，當睡眠時數過短或過長、睡眠品質差時皆會增加罹患高血壓的風險，但目前對於孕期睡眠型態及血壓的關係所知仍十分有限。本研究欲探討孕期睡眠型態及孕期血壓之橫向與縱向相關性，研究目的為: (1)比較孕婦第一及第二孕期之主客觀睡眠型態與血壓狀態；(2)比較孕婦第一及第二孕期不同睡眠型態之血壓狀態；(3)探討孕婦第一及第二孕期主客觀睡眠型態與各孕期血壓狀態之橫向相關性；(4)探討孕婦第一孕期主客觀睡眠型態對第二孕期血壓之影響。本前瞻性研究於北部一所醫學中心產前門診進行收案，共有95位平均年齡為33歲的第一孕期(平均妊娠週數: 11週)婦女參與，孕婦於第一及第二孕期各完成中文版匹茲堡睡眠品質量表(Chinese version of the Pittsburgh Sleep Quality Index；PSQI)、中文版失眠嚴重度量表(Chinese version of the Insomnia Severity Index；ISI-C)、血壓測量及佩戴腕動計7日。研究結果發現孕婦於第一及第二孕期平均夜間睡眠時數僅6.6-6.9小時，平均睡眠效率僅83%，且普遍存在睡眠品質不佳(PSQI >5; 44.2-45.5%)、失眠(ISI-C≧9; 24-42%)以及日間小睡(87.5%-93.7%)之情形；而在控制了年齡、胎次、妊娠週數、孕前身體質量指數、孕前抽菸習慣、孕前運動習慣後，各孕期睡眠型態與血壓間未有顯著相關，多元線性迴歸結果顯示第一孕期無論是睡眠時數或睡眠品質皆不影響第二孕期血壓狀態，孕前身體質量指數是影響第二孕期血壓的獨立因子。睡眠與血壓於懷孕期間的相關生理機轉，值得未來進一步探究。

關鍵字

懷孕婦女 ； 血壓 ； 睡眠型態 ； 女性健康

並列摘要

Background: Associations between sleep patterns and blood pressures have been described in non-pregnant adult populations. However, the relationships between sleep patterns and blood pressures during pregnancy remain unknown. Purpose: The purposes of this study were to: (1) compare sleep patterns and blood pressures among 1st and 2nd trimester pregnant women, (2) compare blood pressures in women with different sleep patterns during the 1st and 2nd trimester of pregnancy, (3) investigate the cross-sectional associations between sleep patterns and blood pressures in women during the 1st and 2nd trimester of pregnancy, and (4) investigate the longitudinal associations between 1st trimester sleep patterns and 2nd trimester blood pressures during pregnancy. Method: Ninety-five 1st trimester pregnant women were recruited from a university affiliated hospital. Women wore a wrist actigragh to objectively monitor sleep for 7 consecutive days, complete the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the Chinese version of the Insomnia Severity Index (ISI-C), and had their blood pressures checked using a mercury sphygmomanometer in the 1st and 2nd trimester of pregnancy. Results: Women had 6.6-6.9 hours of nocturnal sleep duration and 83% sleep efficiency during the 1st and 2nd trimester of pregnancy. Mean PSQI score in the 1st and 2nd trimester were both above 5 points, indicating poor sleep quality. After adjustment for age, parity, gestational age, pre-pregnancy body mass index, pre-pregnancy smoking habit, and pre-pregnancy exercising habit, sleep patterns either measured by self-report or actigraphy were not associated with blood pressure during pregnancy. Pre-pregnancy body mass index was the only predictor for the blood pressure in the 2nd trimester of pregnancy. Conclusion: Results suggest that sleep patterns are not associated with blood pressures in pregnant women. Further research is needed to determine the underlying mechanism between sleep and blood pressure during pregnancy.

並列關鍵字

blood pressure ； pregnant women ； sleep pattern

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