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    政大機構典藏 > 理學院 > 心理學系 > 學位論文 >  Item 140.119/123229
    Please use this identifier to cite or link to this item: http://nccur.lib.nccu.edu.tw/handle/140.119/123229


    Title: 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
    Authors: 陳詠寧
    Tan, Yong-Ning
    Contributors: 楊建銘
    Yang, Chien-Ming
    陳詠寧
    Tan, Yong-Ning
    Keywords: 睡眠延長
    糖尿病
    糖化白蛋白
    Date: 2019
    Issue Date: 2019-05-02 14:43:32 (UTC+8)
    Abstract: 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。
    Reference: 參考文獻
    中文部分
    黃筱珮(2017年3月24日) 。睡不夠啊!台灣人平均一天只睡6.8小時。【新聞群組】。取自http://www.peoplenews.tw/news/f4852b6e-2cdc-4935-b007-c4a81230452c
    黃漢華(2018年1月2日)。世台灣227萬糖尿病友 照護為何輸日韓、新加坡?。【新聞群組】。取自https://www.gvm.com.tw/article.html?id=41746
    衛生福利部中央健康保險署(2007年11月9日)。追蹤腎功能、血糖與血壓,三不可缺一 控制好慢性疾病。【新聞群組】。取自https://www.nhi.gov.tw/Content_List.aspx?n=09 400E3903354254&topn=874605F03B8FDFBA
    衛生福利部國民健康署(2010年12月8日)。洗腎數載情彌堅 執手護腎立範典。【新聞群組】。取自https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1130&pid=2193
    衛生福利部國民健康署(2016年11月1日)。世界糖尿病日由來與國內宣導響應。【新聞群組】。取自https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1090&pid=6426
    衛生福利部(2017年6月19日)。105年國人死因統計結果。【新聞群組】。取自https://www.mohw.gov.tw/cp-16-33598-1.html

    英文部分
    AASM. (2005). The International Classification of Sleep Disorders: diagnostic and coding manual. 2nd Ed. Westchester, IL: AASM.
    AASM. (2014). International Classification of Sleep Disorder, 3rd Ed. Westchester, IL: AASM. American Diabetes Association. (2014). Diagnosis and Classification of Diabetes Mellitus.
    Diabetes Care, 37, S81-S90.
    American Diabetes Association (2016). Diagnosis and Classification of Diabetes Mellitus. Diabetes
    Care, 39, S13-S22.
    American Diabetes Association (2018). Diagnosis and Classification of Diabetes Mellitus. Diabetes
    Care, 41, S13-S27.
    Aronsohn, R.S., H. Whitmore, E. Van Cauter & E. Tasali. 2010. Impact of untreated obstructive sleep apnea on glu- cose control in type 2 diabetes. Am. J. Respir. Crit. Care Med. 181: 507– 513.
    Ayas, N.T., White, D.P., Al-Delaimy, W.K., Manson, J.E, Stampfer, M.J., Speizer, F.E., et al. (2003). A Prospective Study of Self-Reported Sleep Duration and Incident Diabetes in Women Diabetes Care, 26, 380–384.
    Beihl, D. A., Liese, A. D., & Haffner S. M. (2009). Sleep Duration as a Risk Factor for Incident Type 2 Diabetes in a Multiethnic Cohort. Annals of epidemiology, 19, 351-357.
    46
    Bergman, R. N., Ader, M., Huecking, K., & Van Citters, G. (2002). Accurate assessment of beta- cell function: the hyperbolic correction. Diabetes 51, S212– S220.
    Botros, N., J. Concato, V. Mohsenin, et al. 2009. Obstructive sleep apnea as a risk factor for type 2 diabetes. Am. J. Med. 122: 1122–1127.
    Cappuccio, F. P., Strazzullo, P., D’elia L., & Miller, M. A. (2010). Quantity and Quality of Sleep and Incidence of Type 2 Diabetes. Diabetes Care, 33, 414–420.
