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題名 安眠藥使用頻率的發展軌跡與其相關因子：電話追蹤研究
The Developmental Trajectories of Hypnotic Use Frequency and the Associated Factors: A phone-call follow-up research
作者 李昇晃
Lee, Shen-Kwang
貢獻者 楊建銘
Yang, Chien-Ming
李昇晃
Lee, Shen-Kwang
關鍵詞 失眠
安眠藥
群體基礎軌跡分析
BZD
BzRA
Insomnia
Hypnotics
Group-based Trajectory Modeling
BZD
BzRA
日期 2019
上傳時間 7-Aug-2019 16:33:34 (UTC+8)
摘要 研究目的：過去文獻建議短期使用安眠藥，但臨床上不難發現部分患者會發展成長期使用者，而這群人有較高的藥物副作用與依賴風險，是個不容小覷的臨床議題。過往探討安眠藥使用行為機制時，多將安眠藥使用行為簡易區分為短期或長期使用，然而，此區分方式尚不足以描述安眠藥使用者間的用藥行為個別差異，導致後續研究出現異質性。同時過往研究多採用橫斷研究進行探討，凸顯了長期追蹤資料的需求。因此，本研究目的以安眠藥使用頻率的軌跡發展切入，探索個別差異，接著透過人口變項、心理相關變項與睡眠相關變項來了解軌跡差異的可能原因，最後建立初步預測的模型，提供臨床處遇參考。

研究方法與結果： 研究受試者為144名曾經或目前正服用安眠藥的患者，待完成一份心理社會相關問卷後，便進行一年半的電話追蹤（第0、1、3、6、12和第18個月），收集其安眠藥的使用頻率。所收集的追蹤資料先進行群體基礎軌跡模型分析，將安眠藥使用頻率軌跡型態劃分成『穩定高頻使用』、『穩定低頻使用』、『快速降頻使用』、『慢速降頻使用』與『稀有使用』等，五種軌跡型態，其人數比例分別為42.6%、12.4%、12.5%、17.8%、以及14.7%。所有軌跡型態的受試者中，穩定高頻使用的年齡最高、服藥後的失眠嚴重程度最高、安眠藥渴求程度最高，與其他軌跡呈現差異；穩定低頻使用的脆弱樣貌與穩定高頻使用類似，唯有在渴求程度明顯較低。稀有使用則與穩定高頻使用明顯相反，平均年齡最低、服藥後失眠嚴重程度最低、安眠藥渴求程度最低。而下降軌跡分成快速降頻與慢速降頻兩種型態，他們皆有較高的服藥後失眠嚴重程度，不同的是快速降頻使用的平均年齡較低、渴求程度也較低，而慢速降頻使用的樣貌可與穩定高頻使用媲美，唯有在對安眠藥的失控感上明顯低於穩定高頻使用。

結論： 本研究設計以臨床情境為平台，建立了追蹤18個月的安眠藥使用頻率軌跡發展模型。此軌跡模型呈現5種不同的安眠藥使用頻率軌跡，呈現個別差異，且安眠藥渴求程度、服藥後的失眠嚴重程度，被凸顯為安眠藥使用行為相當重要的課題。
Objective: Hypnotics is recommended for short-term use but is commonly prescribed for prolonged period of time in clinical settings. However, past research suggested that there were individual differences in the pattern of hypnotic use and have not been studied over an extended time period. Therefore, the current study aims to categorize the developmental patterns of hypnotic use through trajectory analysis, and to examine the differences in the psychosocial factors associated with the different trajectories.

Methods and Results: 144 Insomnia patients with history of hypnotic use were recruited to participate in the study. They completed a package of questionnaires regarding psychosocial variables and were followed up at 6 points of time (0, 1, 3, 6, 12 and 18 months) to collect their frequency of hypnotic use. All data were used to estimate trajectories of hypnotic use frequency from group-based trajectory modeling and identified five different trajectories among users, they are “stable high users” (42.6%), “stable low users” (12.4%), “fast decline users” (12.5%), “slow decline users” (17.8%) and “rarely users” (14.7%). Among hypnotic use frequency trajectories, MANOVA results showed that “stable high users” were older, had greater insomnia severity with medication and hypnotic-urge level, meanwhile “stable low users” tend to have a similar profile with “stable high users” except for a lower hypnotic-urge level. “Rarely users” had the protective profile which were younger, had lesser insomnia severity with medication and hypnotic-urge level. Interestingly, both “fast decline users” and “slow decline users” showed greater insomnia severity with medication than the “stable low users”and “rarely users”. However, they could be differentiated by the hypnotic-urge level. Specifically, “fast decline users” were much lower and “slow decline users” were as high as “stable high users” in hypnotic-urge level except for the compelling desire to use hypnotic scores.

