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| Title: | 補眠與否？探討週間週末睡眠模式差異之內在機制及其影響
Catch-Up Sleep or not? The mechanism, factors and consequences of weekend-weekday sleep pattern differences |
| Authors: | 蕭帆琦
Hsiao, Fan-Chi |
| Contributors: | 楊建銘
Yang, Chien-Ming
蕭帆琦
Hsiao, Fan-Chi |
| Keywords: | 睡眠不足
補眠
社交時差
時型
約日節律特性
Insufficient sleep
Catch-Up Sleep
Social Jet Lag
Chronotype
Circadian Type Inventory |
| Date: | 2020 |
| Issue Date: | 2020-03-02 11:13:46 (UTC+8) |
| Abstract: | 研究目的 週間睡眠不足，而週末晚睡晚起且補眠是現代人生活常見的睡眠型態，根據睡眠調控的雙歷程理論（two-process model），週末補眠一方面可以補足週間未能滿足恆定系統（homeostatic system）中的睡眠驅力（sleep drive），而有正向的效果，另一方面則可能造成約日節律（circadian rhythm）的干擾，造成「社交時差」─個體內在約日節律與外在時間線索出現不一致，而導致負面的影響。但之前的研究者多從單一面向來討論，多忽略了另一面向之影響，目前尚未有研究綜合影響恆定系統的「睡眠時數」及影響晝夜節律的「醒睡時間」來討論週間週末睡眠模式的差異；而時型（chronotype）也會影響社交時差及週末補眠作用，顯示約日節律相關個人特質也可能會對週間週末睡眠模式造成影響。另外，也未曾有研究對週間週末睡眠模式進行分類，找出最常被使用之類別及其差異。因此本論文嘗試從雙歷程模式出發，討論個人特質、週間睡眠時數、週末補眠時數、社交時差及日常表現間的關係，並進一步澄清週末補眠的補償作用及社交時差的負向影響，再綜合「睡眠時數」及「醒睡時間」區分不同的週間週末睡眠模式，進而找出不同睡眠模式間的差異。
研究方法 本論文包含兩個研究，研究一為大樣本問卷調查研究，透過社群網站招募1000名研究參與者填寫線上問卷，排除漏答、作息不規律或無固定工時者，最後納入850份資料（平均年齡32.4歲：範圍21至55歲；541名女性）進行分析。分析時以配對t檢定比較週間週末睡眠模式是否的確存在差異，並分析各量表間的相關，再進一步以路徑分析探討個人特質、週間睡眠時數、週末補眠時數、社交時差及日常表現間的關聯性。其次，以潛在類別分析，藉由週間醒睡時間、睡眠及躺床時數、各指標在週間週末的差異，以及社交時差指標，將週間週末睡眠模式進行分類，並以單因子變異數分析區分各類別在睡眠相關指標、個人特質及日常表現間的差異。研究二則以實驗法檢驗週末補眠的補償作用及社交時差的負向影響，招募共91名研究參與者，排除未配合實驗操弄、作息變異過大及有睡眠困擾者，最終納入69名研究參與者（平均年齡22.0歲：範圍20至29歲；48名女性），並將研究參與者隨機區分為「週末晚睡晚起（G1：n=20）」、「週末晚睡晚起且補眠（G2：n=24）」及「週末晚起且補眠（G3：n=25）」， 三組皆進行兩週的實驗，採對抗平衡設計（counter-balance design），兩週皆配戴活動記錄腕錶及填寫睡眠日誌，其中一週為基礎期，限制研究參與者的躺床時數為7小時，並固定週間週末的作息相同，基礎期結束後，週一早上以史丹福嗜睡量表（Stanford Sleepiness Scale, SSS）量測主觀嗜睡度，以及正負向情感量表（Positive and Negative Affect Schedule, PANAS）、盤斯心情量表（Profile of Mood State, POMS）量測情緒，並請研究參與者至實驗室後接受心理動作警覺作業（psychomotor vigilance task, PVT）及連續注意力表現測驗（Continuous Performance Test, CPT）以量測認知表現；另一週為實驗期，週間同樣限制躺床時數及固定作息，週末則依不同組別調整作息，分別是未補眠且存在約2小時社交時差的「週末晚睡晚起（G1）組」、補眠2小時及具2小時社交時差的「週末晚睡晚起且補眠（G2）組」及補眠2小時具1小時社交時差的「週末晚起且補眠（G3）組」，同樣在實驗期結束後的週一早上，量測主觀嗜睡度、情緒及認知表現。