    Cellini, N., Buman, M. P., McDevitt, E. A., Ricker, A. A., & Mednick, S. C. (2013). Direct comparison of two actigraphy devices with polysomnographi- cally recorded naps in healthy young adults. Chronobiology International, 30, 691-698.
    Chaput J. P., Després, J. P., Bouchard C., Astrup, A. & Tremblay, A. (2009). Sleep duration as a risk factor for the development of type 2 diabetes or impaired glucose tolerance: Analyses of the Quebec Family Study. Sleep Medicine, 10, 919–924.
    Chao, C. Y., Wu, J. S., Yang, Y. C., Shih, C. C., Wang, R. H., Lu, F. H., Chang, C. J. (2011). Sleep duration is a potential risk factor for newly diagnosed type 2 diabetes mellitus. Metabolism Clinical and Experimental, 60, 799–804.
    Cizza, G., Marincola, P., Mattingly, M., Williams, L., Mitler, M., Skarulis, M., & Csako G. (2010). Treatment of obesity with extension of sleep duration: a randomized, prospective, controlled trial. Clinical Trials, 7, 274–285.
    Cooper, A. J. M., Westgate K., Brage, S., Prevost A. T., Griffin S. J., Simmons R. K. (2014). Sleep duration and cardiometabolic risk factors among individuals with type 2 diabetes. Sleep Medicine, 16, 119-125.
    Dabelea, D., et. al., (2014). Prevalence of Type 1 and Type 2 Diabetes Among Children & Adolescents From 2001 to 2009. JAMA, 311, 1778-1786.
    Eckel, R. H., Kahn, S. E., Ferrannini, E., Goldfine, A. B., Nathan, D. M., Schwartz, M. W., Robert J. Smith, R. J., & Smith S. R. (2011). Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? The Journal of Clinical Endocrinology & metabolism, 96, 1654-1663.
    Flint, J., Kothare, S. V., Zihlif, M., Suarez, E., Adams, R., Legido, A., & Luca, F. D. (2007). Association between Inadequate Sleep and Insulin Resistance in Obese Children (2007). The Journal of Pediatrics, 4, 364-369.
    Freitas, P., Ehlert, L., & Camargo, J. (2017). Glycated albumin: a potential biomarker in diabetes. Archives of Endocrinology and Metabolism, 61, 296-304.
    Furusyo, N., & Hayashi, J. (2013). Glycated albumin and diabetes mellitus. Biochimica et Biophysica Acta, 1830, 5509-5514.
    Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B., Buijs, R. M., Kreier, F., Pickering, T. G., Rundle, A. G., Zammit, G. K., & Malaspina, D. (2007). Sleep Duration as a Risk Factor for Diabetes Incidence in a Large US Sample. Sleep, 30, 1667-1673.
    Gottlieb, D. J., Punjabi, N. M., Newman, A. B., Resnick, H. E., Redline, S., Baldwin, C. M., Nieto, F. J. (2005). Association of Sleep Time With Diabetes Mellitus and Impaired Glucose Tolerance. Arch Intern Med, 165, 863-868.
    47
    Greenberg, A. S., McDaniel, M. L. (2002). Identifying the links between obesity, insulin resistance and beta-cell function: potential role of adipocyte-derived cytokines in the pathogenesis of type 2 diabetes. European Journal of Clinical Investigation, 32, 24-34.
    Gupta, N.K., Mueller, W. H., Chan, W., & Meininger, J. C. (2002). Is obesity associated with poor sleep quality in adolescents? American Journal of Human Biology, 14, 762–768.
    Hasler, G., Buysse, D., Klaghofer, R., et al. (2004). The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep, 27, 661– 666.
    Heffner, J. E., Rozenfeld, Y. Kai, M. Stephens, E. A., Brown, L. K. (2012). Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care. Chest 141, 1414– 1421.
    Hsu, P., et. al., (2015). A comparison of glycated albumin and glycosylated hemoglobin for the screening of diabetes mellitus in Taiwan. Atherosclerosis, 242, 327-333.