Conclusions: The results of the current study suggested that the heterogeneous practice among sleep medication users. At the same time, the predicting model raised the importance of insomnia severity and hypnotic craving as important issues in hypnotic use behavior.
參考文獻 中文部分：
1. 行政院衛生署（2007）。苯二氮平類（Benzodiazepines）藥品用於鎮靜安眠之使用指引。
2. 沈武典（2001）。醫院院所 Benzodiazepine 藥物不當使用的初步分析。行政院衛生署管制藥品管理局九十年度委託科技研究計劃報告。台北市；台北醫院。
3. 李澄賢（2004）。大學生的情緒調節、調節焦點、樂觀與創造力之關係。未出版之碩士論文，國立政治大學，台北市。
4. 吳佳璇（2005）。台灣鎮靜劑安眠藥品使用盛行率以及相關後遺症之研究。行政衛生署管制藥品管理局。
5. 初麗娟、高尚仁（2005）。壓力知覺對負面心理健康影響: 靜坐經驗, 情緒智能調節效果之探討。中華心理學刊，2（47）， 157-79。
6. 車先蕙、盧孟良、陳錫中、張尚文、李宇宙（2006）中文版貝克焦慮量表之信效度。台灣醫學，4（10）， 447-54。
7. 林一真（2000）。貝克焦慮量表中文版。台北市：中國行為科學社。
8. 林詩淳（2007）。慢性失眠者與情境性失眠高危險族群之壓力因應與失眠的關係。未出版之碩士論文，國立政治大學，台北市。
9. 陳昌偉、詹雅雯、楊建銘、林詩淳（2009）。中文版睡眠失功能信念及態度量表之信效度探討。臨床心理學刊，1（4），59-67。
10. 陳昌偉（2014）。安眠藥物長期使用型態之探討。未出版之博士論文，國立政治大學，台北市。
11. 楊建銘、許世杰、林詩淳、周映妤、陳瑩明（ 2009）。失眠嚴重度量表中文版的信, 效度研究。臨床心理學刊， 2（4），95-104。
詹雅雯、陳昌偉、楊建銘、林詩淳（2009）。中文版睡前激發狀態量表之信, 效度探討。臨床心理學刊， 1（4），51-58。
12. 賴羽琁（2016）。以計劃行為理論及渴想探討長期助眠藥物使用之心理因素。未出版之碩士論文，國立政治大學，台北市。
13. 盧孟良、車先蕙, 、張尚文、沈武典 （2002）。中文版貝克憂鬱量表第二版之信度和效度。台灣精神醫學，4（16），301-10.
14. 謝斯婷（2010）。長期使用 Benzodiazepines 與劑量變化之探討。未出版之碩士論文，國立政治大學，台南市。
英文部分：
1. Andersen, A. B. T., & Frydenberg, M. (2011). Long‐term use of zopiclone, zolpidem and zaleplon among Danish elderly and the association with sociodemographic factors and use of other drugs. Pharmacoepidemiology drug safety, 20, 378-85.
2. Ashton, H. (1994). Guidelines for the rational use of benzodiazepines. Drugs, 48, 25-40.
American Psychological Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
3. Bélanger, L., Belleville, G., & Morin, C. M. (2009). Management of hypnotic discontinuation in chronic insomnia. Sleep medicine clinics, 4, 583-92.
4. Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004). Cognitive effects of long-term benzodiazepine use. CNS drugs, 18, 37-48.
5. Bastien, C. H., Vallieres, A., & Morin, C. M. (2004). Precipitating factors of insomnia. Behavioral sleep medicine, 2, 50-62.
6. Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine, 2, 297-307.
7. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting clinical psychology, 56, 893.
8. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78, 490-98.
9. Billioti de Gage, S., Pariente, A., & Bégaud, B. (2015). Is there really a link between benzodiazepine use and the risk of dementia? Expert opinion on drug safety, 14, 733-47.
10. Bocca, M.-L., Marie, S., Lelong-Boulouard, V., Bertran, F., Couque, C., Desfemmes, T., Berthelon, C., Amato, J.-N., Moessinger, M., & Paillet-Loilier, M. (2011). Zolpidem and zopiclone impair similarly monotonous driving performance after a single nighttime intake in aged subjects. Psychopharmacology, 214, 699-706.
