嬰兒身體活動與睡眠型態之描述性研究

Abstract

嬰兒的身體活動與睡眠皆與健康息息相關，過去文獻曾探討身體活動與睡眠之相關性，成人族群研究發現適度的中高度身體活動有助於提升睡眠品質及增加睡眠時數，兒童族群亦發現相似結果，然而目前尚未有文獻探討嬰兒身體活動與睡眠型態之關係。本研究欲對嬰兒身體活動與睡眠型態進行描述性研究，研究目的為：(1) 描述及比較六個月及十二個月嬰兒日間身體活動及日夜睡眠型態；(2) 分析活動記錄器所測得六個月及十二個月嬰兒靜態至輕度及中高度身體活動之活動計數值及其切割點；(3) 探討六個月及十二個月嬰兒日間身體活動與日夜睡眠型態之相關性。本橫斷性研究於北部某醫學中心健兒門診進行收案，有46位六個月及38位十二個月之健康嬰兒參與研究，嬰兒佩戴活動記錄器七日；父母完成嬰兒基本家庭資料表、長版簡易嬰兒睡眠問卷；嬰兒主要照顧者完成嬰兒睡眠活動日誌。研究結果發現六個月及十二個月嬰兒夜間睡眠百分比分別為88.24% 及88.33%、夜間睡眠時數為462.96分鐘及485.29分鐘，而十二個月嬰兒相較於六個月嬰兒，其夜間睡眠潛伏期、日間睡眠時數、及整日睡眠時數皆有顯著下降，分別減少3.81分鐘、47.33分鐘、及27.27分鐘 (p＜0.05)。以Receiver Operating Characteristic curve (ROC) 分析出活動記錄器代表六個月及十二個月嬰兒中高度身體活動計數值分別為≧228計數/30秒及≧175計數/30秒，並以此進一步計算出兩族群每日參與中高度身體活動時數為282.82及340.31分鐘。Pearson Cor-relation分析發現六個月嬰兒較高的日間中高度身體活動百分比與較短的整日睡眠時數、及較低的夜間睡眠百分比有相關 (r=-.32，p＜0.05；r=-.35，p＜0.05)；十二個月嬰兒較高的日間中高度身體活動百分比與較長的夜間睡眠時數有關 (r=.36，p＜0.05)。總結本研究結果顯示嬰兒身體活動與睡眠時數具有相關性，但究竟中高度身體活動會增長還是縮短睡眠時數，本研究兩族群間未有一致結果，推估可能因兩族群從事中高度身體活動的時間點分布不同進而出現相異之結果，建議未來能有更多研究加入探究。

Background: Associations between physical activity and sleep patterns have been described in adult and child populations. Previous studies show that regular participa-tion in physical activity can improve sleep quality and quantity. However, the rela-tionships between physical activity and sleep patterns in infants remain unknown. Purpose: The purposes of this study were to: (1) describe and compare physical activ-ity and sleep patterns in the six-month-old and twelve-month-old infants, (2) define the count values and cut-points of actigraphy for sedentary-to-light and moder-ate-to-vigorous physical activity in the six-month-old and twelve-month-old infants, and (3) investigate the associations between physical activity and sleep patterns in the six-month-old and twelve-month-old infants. Methods: Forty-six six-month-old and thirty-eight twelve-month-old infants were recruited from a university affiliated hos-pital. Infants wore the actigraphy to monitor physical activity and sleep patterns for 7 consecutive days. Parents completed the Extended version of the Brief Infant Sleep Questionnaire and a sleep-activity diary. Results: Six-month-old and twelve-month-old infants’ sleep percent were 88.24% and 88.33%, respectively. Their nocturnal sleep time was 462.96 minutes and 485.29 minutes, respectively. Compared to the six-month-old infants, the twelve-month-old infants had shorter sleep latency, nap time, and total sleep time per day (all p＜0.05). Receiver Operating Characteristic curve analysis showed that the cut-points for sedentary-to-light and moder-ate-to-vigorous physical activity by actigraphy was≧228 counts/30s for six-month-old infants and ≧175 counts/30s for twelve-month-old infants. All the infants spent ＞1 hour per day in moderate-to-vigorous physical activity. Percentage of moder-ate-to-vigorous physical activity was negatively correlated with sleep percent and total sleep time per day in the six-month-old infants (r=-.32, p＜0.05; r=-.35, p＜0.05). Percentage of moderate-to-vigorous physical activity was positively correlated with nocturnal sleep time in the twelve-month-old infants (r=.36, p＜0.05). Conclusion: Our results suggest a link between physical activity and sleep patterns in the infants. Further studies are needed to confirm these results.