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    題名: 睡眠延長時間與糖尿病患者血糖代謝提升之關聯研究
    The association between sleep extension and plasma glucose metabolism in diabetes patient
    作者: 陳詠寧
    Tan, Yong-Ning
    貢獻者: 楊建銘
    Yang, Chien-Ming
    陳詠寧
    Tan, Yong-Ning
    關鍵詞: 睡眠延長
    糖尿病
    糖化白蛋白
    日期: 2019
    上傳時間: 2019-05-02 14:43:32 (UTC+8)
    摘要: 研 究 目 的 ：近幾十年罹患糖尿病的比例逐漸攀升，與此同時人們自陳的睡眠時間卻越來越 少，台灣睡眠醫學會於 2017 提出國人平均一天只睡 6.8 小時;睡眠不足可直接影響葡萄糖 代謝失功能，進而使體內血糖過高、胰島素敏感性下降，導致胰島素阻抗的情形，因而有研 究提出增加睡眠時數有助於促進血糖代謝。過去研究在睡眠時數小於 7 小時的健康者中發 現，成功增加 1 小時的睡眠有助於降低空腹胰島素的濃度，提高胰島素敏感性(Leproult et al., 2015);由於尚未有研究探討延長睡眠對於較短睡眠的糖尿病患者血糖的影響，因此本 研究納入睡眠時數小於 7 小時的糖尿病患者，探討增加 1 小時的躺床時數後與血糖變化的關 聯。

    研究方法：本研究納入 19 名糖尿病患者(男:女 = 12:7;年齡:58.95 歲 ± 9.61)。研究 流程分為三階段，在篩檢期納入符合研究條件的受試者後，首先進行睡眠基準期 3 週，依據 習慣的睡眠時間作息，之後進行血糖檢測;在睡眠延長期時依據其生活型態增加 1 小時的睡 眠時間亦為期 3 週，之後再進行血糖檢測。研究期間受試者每日需填寫睡眠日誌睡眠日誌作 為主觀睡眠量測，配戴睡眠活動腕錶(actigraph)為客觀睡眠量測，血糖檢測部分使用空腹 血糖(fasting plasma glucose, FPG)、糖化白蛋白(glycated albumin, GA)及糖化血色素 (glycated hemoglobin, HbA1C)進行量測。 研究結果:總躺床時數在基準期(主觀:440.06 分鐘;客觀:413.18 分鐘)與延長期(主 觀:473.18 分鐘;客觀:440.60 分鐘)達顯著差異(t = -3.298, p = 0.004;t = -3.932 p = 0.001)。研究將在睡眠延長期所增加的客觀總躺床時數分為增加最少組(≤ 15.72 分鐘)、 增加中等組(16 至 37 分鐘)及增加最多組(≥ 37.25 分鐘)，使用二因子混合設計探討三組 在增加躺床時數後的血糖變化，研究發現相較於客觀躺床時數增加最少組(基準期:延長期 = 15.32:16.20)，躺床時數增加中等(16.19:15.86)與最多組(14.84:14.76)在延長睡 眠後 GA 值下降的幅度較大(F(2,1) = 5.038, p = .02)，然而在 FPG 與 HbA1c 的血糖指標上並 未有顯著差異。

    研究結論：本研究結果支持原先的假設，顯示在年齡較長、平均睡眠時數小於 7 小時的糖 尿病患者中，延長睡眠可以降低 GA 值，然而此一現象並未呈現在其他血糖指標。由於本研 究睡眠延長為期 3 週，因此相較於 FPG 與 HbA1c，GA 所得結果應更能顯示研究睡眠時數
    操弄的影響。然而，研究操弄延長一小時的躺床時間並未完全成功，平均躺床時間增加約半 小時，因此在臨床實務上增加 30 分鐘的躺床時數是可行的。此外，研究結果顯示在客觀躺 床時數增加 16 分鐘以上後，GA 值即呈下降的趨勢，因此建議睡眠時數較短的糖尿病患者 增加其躺床時數至充足的時間(以增加 30 分鐘的躺床時間為目標)，有利於後續血糖代謝的調控。
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    描述: 碩士
    國立政治大學
    心理學系
    103752022
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G0103752022
    資料類型: thesis
    DOI: 10.6814/THE.NCCU.PSY.004.2019.C01
    顯示於類別:[心理學系] 學位論文

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