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| Title: | 壓力下睡眠脆弱特質與自主神經反應歷程之關係：以誘發壓力反應和夜間擾醒探討
The Association between Stress-related Sleep Vulnerability and ANS Reaction Process: An Investigation with Induced Stress Reaction and Nocturnal Arousal |
| Authors: | 李語荃
Li, Yu-Chuan |
| Contributors: | 楊建銘
Yang, Chien-Ming
李語荃
Li, Yu-Chuan |
| Keywords: | 睡眠脆弱特質
壓力反應性
壓力恢復性
自主神經激發
Stress-related sleep vulnerability
Stress reactivity
Stress recovery
Nocturnal autonomic arousal |
| Date: | 2025 |
| Issue Date: | 2025-07-01 14:12:29 (UTC+8) |
| Abstract: | 研究目的：壓力下睡眠脆弱特質（stress-related sleep vulnerability）指的是個體在面對壓力事件時，其睡眠易受到干擾的程度，被視為失眠發展歷程中重要的前置因子。本研究主要目的在探討高與低睡眠脆弱特質的個體在面對日間壓力與夜間擾醒情境時，自主神經系統的反應性與恢復性歷程差異，並進一步分析日間與夜間的自主神經反應歷程是否具有一致性，以了解其是否為一種穩定的生理特質，以期作為失眠風險的潛在指標。
研究方法：本研究以福特壓力下失眠反應量表（Ford Insomnia Response to Stress Test, FIRST）作為睡眠脆弱特質的測量，篩選得分大於23分的高FIRST組受試者19名，與得分低於18分的低FIRST組受試者21名。受試者於實驗前配戴睡眠腕錶並填寫三天睡眠日誌，維持規律作息，實驗當日，會先進行心理生理壓力反應測量（Psychophysiological Stress Profile, PSP），記錄心率與心跳變異率（heart rate variability, HRV）指標以觀察壓力反應歷程，而後受試者進行多向度睡眠生理記錄，並在整夜睡眠中透過播放遞增的聲音刺激誘發擾醒，進一步分析擾醒後的自主神經激發反應性與恢復性。本研究比較兩組在日間與夜間自主神經反應歷程的差異，並分析其間的關聯，以探討自主神經反應歷程是否具穩定的特質性。
研究結果：壓力反應測量中，兩組在壓力反應性和壓力恢復性的心率及心跳變異率的高頻功率（high-frequency power, HF）、低/高頻比（LF/HF ratio）等指標上皆無顯著差異。在夜間睡眠中，高FIRST組於非快速動眼期（non-rapid-eye-movement, NREM）的心跳反應峰值顯著高於低FIRST組，但以曲線下面積量化自主神經激發反應性時，兩組無顯著差異；相對地，在以AUC量化的自主神經激發恢復性方面，高FIRST組顯著高於低FIRST組，顯示其在夜間擾醒時自主神經恢復能力較差。此外，研究亦發現，高FIRST組的壓力反應性（以心率為指標）與夜間自主神經激發反應性之間具有顯著正相關，顯示自主神經反應具有一定的一致性與特質性。
結論：本研究整合日間與夜間兩種情境，從歷程觀點探討高、低睡眠脆弱特質個體在自主神經反應性與恢復性上的差異，發現高睡眠脆弱特質者於夜間覺醒後呈現較差的自主神經恢復能力，支持其在壓力下可能更易累積生理激發、干擾睡眠穩定性的假設，此外亦發現高睡眠脆弱特質個體經歷日間壓力操弄與夜間擾醒時，心率反應的一致性亦顯示自主神經反應特性可能具有一定特質性，支持自主神經恢復困難的傾向可能為失眠的前置生理特徵，值得未來更多研究探討其在失眠發展歷程的角色以及其作為失眠脆弱因子的生理標記的可能性。
Objectives: Stress-related sleep vulnerability refers to the degree to which an individual’s sleep is susceptible to disruption in response to stress, and is considered a key psychophysiological vulnerability factor in the development of insomnia. This study aimed to investigate differences in autonomic nervous system (ANS) reactivity and recovery between individuals with high and low stress-related sleep vulnerability when exposed to daytime stress and nocturnal arousal. Additionally, it examined whether ANS responses across day and night contexts exhibit consistency, to assess whether such responses represent a stable physiological trait and a potential marker for insomnia vulnerability.
Method: This study used the Ford Insomnia Response to Stress Test (FIRST) to assess stress-related sleep vulnerability, selecting 19 participants with scores above 23 as the high FIRST group and 21 participants with scores below 18 as the low FIRST group. Participants wore actigraphies and completed sleep diaries for three consecutive days to maintain regular sleep routines. On the experiment day, they first went through the Psychophysiological Stress Profile (PSP) assessment to measure their stress reactivity and recovery on heart rate (HR) and heart rate variability (HRV) indices. During the subsequent overnight polysomnographic recording, auditory stimuli of increasing intensity were used to induce nocturnal arousals, from which autonomic arousal reactivity and recovery patterns were extracted. Group differences in ANS dynamics across daytime and nighttime conditions were analyzed, along with correlations between responses to explore trait-like consistency.
Result: During the PSP assessment, no significant group differences were observed in HR or HRV indices, high-frequency power (HF) and the low-frequency to high-frequency ratio (LF/HF), for either stress reactivity or recovery. During sleep, the high FIRST group exhibited significantly higher peak heart rate during non-rapid-eye-movement (NREM)sleep. However, there were no significant differences in autonomic arousal reactivity when quantified by the area under the curve (AUC). In contrast, in terms of autonomic arousal recovery quantified by AUC, the high-FIRST group showed significantly higher values than the low-FIRST group, indicating poorer autonomic recovery following nocturnal arousal. Moreover, in the high-FIRST group, a significant positive correlation was found between HR stress reactivity and nocturnal autonomic arousal reactivity, suggesting a degree of consistency and trait-like response patterns.
Conclusion: By introducing daytime stress and nighttime arousal, this study examines the process of ANS reactivity and recovery in individuals with varying levels of stress-related sleep vulnerability. These findings suggest that individuals with high stress-related sleep vulnerability show poorer recovery of nocturnal autonomic arousal following cortical arousals, which may predispose them to cumulative physiological activation that disrupts sleep stability. The observed consistency in heart rate reactivity across contexts also supports the notion that ANS response patterns may reflect a stable physiological trait. These results support the notion that impaired autonomic recovery may represent a predisposing physiological feature of insomnia and underscore the importance of future research investigating its role in insomnia development and its potential as a biomarker of insomnia vulnerability. |
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| Description: | 碩士
國立政治大學
心理學系
110752024 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0110752024 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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