    Johnson, M. S., et. al., (2007). Sleep Estimation Using Wrist Actigraphy in Adolescents With and Without Sleep Disordered Breathing: A Comparison of Three Data Modes. Sleep, 30, 899- 905.
    Kawakami, N., Takatsuka N., & Shimizu, N. (2004). Sleep Disturbance and Onset of Type 2 Diabetes. Diabetes Care, 27, 282-283.
    Kim, C., Bullard, K., Herman, W., Beckles, G. (2010). Association Between Iron Deficiency and A1C Levels Among Adults Without Diabetes in the National Health and Nutrition Examination Survey, 1999 –2006. Diabetes Care, 33, 780–785.
    Kim, B. K., Kim, B. S., An, S. Y., Lee, M. S., Choi, Y. J., Han, S. J., Chung, Y. S., Lee, K. W., & Kim, D. J. (2013). Sleep Duration and Glycemic Control in Patients with Diabetes Mellitus: Korea National Health and Nutrition Examination Survey 2007-2010. The Korean Academy of Medical Sciences, 28, 1334-1339.
    Koga, M. (2014). Glycated albumin; clinical usefulness. Clinica Chimica Acta, 433, 96-104. Knutson, K. L., & Van Cauter, E. (2008). Associations between Sleep Loss and Increased Risk of
    Obesity and Diabetes. Annals of the New York Academy of Sciences, 1129, 287-304.
    Knutson, K. L., Van Cauter, E., Zee, P., & Liu K., & Lauderdale, D. S. (2011). Cross-Sectional Associations Between Measures of Sleep and Markers of Glucose Metabolism Among Subjects With and Without Diabetes. Diabetes Care, 34, 1171–1176.
    Kripke, D. F., Garfinkel, L., Wingard, D.L., et al. (2002). Mortality associated with sleep duration and insomnia. Archives of General Psychiatry, 59, 131–136.
    Kuhn, E., Brodan, V., Brodanova, M., & Rysanek, K. (1969). Metabolic effects of sleep deprivation. Activitas Nervosa Superior (Praha), 11, 165–174.
    Leproult, R., Deliens, G., Gilson, M., & Peigneux, P. (2015). Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction. Sleep, 38, 707–715.
    Lindberg, E., J. Theorell-Haglow, M. Svensson, et al. 2012. Sleep apnea and glucose metabolism: a long-term follow- up in a community-based sample. Chest 142: 935–942.
    48
    Locard, E., Mamelle, N., Billette, A., Miginiac, M., Munoz, F., & Rey, S. (1992). Risk factors of obesity in a five year old population. Parental versus environmental factors. International Journal of Obesity and Related Metabolism Disorder, 16, 721–729.
    Lou, P., Chen, P., Zhang, L., Zhang P., Chang, G., Zhang, N., Li, T., & Qiao, C. (2014). Interaction of sleep quality and sleep duration on impaired fasting glucose: a population-based cross- sectional survey in China. BMJ Open 2014;4: e004436. doi:10.1136/ bmjopen-2013-004436.
    Louis, M. & Punjabi, N. M. (2009). Effects of acute inter- mittent hypoxia on glucose metabolism in awake healthy volunteers. Journal of Applied Physiology. 106, 1538-1544.
    Mander, B., Colecchia, E., Spiegel, K., Kim, R., Sannar, E., and Van Cauter, E. (2001) Short sleep: a risk factor for insulin resistance and obesity. Diabetes 50, Suppl 2 , A45.
    Maquet, P. (2000). Functional neuroimaging of normal human sleep by positron emission tomography. Journal of Sleep Reseach, 9, 207–231.
    Mayer-Davis, E., (2017). Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002– 2012. The New England Journal of Medicine, 376, 1419-1429.
    Meltzer, L., Montgomery-Downs, H., Insana, S., & Walsh, C. (2012). Use of actigraphy for assessment in pediatric sleep research. Sleep Medicine Reviews, 16, 463–75.
    Meisinger, C., Heier M., & Loewel H.(2005). Sleep disturbance as a predictor of type 2 diabetes mellitus in men and women from the general population. Diabetologia, 48, 235–241.
