- 學位論文
青少年社會性時差、睡眠時長與心理功能關聯之探討
Associations Between Social Jetlag, Sleep Duration, and Psychological Function Among Adolescents
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摘要
研究背景與目的：睡眠型態在青春期的劇烈變化，使得青少年週間睡眠不足、週間週末作息有明顯差距的問題被凸顯出來，其中睡眠不足已證實會對於許多生心理功能造成影響，而關於週間週末作息差距的問題，有一名詞特別指稱這樣的現象，為「社會性時差」，社會性時差作為睡眠不規律的型態之一，反映了內在晝夜節律與外在社會要求的不同所導致的作息不一致，因此在青少年族群上除了睡眠不足外，社會性時差的問題也尤其明顯，但是與其相關的主題在近年才開始逐漸受到關注。在青少年睡眠相關的研究上過去多聚焦於睡眠不足之影響，而關於社會性時差對青少年情緒及認知影響的研究結果尚不一致，部分研究發現社會性時差與憂鬱程度具顯著相關；在認知功能方面，社會性時差/晝夜節律紊亂會影響記憶、注意力等多項能力，但在高階認知能力如執行功能的影響上，研究結果仍待釐清。考量到國內青少年族群睡眠問題的嚴重性，以及睡眠障礙與自殺風險的關聯，本研究擬同時納入社會性時差與週間平均睡眠時長作為變項，探討兩者與青少年情緒及認知的潛在關係，補強國內研究在青少年社會性時差與睡眠時長影響層面之空白。 研究方法：本研究招收642名國高中少年，排除問卷填答遺漏、誤填、極端值後，共557名受試者進入分析。實驗首先將請受試者填寫問卷，包含（1）基本資料及睡眠、生活習慣調查、（2）貝克兒童及青少年量表第二版中文版（國中學生）；貝克憂鬱量表第二版中文版（高中學生）、貝克焦慮量表中文版（高中學生），以及進行電腦版之威斯康辛卡片分類測驗。本研究使用SPSS29.0（Statistical Package for the Social Sciences, Inc.）進行分析，以描述統計的方式分析受試者之人口學變項，以及憂鬱、焦慮、睡眠、執行功能測驗結果，並透過獨立樣本t檢定分析人口學變項在睡眠相關指標、情緒、認知功能表現之差異。以皮爾森積差相關進行分析，探討睡眠相關變項與情緒、執行功能測驗結果之間的關聯性，並使用階層迴歸分析檢驗週間社會性時差與睡眠時長之交互作用對於情緒、執行功能之預測力。 研究結果：結果顯示（1）國內青少年週間平均睡眠時長為6.63小時，週末8.85小時，週間睡眠時長低於8小時者比例高達89.6％，且社會性時差高達1.72小時，其中75.9％的人社會性時差大於1小時。結果顯示高中生與國中生相比睡眠時長更短，就寢時間更延遲、而在週間起床時間比國中生更早起、週末則是更晚起，高中生的社會性時差也較國中生更大。整體顯示國內青少年週間睡眠時長較短、週間週末作息存在顯著差異。（2）睡眠參數與心理功能分析方面，相關分析顯示對於國中生來說週間平均睡眠時長越短焦慮與憂鬱程度越高有顯著之關聯，社會性時差越大則與憂鬱程度越高有顯著之關聯；而對於高中生來說週間平均睡眠時長越短與焦慮、憂鬱程度越高有顯著之關聯，但在執行功能上，週間睡眠時長、社會性時差與WCST各指標皆無顯著關聯（3）而在迴歸分析結果顯示社會性時差與睡眠時長之交互作用對於心理功能之預測力皆未達顯著（焦慮、憂鬱、執行功能）。睡眠型態與心理功能的關聯性上，在執行功能方面，無論是社會性時差或是週間睡眠時長對於WCST各指標皆沒有顯著預測力；雖在社會性時差與週間睡眠時長之交互作用對於情緒、執行功能之預測力未達顯著，但結果仍顯示青少年週間睡眠時長較短可預測較高焦慮、憂鬱程度，而國中生社會性時差高可預測較較高憂鬱程度。 結論：本研究提供目前國內青少年睡眠型態之現況，結果說明了國內青少年有週間睡眠不足以及社會性時差問題的比例非常高，普遍具有週間睡眠時長短且週末睡眠時相延後之作息型態，且隨著國中升至高中，這樣的問題可能會加劇。在社會性時差、週間睡眠時長與心理功能之間的關聯性中發現，週間睡眠時長與情緒之間的關係獲得較一致性的支持，社會性時差則僅對國中生之憂鬱情緒存在預測力。在未來介入與政策方面應優先滿足青少年基本睡眠需求，而非以學業為主要導向。另外藉由調整上學時間或是調整課後行程，將有助於增加青少年週間睡眠時長、減少社會性時差，可有益於降低青少年情緒困擾的風險。
並列摘要
Background: Dramatic changes in adolescent sleep patterns underscore the issue of insufficient weekday sleep and significant differences between weekday and weekend sleep schedules. Insufficient sleep adversely affects physiological and psychological functions. "Social jetlag" refers to the discrepancy between weekday and weekend sleep schedules, highlighting inconsistencies between internal circadian rhythms and external demands, a problem particularly pronounced in adolescents. Research on the impact of social jetlag on emotions and cognition is relatively recent and yields inconsistent findings. Some studies have linked social jetlag to depression and cognitive impairments, such as in memory and attention. Given the severity of sleep problems among adolescent in Taiwan and their association with increased suicide risk, this study aims to investigate the relationship between social jetlag, average weekday sleep duration, and adolescents' emotions and cognition. Methods: The study recruited 642 junior and senior high school students, After excluding incomplete or incorrect questionnaires, 557 subjects were included in the final analysis. Participants completed surveys on basic information, sleep, and lifestyle habits and the computerized Wisconsin Card Sorting Test. They also completed either the Beck Youth Inventories-Second Edition or the Beck Depression Inventory-Second Edition