11. Bonnet, M., & Arand, D. (1997). Hyperarousal and insomnia. Sleep medicine reviews, 1, 97-108.
12. Busto, U., & Sellers, E. (1991). Pharmacologic aspects of benzodiazepine tolerance and dependence. Journal of substance abuse treatment, 8, 29-33.
13. Carney, C. E., & Edinger, J. D. (2006). Identifying critical beliefs about sleep in primary insomnia. Sleep, 29, 342-50.
14. Charles, J., Harrison, C., & Britt, H. (2009). Insomnia. Australian Family Physician, 38, 283-283.
Chen, C.W., Yang, C.M., Lin, Y.S., & Tsai, Y.L. (2016). Qualitative Study of Long-Term Sedative-Hypnotic use Patterns. Journal of Sleep Disorders: Treatment Care, doi: 10.4172/2325-9639.1000184
15. Chen, W. J., Chen, H.M., Chen, C.C., Chen, C.C., Yu, W.Y., & Cheng, A. T. (2002). Cloninger`s Tridimensional Personality Questionnaire: psychometric properties and construct validity in Taiwanese adults. Comprehensive Psychiatry, 43, 158-66.
16. Cheung, J., Jarrin, D., Beaulieu-Bonneau, S., Ivers, H., Morin, G., & Morin, C. (2018). 0376 Trajectories of Natural Product and Over-the-Counter Sleep Aid Users: A Five Year Follow-Up. Sleep, 41, A143-A44.
17. Cheung, J. M., Bartlett, D. J., Armour, C. L., Laba, T.L., & Saini, B. (2018). To drug or not to drug: a qualitative study of patients’ decision-making processes for managing insomnia. Behavioral sleep medicine, 16, 1-26.
18. Cloninger, C. R. (1986). A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatric developments, 3, 167-226.
19. Cloninger, C. R. (1987). A systematic method for clinical description and classification of personality variants: A proposal. Archives of general psychiatry, 44, 573-88.
20. Cloninger, C. R., Przybeck, T. R., & Svrakic, D. M. (1991). The tridimensional personality questionnaire: US normative data. Psychological reports, 69, 1047-57.
21. Cloos, J.M., Bocquet, V., Rolland-Portal, I., Koch, P., & Chouinard, G. (2015). Hypnotics and triazolobenzodiazepines-best predictors of high-dose benzodiazepine use: results from the Luxembourg National Health Insurance Registry. Psychotherapy psychosomatics, 84, 273-83.
22. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of health social behavior, 385-96.
23. Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27, 285-91.
24. Fang, S.Y., Chen, C.Y., Chang, I.S., Wu, E. C.H., Chang, C.M., & Lin, K.M. (2009). Predictors of the incidence and discontinuation of long-term use of benzodiazepines: a population-based study. Drug alcohol dependence, 104, 140-46.
25. Flick, U., Garms-Homolová, V., & Röhnsch, G. (2012). “And mostly they have a need for sleeping pills”: Physicians` views on treatment of sleep disorders with drugs in nursing homes. Journal of aging studies, 26, 484-94.
26. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality social psychology, 85, 348-362.
27. Hajak, G., Müller, W. E., Wittchen, H. U., Pittrow, D., & Kirch, W. (2003). Abuse and dependence potential for the non‐benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data. Addiction, 98(10), 1371-1378.
28. Hall-Porter, J. M., Schweitzer, P. K., Eisenstein, R. D., Ahmed, H. A. H., & Walsh, J. K. (2014). The effect of two benzodiazepine receptor agonist hypnotics on sleep-dependent memory consolidation. Journal of Clinical Sleep Medicine, 10, 27-34.
29. Harnod, T., Lin, C.L., Sung, F.C., & Kao, C.H. (2014). An association between benzodiazepine use and occurrence of benign brain tumors. Journal of the neurological sciences, 336, 8-12.
30. Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour research therapy, 40, 869-93.
31. Healey, E. S., Kales, A., Monroe, L. J., Bixler, E. O., Chamberlin, K., & Soldatos, C. R. (1981). Onset of insomnia: role of life-stress events. Psychosomatic medicine, 45(5), 439-451.
32. Holbrook, A. M., Crowther, R., Lotter, A., Cheng, C., & King, D. (2000). Meta-analysis of benzodiazepine use in the treatment of insomnia. Cmaj, 162, 225-33.
33. Hsiao, F.-Y., Hsieh, P.-H., & Gau, C.-S. (2013). Ten-year trend in prescriptions of z-hypnotics among the elderly: a nationwide, cross-sectional study in Taiwan. Journal of Clinical Gerontology Geriatrics, 4, 37-41.
