舒曼波對促進早產兒睡眠的成效探討

The effect of Schumann resonance on sleep in premature infant.

李佳穎(Chia-Ying Lee)

指導教授 ： 莊小玲 ； 李淑杏

中山醫學大學/醫學院/護理學系/碩士(2020年)

https://doi.org/10.6834/CSMU202000025

摘要

目的：睡眠對早產兒的發育及神經發展至關重要，若嬰兒的睡眠受到剝奪，可能會對其感覺系統的發育及神經傳導迴路造成負面影響，也會影響大腦皮質的成熟及大腦可塑性，然而新生兒加護病房的環境干擾常使早產兒的睡眠中斷。因此本研究將探討以非侵入性的舒曼波改善新生兒加護病房內早產兒的睡眠品質及促進體重增加的成效。
方法：本研究為實驗性研究設計，將研究對象分為實驗組及對照組，選取32位出生週數介於32至35週、無先天異常，且疾病嚴重度(新生兒的疾病嚴重度量表；NTISS)小於9分之早產兒，其中實驗組17位(男嬰10位、女嬰7位，平均週數34週)、對照組15位(男嬰8位、女嬰7位，平均週數34週)。研究工具以穿戴式睡眠活動紀錄儀(Fitbit Alta HR)紀錄個案的睡眠開始時間、睡眠結束時間及覺醒次數與時間。介入方式：從收案開始第四天，實驗組以舒曼波睡眠機做為介入措施，在晚上10點至早上10點將睡眠機放置於個案腳底之位置，對照組則僅採一般常規照顧，並分別於介入一週後及二週後評值成效。資料分析方法採無母數檢定、廣義估計方程式，來比較兩組日、夜的睡眠總時間、睡眠覺醒次數與時間、睡眠品質(睡眠連續時間)及體重變化。
研究結果：使用舒曼波一週後，實驗組早產兒較對照組每晚夜間睡眠總時間多23分鐘、覺醒次數少約7次、覺醒時間少約4分鐘，且夜晚睡眠品質(睡眠連續時間)增加約37分鐘；使用舒曼波兩週後，實驗組比對照組每晚夜間睡眠時間少約36分鐘、覺醒次數少約6次、覺醒時間少約18分鐘、最大連續睡眠時間多約44分鐘，除覺醒次數達統計顯著差異(p<.05)外，其餘變項皆未達統計顯著差異(p>.05)。使用舒曼波2週後，實驗組比對照組之夜晚連續睡眠時間多增加約44分鐘、白天連續睡眠時間則縮短約25分鐘，也就是說，使用舒曼波睡眠機的早產兒有白天睡眠時間減少、夜晚睡眠時間增加的趨勢，雖未達統計上顯著差異，但具臨床參考意義。
　　在體重方面，使用舒曼波一週後，實驗組的早產兒比對照組的早產兒體重多增加68公克(P=0.034)，使用舒曼波二週後，實驗組比對照組體重多增加119公克(P=0.018)，且皆達統計上顯著差異，尤其實驗組體重平均每天成長38.6公克，優於臨床理想的成長速度(20公克/天)。
結論與建議：舒曼波使用兩週後能顯著減少早產兒夜晚睡眠覺醒次數，但對於早產兒的睡眠總時間、睡眠百分比、夜晚的睡眠品質(睡眠連續時間)則無影響，亦無法減少覺醒的時間。在體重方面，使用舒曼波一週後早產兒的體重即可顯著增加(約38.4公克/天)，若持續使用到第二週，則體重可以每天穩定成長約38.6公克，將近臨床理想的體重增加速度(20公克/天)的兩倍，故建議舒曼波睡眠機可以運用於臨床來促進早產兒的睡眠品質及體重增加。但本研究個案數較少，未來仍需要更多的研究及擴大樣本數，來探討舒曼波對促進早產兒睡眠的成效。

關鍵字

早產兒,睡眠 ； 舒曼波 ； 舒曼共振

並列摘要

Purpose: Sleep is critical to physical maturation and neural development in premature infants. Sleep deprivation can negatively affect sensory system development and nerve conduction, reduce the size of the cerebral cortex relative to that of a non-sleep-deprived baby of the same age, and affect brain plasticity. However, the environment of the neonatal intensive care unit (NICU) usually disrupts sleep quality in premature infants. This study used a non-invasive Schumann resonance sleep device to improve the sleep quality of preterm infants in the NICU. This device can reduce the energy consumed and promote weight gain. The Fitbit Alta HR is used to record total sleep time, sleep quality, and the number and duration of nighttime waking.
Method: An experimental design was used in this study. Thirty-two preterm infants of 32–35 weeks gestational age (GA) were recruited from the NICU, 17 of which were allocated to the experimental group (10 boys and 7 girls, average GA: 34 weeks) and 15 to the control group (8 boys and 7 girls, average GA: 34 weeks). A Fitbit Alta HR was used to record total sleep time, , sleep quality , and the frequency and duration of nighttime waking during hospitalization. A Shuman wave sleep device was placed beside the infant’s foot in the experimental group during the period 10 pm to 10 am. We compared the total sleep time, sleep quality, frequency and duration of nighttime waking, and weight gain between the experimental and control groups.
Result: Use of the Schumann Wave for one week in the experimental group increased total sleep time by 23 minutes and sleep quality (the longest sleep duration) by 44 minutes in the night. It could also reduce the frequency and duration of nighttime waking in preterm infants. Use of the Schumann Wave for 2 weeks in the experimental group reduced total sleep time by 36 minutes, decreased the number of nighttime waking to 6, decreased the duration of nighttime waking by 18 minutes, and increased sleep quality (the longest sleep duration) by 44 minutes, compared with the control group at night. Otherwise, use of the Schumann Wave for 2 weeks in the experimental group increased sleep quality (the longest sleep duration) by 44 minutes at night and reduced sleep time by 25 minutes in the day, relative to the control group. An increase in nighttime sleep and a decrease in daytime sleep can promote the formation of a circadian rhythm. However, there was no statistically significant difference in the total sleep time and wakeful time, except for the number of night awakenings (p < 0.05), in preterm infants.
In addition, Schumann resonance can increase the rate of weight gain in premature infants. After using the Schumann wave for a week, the weight gain rate in the experimental group was 36 g/day; this result was statistically significant (p < 0.05).
Conclusions and suggestions: Schumann resonance cannot increase the total sleep time, the duration of nighttime waking, and sleep quality (the longest sleep duration), but it can reduce the number of nighttime waking and increase weight gain over the usual clinically suggested level (20 g/day). Therefore, it is suggested that Schumann resonance can be used to promote sleep condition and weight gain in preterm infants. More research is needed in the future to explore the effect of using Schumann resonance to promote sleep and body weight gain in preterm infants.

並列關鍵字

Preterm infant ； Premature infant ； Schumann resonance ； sleep

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