國中生睡眠狀況之變化類型及相關因素探討：七至九年級追蹤資料之分析結果

Abstract

目標：探討國中生從七至九年級之睡眠狀況，並進一步找出與睡眠狀況之變化類型有關的因素。方法：運用兒童與青少年行為之長期發展研究計畫（簡稱CABLE計畫）的資料庫，擷取其中於2001年時就讀國小一年級之研究樣本，以2007年（七年級）至2009年（九年級）持續被追蹤者為本研究的樣本，共有2,422人。以潛在類別成長模式分類隨時間變動之變項；並以多元羅吉斯迴歸模式，控制性別與父母教育程度之後，檢定相關因素與睡眠狀況之變化類型的關係。結果：1. 研究樣本七至九年級的夜間失眠日數，從一個月平均0.90日增加到1.08日；睡眠債從98.58分鐘提高到111.29分鐘；日間嗜睡日數，從一個月平均2.31日增至3.84日；三者都有逐年增加的趨勢。2. 研究樣本在七至九年級的三個年度，睡眠狀況的變化趨勢為：夜間失眠的變化類型可分為持續正常組（93.1%）和持續失眠組（6.9%）；睡眠債的變化類型可分為持續少組（55.6%）和持續多組（44.4%）；日間嗜睡的變化類型可分為持續正常組（90.9%）和持續嗜睡組（9.1%）。3. 研究樣本七至九年級較易成為夜間失眠者，主要是健康狀況持續差者或持續中等者；持續有憂鬱情緒者；課業壓力持續高者；以及飲酒頻率持續高者。4. 研究樣本七至九年級較易成為睡眠債持續多者，主要是課業壓力為中等漸增者。5. 研究樣本七至九年級較易成為日間嗜睡者，主要是BMI超重變正常者；持續有憂鬱情緒者；以及飲酒頻率持續中等者和持續高者。建議：教育單位和學校教師，必須及早關注青少年的睡眠問題。推動預防國中生睡眠問題的計畫時，可考慮健康狀況不佳、BMI超重、有憂鬱情緒、課業壓力較大、以及飲酒頻率較高的學生；設計預防國中生睡眠問題之介入策略時，可將改善身體與精神健康狀況，強化壓力因應技巧，以及減少飲酒頻率的相關內容納入。

Objectives: To investigate the sleep trajectories among 7th to 9th graders and to examine the related factors. Methods: Data from 2,422 students followed from the 7th to 9th grade (from 2007 to 2009) as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) Project were used for analysis. The latent class growth model (LCGM) and logistic regression model were utilized in the statistical analysis. Results: 1. The number of nights with insomnia (0.90 to 1.08 within 1 month), the sleep debt (98.58 to 111.29 minutes), and the number of daytime sleepiness (2.31 to 3.84 within 1 month), increased as the years went by from the 7th to 9th grades. 2. The best LCGM for insomnia identified 2 latent classes, the Normal class (93.1%) and the Insomnia class (6.9%). The best LCGM for sleep debt included 2 latent classes, the Less class (55.6%) and the More class (44.4%). The best LCGM for daytime sleepiness identified 2 latent classes, the Normal class (90.9%) and the Sleepy class (9.1%). 3. Individuals with higher odds of being in the Insomnia class were those with Worse or Fair health status, a Depressive tendency, High academic obligations, and Often alcohol consumption. 4. Those with Increasing from moderate academic obligations had higher odds of being in the More sleep debt class. 5. Individuals with higher odds of being in the Sleepy class were those with From overweight to normal BMI, a Depressive tendency, and Usually or Often alcohol consumption. Conclusions and Suggestions: Education policy makers and junior high schools teachers should pay attention to adolescents’ sleep problems as early as possible. Multidimensional adolescent health promotion programs should be implemented and include general health, BMI, depressive tendency, academic obligations, and alcohol consumption. Strategies to improve physical and mental health, learn skills to cope with stress, and decrease the frequency of alcohol consumption should be included in intervention projects to prevent sleep problems among junior high school students.