    National Sleep Foundation. (2002). “Sleep in America” Poll. Washington, DC: National Sleep Foundation, 2002.
    Nofzinger, E.A., Buysse, D. J., Miewald, J. M., et al. (2002). Human regional cerebral glucose metabolism during non- rapid eye movement sleep in relation to waking. Brain 125, 1105– 1115.
    Nuyujukian, D. S., Beals, J., Huang, H., Johnson, A., Ann Bullock, A., Spero M. Manson, S. M., Jiang, L. (2016). Sleep Duration and Diabetes Risk in American Indian and Alaska Native Participants of a Lifestyle Intervention Project. Sleep, 39, 1919 –1926.
    Pamidi, S., K. Wroblewski, J. Broussard, et al. (2012). Obstructive sleep apnea in young lean men: impact on insulin sensitivity and secretion. Diabetes Care 35, 2384-2389.
    Patricia, M. W., Manuck, S. B., DiNardo, M. M., Korytkowski, M., & Muldoon, M. F. (2015). Shorter Sleep Duration is Associated with Decreased Insulin Sensitivity in Healthy White Men. Sleep, 38, 223-231.
    Pillai, A., G. Warren, W. Gunathilake & I. Idris. 2011. Effects of sleep apnea severity on glycemic control in patients with type 2 diabetes prior to continuous positive airway pressure treatment. Diabetes Technol. Ther. 13: 945–949.
    Ramtahal, R., et, al., (2015). Prevalence of self-reported sleep duration and sleep habits in type 2 diabetes patients in South Trinidad. Journal of Epidemiology and Global Health, 5, s35-s43.
    Reichmuth, K.J., D. Austin, J.B. Skatrud & T. Young. 2005. Association of sleep apnea and type Ii diabetes: a population-based study. Am. J. Respir. Crit. Care Med. 172: 1590–1595.
    49
    Reutrakul, S., & Van Carter, E. (2014). Interactions between sleep, circadian function, and glucose metabolism: implications for risk and severity of diabetes. Annals of the New York Academy of Sciences, 1311, 151-173.
    Ried-Larsen, et. al., (2015). Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial (Protocol). BMJ Open, 5, doi: 10.1136/bmjopen-2015-009764.
    Robertson, M. D., Russell-Jones, D., Umpleby A. M., & Dijk, D. (2013). Effects of three weeks of mild sleep restriction implemented in the home environment on multiple metabolic and endocrine markers in healthy young men. Metabolism Clinical and Experimental, 62, 204- 211.
    Sadeh, A. (2011). The role and validity of actigraphy in sleep medicine: An update. Sleep Medicine Reviews, 15, 259-267.
    Scheen, A. J., Byrne, M. M., Plat, L., Leproult, R., & Van Cauter, E. (1996). Relationships between sleep quality and glucose regulation in normal humans. American Journal of Phisiology- Endocrinology & Metabolism, 271, E261–E270.
    Schmid, S. M., Hallschmid, M., Jauch-Chara, K., Born, J., & Schultes, B. (2008). A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. Journal of Sleep Research, 17, 331-334.
    Spiegel, K., Knutson, K., Leproult, R., Tasali, E., & Cauter, E. V. (2005). Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes. Journal Apply Physiology, 99, 2008-2019.
    Spiegel, K., Leproult, R., & Cauter, E. V. (1999). Impact of sleep debt on metabolic and endocrine function. Lancet, 354, 1435–1439.
    Spiegel, K., Lepoult, R., L’hermite-Baleriaux, M., Copinschi, G., Penev, P. D., & Van Cauter, E. (2004a). Leptin Levels Are Dependent on Sleep Duration: Relationships with Sympathovagal Balance, Carbohydrate Regulation, Cortisol, and Thyrotropin. The Journal of Clinical Endocrinology & Metabolism, 89, 5762–5771.
    Spiegel, K., Tasali, E., Penev, P., & Van Cauter E. (2004b). Brief Communication: Sleep Curtailment in Healthy Young Men Is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite. Annals of Internal Medicine, 141, 846- 850.