研究結果 研究一第一部分結果顯示週間週末睡眠模式的確存在差異，週末的就寢、起床時間、睡眠時間中點皆晚於週間，睡眠時數也較長。週間睡眠時數與以艾普沃斯嗜睡量表（Epworth Sleepiness Scale, ESS）測量的主觀嗜睡度及以流行病學研究中心憂鬱量表（The Center for Epidemiologic Studies, Depression Scale, CES-D）量測的憂鬱情緒有顯著負相關，而週末補眠時數及社交時差則與ESS及CES-D得分有顯著正相關，與量測個體工作投入程度的工作敬業量表（Utrecht Work Engagement Scale, UWES）為顯著負相關。路徑分析結果顯示時型對週間睡眠時數、週末補眠時數及社交時差存在顯著影響，而週間睡眠時數對於日常表現為存在一直接效果，即週間睡眠時數越少，對日常表現有較負向的影響；但也會透過週末補眠時數，使社交時差增加，進而使負向影響增加，存在一間接影響路徑。另外，研究一的第二部份則藉由潛在類別分析，將研究參與者區分四個類別，分別是週末早睡早起不補眠的「不補眠組（n=192）」、週末早睡稍晚起補眠少的「低補眠組（n=229）」、週末晚起且補眠時數高的「中補眠組（n=318）」，以及週間睡眠時數最短週末晚起且補眠時數最高的「高補眠組（n=111）」。研究結果發現不補眠組年齡最長、時型最接近白日型，其次是低補眠組、中補眠組，高補眠組年齡最輕、時型最接近夜貓型，且有較高的嗜睡度、憂鬱情緒。研究二則以組別（3）x週間週末（2）x實驗操弄（2）三因子混合設計變異數分析（three-way ANOVA, mixed design）比較各組在基礎期及實驗期週間活動記錄腕錶週末睡眠相關指標差異，結果發現各組在實驗期週末的入睡耗時存在組間差異，因就寢時間越晚的組別，則入睡耗時越短，而有補眠的兩組（G2、G3）在實驗期週末的入睡後清醒時間皆顯著高於基礎期；而週末晚起且補眠（G3）組在實驗期結束後的週一早上，其疲倦分數及POMS總分低於基礎期，但另外兩組皆呈現實驗期高於基礎期。
結論 本論文研究結果顯示時型確實會影響週間週末睡眠模式，而週末補眠習慣可能非因應週間睡眠不足的最佳策略，週末補眠越多，可能反映的是週間睡眠不足越嚴重，同時還會間接使社交時差增加，造成負向影響，特別是影響主觀嗜睡度、情緒狀態及工作投入程度。然而，本論文也發現週間週末睡眠模式有不同類型，與個體的年齡、時型及約日節律特性可能有關，年齡越長、時型越接近白日型且約日節律較為彈性者，選擇週末補眠的機率較小，推測個人特質可能會影響其選擇睡眠型態，使不同的週間週末睡眠模式存在群體差異，未來也可針對不同族群發展不同之因應策略。
Introduction It is common practice in modern life to deprive oneself of sleep on weekday nights and to sleep-in on weekend mornings to catch up on sleep loss. According to the two-process model of sleep regulation, this "catch-up sleep（CUS）" pattern might be useful to satiate homeostatic sleep drive and to compensate for the sleep loss on weekday nights, but it might also cause circadian misalignment and lead to“social jet lag（SJL）”─ the discrepancy between the internal circadian rhythm and external time cue. However, very few studies have considered the mechanism of weekend sleep patterns which take both the homeostatic and circadian mechanisms into consideration. Thus, this study aimed to explore the relationship between insufficient sleep on weekdays, CUS and SJL, considering both the sleep duration and timing. Previous studies have also reported that individual traits, such as chronotype, might be associated with the degree of SJL and the effect of CUS. This study therefore also explores the role of circadian-related individual traits in SJL and CUS. Moreover, this study aimed to find the subgroups of weekday and weekend sleep patterns to further investigate the association between different individual characteristics and weekday/weekend sleep patterns.