and the Beck Anxiety Inventory, depending on their age. SPSS 29.0 was used for analysis. Descriptive statistics analyzed demographic variables and test results for depression, anxiety, sleep, and executive function. Independent samples t-tests were used to analyzed differences in sleep parameters, emotions, and cognitive performance. Pearson correlation was used to explored relationships between sleep-related variables and test results. Hierarchical multiple regression was employed to examined the interaction between weekday social jetlag and sleep duration on emotions and executive function. Results: Three important results was found in this study. First of all, the average weekday sleep duration was 6.63 hours, compared to 8.85 hours on weekends. A high proportion (89.6%) of adolescents sleep less than 8 hours on weekdays, and the average social jetlag is 1.72 hours, with 75.9% experiencing social jetlag greater than 1 hour. High school students have shorter sleep durations, later bedtimes, earlier wake times on weekday, and sleep in later on weekend than junior high students. High school students also have a greater social jetlag compared to junior high school students. Overall, adolescents exhibit shorter weekday sleep duration and significant differences between weekday and weekend sleep schedules. Secondly, shorter average weekday sleep duration is significantly correlated with higher levels of anxiety and depression, and greater social jetlag is significantly associated with higher levels of depression among junior high students. For high school students, shorter average weekday sleep is significantly associated with higher levels of anxiety and depression, but there is no significant correlations were found between sleep duration, social jetlag, and executive function. Third, regression analysis results showed that the interaction between social jetlag and sleep duration does not significantly predictive psychological functions. Although the interaction between social jetlag and weekday sleep duration did not significantly predict emotions and executive function, the results still show that shorter weekday sleep can predicte higher levels of anxiety and depression, and greater social jetlag can predicte higher levels of depression among junior high students. Conclusion: This study provides recency sleep patterns of adolescents in Taiwan, highlighting the high prevalence of insufficient weekday sleep and social jetlag. The findings indicate that adolescents generally have shorter weekday sleep durations and delayed sleep schedules on weekends, with these issues potentially worsening from junior high to high school. A consistent association was found between weekday sleep duration and emotions, while social jetlag was only predictive of depression among junior high school students. Future interventions should prioritize meeting adolescents' basic sleep needs over academic demands. Adjusting school start times or after-school activity schedules could help increase weekday sleep duration and reduce social jetlag, thereby potentially reducing the risk of emotional problems among adolescents.
參考文獻
中文部分
臺灣睡眠醫學學會（2016）。研究調查。https://tssm.org.tw/file/1483682380.pdf
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