登階運動訓練對阻塞型睡眠呼吸中止症候群患者睡眠狀況成效之前驅研究

Effectiveness of Stair Stepping Exercise on Sleep Condition in Patients With Obstructive Sleep Apnea Syndrome: A Pilot Study

林思靜(Sz-Ching Lin) ； 馬素華(Suh-Hwa Maa) ； 林鴻銓(Horng-Chyuan Lin) ； 張玉坤(Yue-Cune Chang)

《台灣專科護理師學刊》 4卷1期 (2017/11) Pp. 36-46

摘要

背景：阻塞型睡眠呼吸中止症是常見的睡眠疾病之一，若未治療將會產生不可逆之合併症，如：心肌梗塞或 是腦中風，但卻時常被忽略。因此以規律運動降低體重，可間接降低疾病嚴重度進而增加睡眠品質。目的：探討登階運動訓練對阻塞型睡眠呼吸中止症候群患者睡眠狀況之成效。方法：將研究對象隨機分派至實驗組與對照組。兩組個案皆接受內科治療與阻塞型睡眠呼吸中止症候群護理指導，實驗組個案另外在家施行登階運動八週。結果測量包括睡眠狀況參數：多項式睡眠生理檢查、Epworth日間嗜睡量表、匹茲堡睡眠品質量表，於第一週、第五週及第九週至門診回診，各接受乙次測量共三次。研究資料使用描述性統計及Generalized Estimating Equation（GEE）等推論性統計方法進行分析。結果：共收集27位門診阻塞型睡眠呼吸中止症患者進行九週的資料收集，研究結果顯示，在調整了年齡、性別及BMI等干擾因素效應將以GEE方法之多項式線性迴歸（Multiple Linear Regression）加以控制。在時間效應下與組別的交互作用，達統計上顯著性差異的參數包括：呼吸暫停指數實驗組由51.16 ± 31.6下降至34.03 ± 27.12（p = .02）、Epworth日間嗜睡量表實驗組由10.57 ± 5.20下降至7.29 ± 5.65（p = .01）及匹茲堡睡眠品質量表實驗組由13.75 ± 2.56下降至11.68 ± 3.24（p ＜ .05），對照組則皆無顯著改變。其他參數未達統計上顯著性差異。結論/實務應用：登階運動可以有效的降低體重進而改善阻塞型睡眠呼吸中止症候群患者睡眠狀況，因此設計方便可居家每日進行之運動，登階運動訓練計劃是一般民眾居家可容易獲得之工具。在未來的護理指導中應教導病患，利用規律的運動習慣降低體重，進而降低疾病嚴重度、日間嗜睡情況及增加睡眠品質。

關鍵字

阻塞型睡眠呼吸中止症 ； 登階運動 ； 睡眠狀況

並列摘要

Background: Obstructive sleep apnea syndrome (OSAS) is a common sleep problem that can lead to multiple complications, such as myocardial infarction or stroke, if not cured. However, OSA is frequently ignored. Therefore, regular exercise to reduce body weight is suggested to indirectly reduce the severity of the disease and thus increase sleep quality. Purpose: This study investigated whether a stair-stepping exercise could improve sleep in patients with obstructive sleep apnea syndrome (OSAS). Methods: A total of 27 patients with OSAS from the outpatient department of a medical center were recruited over a period of 9 weeks. Patients were randomly assigned to receive either stair-stepping training in addition to nursing education and standard care, or nursing education and standard care alone. The stair-stepping exercises were performed at home daily for 8 weeks. The outcome measures for sleep condition included polysomnography, daytime sleepiness as measured by the Epworth sleepiness scale, and the Pittsburgh sleep quality index. Data were analyzed using descriptive statistics and the multiple linear regression of the generalized estimating equation. Results: After adjustment for the effects of sex, age, and body mass, the Apnea-Hypopnea Index of the experimental group decreased from 51.16 ± 31.6 to 34.03 ± 27.12 (p = .02), and the Epworth sleepiness scale scores decreased from 10.57 ± 5.20 to 7.29 ± 5.65 (p = .01) Furthermore, the Pittsburgh sleep quality index (p ＜ .05) scores significantly improved from 13.75 ± 2.56 to 11.68 ± 3.24. Conclusions/Implications for Practice: Regular exercise can reduce body weight and improve the sleep of patients with OSAS. Nursing health education should therefore include teaching patients with OSAS to develop regular exercise habits, in order to reduce the severity of the disease and daytime sleepiness as well as improve sleep quality.

並列關鍵字

obstructive sleep apnea syndrome (OSAS) ； stair-stepping exercise ； sleep condition

參考文獻

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