2011-08-012024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/658013摘要：睡眠品質不佳已成為世界各國的主要健康議題。調查顯示台灣地區成人失眠的盛行率與國外接近，而約有半數的老年人抱怨睡眠不佳。老年人失眠可能導致情緒焦慮、認知缺損或跌倒，影響日常功能和生活品質。近年來研究更指出失眠會影響內分泌功能，導致代謝疾病發生，並與心血管疾病死亡率有關，因此改善睡眠品質是相當重要的健康議題。由於治療失眠的藥物副作用較高，認知行為治療施行困難且花費較高，因此運動訓練被認為是改善失眠老人睡眠品質的替代選擇。雖然有關失眠老人的研究很多，但目前仍不清楚失眠老人的健康體適能和代謝功能的長期變化，運動治療的效果也未有定論。因此本計畫將分三年逐步探討失眠老人健康體適能與代謝功能變化，以及運動訓練的效果及可能機轉：第一年比較睡眠品質不良與睡眠品質佳的社區老人之心肺適能、身體組成、日常活動量，以及代謝功能的差異。預計徵求120位社區老人接受活動記錄儀測定、睡眠品質問卷、運動測試、生物電阻分析儀、心跳變異率分析、認知功能及憂鬱程度問卷，以及代謝生化指標等評估。第二年探討16週運動訓練對失眠老人的效果並分析可能機轉。預計徵求60位符合失眠診斷之老年人，隨機分為運動組和控制組。運動組需到實驗室接受每週3次共16週的有氧運動及阻力訓練；控制組則接受睡眠保健教育及諮商。第三年追蹤前述120位老人1年後心肺適能、身體組成及代謝功能的變化，以及運動訓練改善老年人睡眠品質的長期效果。我們預期睡眠品質不良老人有較差的健康體適能與代謝功能，運動訓練可改善病患睡眠品質、代謝功能和整體健康，而且效果可持續。<br> Abstract: Poor sleep quality has been recognized as a major public health concern in theworld. The prevalence of insomnia in Taiwan is comparable to that ofWesterncountries. It is estimated that up to 50% of elderly complain about their sleep.Insomnia is associated with anxiety, falls, or cognitive impairment in the elderly,which may compromise their daily activities function and quality of life. Recently,researches have demonstrated the associations between insomnia and endocrinesystem dysfunction, metabolic disorders, and cardiovascular events and death.Therefore, it is an important issue to improve sleep quality of the elders. Theside-effects of pharmacological treatments and high-cost of cognitive behaviortherapy limit their accessibility and effectiveness, and exercise training has beenexpected to provide an alternative intervention for insomnia. However, the long-termimpact of insomnia on health-related fitness and metabolic function, and the effect ofexercise training remain inconclusive. This project will be conducted in three years: inthe first year, we will compare the cardiorespiratory function, body composition,physical activity, and metabolic biochemistry parameters in community-dwellingelders with good and poor sleep quality. One hundred and twenty elders will berecruited to receive the actigraph accelermometer recording, sleep qualityquestionnaire, exercise test, bioelectrical impedance analysis, heart rate variabilityanalysis, cognitive and depression evaluation, and biochemistry analysis. Secondly,the study will evaluate the efficacy and possible mechanisms of a 16-week exercisetraining for insomnia. Sixty patients with insomnia elders will be randomized toexercise group or control group. Participants in the exercise group will receive aerobicand resistance exercise 3 times per week for 16 weeks. The controls will receive sleephygiene education and consultation. All measurements will be performed as describedbefore. Finally, all the 120 elders participating in this study will receive 12-monthfollow-up assessments to explore the longitudinal impact of insomnia oncardiorespiratory function, body composition and metabolic function, and long-termeffect of exercise training on insomnia.We expect elders with poor sleep quality havelower level of health-related fitness and metabolic function; exercise training iseffective to improve sleep quality, metabolic function and general health in the elderswith insomnia, and the effect can be sustained for a long period.失眠心肺適能憂鬱失能老化Insomniacardiopulmonary fitnessdepressionphysical disabilityaging