Methods The dissertation includes an online survey study and a laboratory experiment. The online survey（Study 1）recruited 1,000 participants. Among them, 850（average age: 32.4 years, range: 21-55 years; 541 female） were eligible and completed the survey. Paired-t test was used to confirm the differences between weekday and weekend sleep patterns. Pearson`s correlation was conducted to examine the correlations between the variables. Path analysis was then performed to explore the association between individual circadian-related traits, sleep duration on weekdays, CUS, SJL and daily performance. In addition, latent class analysis was used to find subtypes of weekday and weekend sleep patterns based on bedtime, rising time, total sleep time, and time in bed（TIB）on weekdays, the differences in those indexes on weekdays and weekends, and SJL. One-way ANOVA was conducted to compare the individual characteristics among the different subtypes of sleep pattern. The experiment（study 2）included 69 （average age: 22.0 years, range: 20-29 years; 48 female） young adults as participants. They were randomly assigned to three groups: a "delayed weekend sleep schedule" group（G1: n=20）, a "delayed weekend sleep schedule + CUS" group（G2: n=24）, and a "delayed rising schedule + CUS" group（G3: n=25）. All participants had to go through a two-week study period: a baseline condition and an experimental condition. The sequence for the two conditions was counter-balanced across participants. During the two weeks, participants were requested to fill in a sleep diary and to wear an actigraph every day. During the baseline week, participants had to restrict their TIB to 7 hours; during the experimental week, they were required to follow a regular sleep schedule with restricted TIB on weekdays, and to follow one of three experimental sleep patterns on weekends: G1- no CUS and 2 hours of SJL; G2- 2 hours of CUS and SJL, and G3- 2 hours of CUS and 1 hour of SJL. At the end of the baseline and experimental period, each participant rated their subjective sleepiness on the Stanford Sleepiness Scale（SSS）and emotion on the Positive and Negative Affect Schedule（PANAS）and Profile of Mood State（POMS）after awakening, as well as to come to the laboratory to complete the Psychomotor Vigilance Task（PVT）and the Continuous Performance Test（CPT）in the lab on Monday mornings.
Results Online survey data confirmed that there were significant differences between weekday and weekend sleep patterns, with delayed bedtime, rising time and midpoint of sleep on weekends compared with weekdays. Sleep duration on weekdays（SDw） correlated negatively with the Epworth Sleepiness Scale（ESS）and The Center for Epidemiologic Studies Depression Scale（CES-D）, while CUS and SJL showed positive correlations with ESS and CES-D. Besides, CUS and SJL were negatively related with the Utrecht Work Engagement Scale（UWES）. Path analysis showed that chronotype could affect SDw, CUS and SJL; there was a direct effect from SDw to measures of daytime functioning（ESS, CES-D and reversed UWES）, with CUS and SJL as two mediators subsequently between SDw and daytime functioning. Latent class analysis found four types of sleep pattern, namely no-CUS type（n=192）, Low-CUS type（n=229）, Median-CUS type（n=318）and High-CUS type（n=111）. No-CUS type were older than other types and their OLQ scores were higher than those of other types. High-CUS type were younger than other types and they had the lowest OLQ scores. In the laboratory study, there was a group difference between sleep onset latency（SOL） on weekends in the experiment period. Those groups with CUS（G2 and G3）showed higher wake after sleep onset（WASO）on weekend nights in the experiment period than the baseline. G3, compared to the other two groups, showed a decreasing trend on negative emotion report compared to the baseline after the experimental manipulation. However, G1 and G2 showed increasing negative emotion compared to their baseline.
Conclusions The results showed that chronotype seems to be an important factor in the different sleep patterns of weekdays and weekends. More important, CUS seems not to be a good coping strategy to compensate for insufficient sleep on weekdays. More CUS might lead to larger SJL, while SJL is related to higher sleepiness, elevated levels of negative mood and lower degrees of job involvement. The positive compensatory effect of CUS might be cancelled out by the negative effect of SJL. Moreover, different people would choose diverse weekday and weekend sleep habits. Older people showed sufficient sleep on weekdays and less CUS on weekends. Younger people slept less on weekdays and extended their sleep on weekends; they also showed the highest levels of sleepiness and depressive mood. Different coping strategies for different populations for weekday sleep debt should be developed and tested in future studies. |
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| Description: | 博士
國立政治大學
心理學系
100752502 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0100752502 |
| Data Type: | thesis |
| DOI: | 10.6814/NCCU202000260 |
| Appears in Collections: | [心理學系] 學位論文
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