    Spruyt, K., Gozal, D., Dayyat, E., Roman, A., & Molfese, D. (2011). Sleep Assessments In Healthy School-Aged Children Using Actigraphy: Concordance with Polysomnography. Journal of Sleep Research, 20, 223-232.
    Taheri, S., Lin, L., Austin, D., et al. (2004). Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLOS Medicine, 1 : e62.
    Tasali, E., Leproult, R., & Spiegel, K. (2009). Reduced Sleep Duration or Quality: Relationships With Insulin Resistance and Type 2 Diabetes. Progress in Cardiovascular Diseases, 51, 381- 391.
    Tsai, Y.W., Kann, N.H., Tung, T. H. et. al., (2012). Impact of subjective sleep quality on glycemic control in type 2 diabetes mellitus. Family Practice, 29, 30-35.
    50
    Van Cauter, E., Blackman, J. D., Roland, D., et al. (1991). Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep. The Journal of Clinical Investigation, 88, 934– 942.
    Van Cauter, E., Polonsky, K. S., & Scheen, A. J. (1997). Roles of circadian rhythmicity and sleep in human glucose regulation. Endocrine Reviews, 18, 716–738.
    Vgontzas, A. N., Bixler, E. O. & Chrousos, G. P. (2003). Metabolic disturbances in obesity versus sleep apnoea: the importance of visceral obesity and insulin resistance. Journal of Internal Medicine, 254, 32-44.
    Vgontzas, A. N., & Chrousos, G. P. (2002). Sleep, the hypothalamic-pituitary-ad- renal axis, and cytokines: multiple interactions and disturbances in sleep disorders. Endocrinology and Metabolism Clinics of North America, 31, 15-36.
    Vgontzas, A. N., Papanicolaou, D. A., Bixler, E. O., et al. (1999). Circadian interleukin-6 secretion and quantity and depth of sleep. The Journal of Clinical Endocrinology & Metabolism, 84, 2603–2607.
    Vgontzas, A. N., Zoumakis, E., Bixler, E. O., et al. (2004). Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. The Journal of Clinical Endocrinology & Metabolism, 89, 2119–2126.
    Vioque, J., Torres, A., & Quiles, J. (2000). Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain. International Journal of Obesity, 24, 1683–1688.
    Vorona, R., Winn, M., Babineau, T., Eng, B., Feldman, H., & Ware, J. (2005). Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Arch Intern Med, 165, 25–30.
    Walch, O. J., Cochran, A., & Forger, D. B. (2016). A global quantification of “normal” sleep schedules using smartphone data. Science Advances, 2, e1501705.
    Wong, K. C., & Wang, Z. (2006). Prevalence of type 2 diabetes mellitus of Chinese populations in Mainland China, Hong Kong, and Taiwan. Diabetes Research and Clinical Practice, 73, 126- 134.
    World Health Organization (2016). Global Report on Diabetes.
    Yaggi, H. K., Araujo, A. B., & Mckinlay, J. B. Sleep Duration as a Risk Factor for the
    Development of Type 2 Diabetes (2006). Diabetes Care, 29, 657–661.
    Youngstedt, S. D., & Kripkr, D. F. (2004). Long sleep and mortality: rationale for sleep restriction.
    Sleep Medicine Reviews, 8, 159–174.
    Zheng, Y., Wang, A., Pan, C., Lu, J., Dou, J., Lu, Z., Ba, J., Wang, B., & Mu, Y. (2015). Impact of night sleep duration on glycemic and triglyceride levels in Chinese with different glycemic status. Journal of Diabetes, 7, 24–30.
    Zuo, H., Shi, Z., & Hussain, A. (2014). Prevalence, trends and risk factors for the diabetes epidemic in China: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 104, 63-72.
    Description: 碩士
    國立政治大學
    心理學系
    103752022
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0103752022
    Data Type: thesis
    DOI: 10.6814/THE.NCCU.PSY.004.2019.C01
    Appears in Collections:[心理學系] 學位論文

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