34. Huedo-Medina, T. B., Kirsch, I., Middlemass, J., Klonizakis, M., & Siriwardena, A. N. (2012). Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. Bmj, 345, e8343.
35. Iqbal, U., Nguyen, P.A., Syed-Abdul, S., Yang, H.C., Huang, C.W., Jian, W.S., Hsu, M.-H., Yen, Y., & Li, Y.C. (2015). Is long-term use of benzodiazepine a risk for cancer? Medicine, 94(6), e483.
36. Isacson, D. (1997). Long-term benzodiazepine use: factors of importance and the development of individual use patterns over time—a 13-year follow-up in a Swedish community. Social science medicine, 44, 1871-80.
37. Ishigooka, J., Sugiyama, T., Suzuki, M., Kobayashi, K., Takeuchi, H., & Murasaki, M. (1998). Survival analytic approach to long‐term prescription of benzodiazepine hypnotics. Psychiatry clinical neurosciences, 52, 541-45.
38. Jen, C.H., Yang, C.M., Chen, C.W., Yu, H.T., Lai, Y.S., Lee, H.C., & Sung, J.Y. (2019). Development and psychometric evaluation of the Hypnotic-Use Urge Scale. Sleep Biological Rhythms, 17, 63-72.
39. Jones, B. L., & Nagin, D. S. (2007). Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociological methods research, 35, 542-71.
40. Kassam, A., & Patten, S. B. (2006). Hypnotic use in a population-based sample of over thirty-five thousand interviewed Canadians. Population health metrics, 4, 15-15.
41. Konopka, A., Pełka-Wysiecka, J., Grzywacz, A., & Samochowiec, J. (2013). Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Progress in Neuro-Psychopharmacology Biological Psychiatry, 40, 229-35.
42. Krakow, B., Ulibarri, V. A., & Romero, E. (2010). Persistent insomnia in chronic hypnotic users presenting to a sleep medical center: a retrospective chart review of 137 consecutive patients. The Journal of nervous mental disease, 198, 734-41.
43. Krystal, A. D., Erman, M., Zammit, G. K., Soubrane, C., Roth, T., & Group, Z. S. (2008). Long-term efficacy and safety of zolpidem extended-release 12.5 mg, administered 3 to 7 nights per week for 24 weeks, in patients with chronic primary insomnia: a 6-month, randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Sleep, 31, 79-90.
44. Krystal, A. D., Walsh, J. K., Laska, E., Caron, J., Amato, D. A., Wessel, T. C., & Roth, T. (2003). Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia. Sleep, 26, 793-99.
45. Liang, K.Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13-22.
46. Lin, F.Y., Chen, P.C., Liao, C. H., Hsieh, Y.W., & Sung, F.C. (2014). Retrospective population cohort study on hip fracture risk associated with zolpidem medication. Sleep, 37, 673-79.
47. Lowinson, J. H. (2011). Lowinson and Ruiz`s substance abuse: A comprehensive textbook: Lippincott Williams & Wilkins.
48. Mayer, G., Wang-Weigand, G., Roth-Schechter, B., Lehmann, R., Staner, C., & Partinen, M. (2009). Efficacy and safety of 6-month nightly ramelteon administration in adults with chronic primary insomnia. Sleep, 32, 351-60.
49. Morgan, K., Dallosso, H., Ebrahim, S., Arie, T., & Fentem, P. H. (1988). Prevalence, frequency, and duration of hypnotic drug use among the elderly living at home. British Medical Journal, 296, 601-02.
50. Morin, C. M. (1993). Insomnia: Psychological assessment and management: Guilford Press.
51. Morin, C. M., Bélanger, L., Bastien, C., Vallières, A., & therapy. (2005). Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse. Behaviour research, 43, 1-14.
52. Morin, C. M., Bélanger, L., & Bernier, F. (2004). Correlates of benzodiazepine use in individuals with insomnia. Sleep medicine, 5, 457-62.
53. Morin, C. M., Bélanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A., Mérette, C., Baillargeon, L., & Grégoire, J.-P. (2009). The natural history of insomnia: a population-based 3-year longitudinal study. Archives of internal medicine, 169, 447-53.
54. Morin, C. M., Bastien, C., Guay, B., Radouco-Thomas, M., Leblanc, J., & Vallières, A. (2004). Randomized clinical trial of supervised tapering and cognitive behavior therapy to facilitate benzodiazepine discontinuation in older adults with chronic insomnia. American Journal of Psychiatry, 161, 332-42. 
55. Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. Jama, 281, 991-99.
56. Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep medicine, 7, 123-30.
57. Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology aging, 8, 463-467.
58. Morin, C. M., Vallières, A., & Ivers, H. (2007). Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30, 1547-54.
59. Nagin, D. S., & Odgers, C. L. (2010). Group-based trajectory modeling in clinical research. Annual review of clinical psychology, 6, 109-38.
60. Nagin, D. S., & Tremblay, R. E. (2005). What has been learned from group-based trajectory modeling? Examples from physical aggression and other problem behaviors. The Annals of the American Academy of Political Social Science, 602, 82-117.
61. Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale. Behaviour research therapy, 23, 263-71.
62. O`Connor, K. P., Marchand, A., Bélanger, L., Mainguy, N., Landry, P., Savard, P., Turcotte, J., Dupuis, G., Harel, F., & Lachance, L. (2004). Psychological distress and adaptational problems associated with benzodiazepine withdrawal and outcome: a replication. Addictive Behaviors, 29, 583-93.
63. O’Connor, K., Bélanger, L., Marchand, A., Dupuis, G., Elie, R., & Boyer, R. (1999). Psychological distress and adaptational problems associated with discontinuation of benzodiazepines. Addictive Behaviors, 24, 537-41.
64. Omvik, S., Pallesen, S., Bjorvatn, B., Sivertsen, B., Havik, O. E., & Nordhus, I. H. (2010). Patient characteristics and predictors of sleep medication use. International clinical psychopharmacology, 25, 91-100.
65. Perlis, M. L., McCall, W. V., Krystal, A. D., & Walsh, J. K. (2004). Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia. The Journal of clinical psychiatry, 65, 1128-37.
66. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 165, 125-33.
67. Rhee, S.J., Ko, S.M., Choi, J.W., & Park, H. (2012). High-dose zolpidem dependence and detoxification from withdrawal symptoms using diazepam. Journal of Korean Neuropsychiatric Association, 51, 134-38.
68. Riemann, D., & Perlis, M. L. (2009). The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep medicine reviews, 13, 205-14.
69. Roehrs, T., Bonahoom, A., Pedrosi, B., Rosenthal, L., & Roth, T. (2002). Disturbed sleep predicts hypnotic self-administration. Sleep medicine, 3, 61-66.
70. Roehrs, T., Hollebeek, E., Drake, C., & Roth, T. (2002). Substance use for insomnia in Metropolitan Detroit. Journal of psychosomatic research, 53, 571-76.
71. Roehrs, T., Pedrosi, B., Rosenthal, L., & Roth, T. (1996). Hypnotic self administration and dose escalation. Psychopharmacology, 127, 150-54.
72. Roehrs, T. A., Randall, S., Harris, E., Maan, R., & Roth, T. (2011). Twelve months of nightly zolpidem does not lead to dose escalation: a prospective placebo-controlled study. Sleep, 34, 207-12.
73. Saddichha, S. (2010). Diagnosis and treatment of chronic insomnia. Annals of Indian Academy of Neurology, 13, 94-102.
74. Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13, 307-49.
75. Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine, 4, 487-504.
76. Sharma, A., & Dewan, V. K. (2005). A Case Report of Zolpidem-Induced Somnambulism. Primary care companion to the Journal of clinical psychiatry, 7, 74-74.
Smith, M., Perlis, M., Smith, M., Giles, D., & Carmody, T. (2000). Sleep quality and presleep arousal in chronic pain. Journal of behavioral medicine, 23, 1-13.
76. Soumerai, S. B., Simoni-Wastila, L., Singer, C., Mah, C., Gao, X., Salzman, C., & Ross-Degnan, D. (2003). Lack of relationship between long-term use of benzodiazepines and escalation to high dosages. Psychiatric Services, 54(7), 1006-1011.
77. Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10, 541-53.
Szentkirályi, A., Madarász, C. Z., & Novák, M. (2009). Sleep disorders: impact on daytime functioning and quality of life. Expert review of pharmacoeconomics outcomes research, 9, 49-64.
78. Takaesu, Y., Komada, Y., Asaoka, S., Kagimura, T., & Inoue, Y. (2014). Factors associated with long-term use of hypnotics among patients with chronic insomnia. PloS one, 9(11), e113753.
79. Tiffany, S. T. (1990). A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. Psychological review, 97, 147-168.
80. Troy, S. M., Lucki, I., Unruh, M. A., Cevallos, W. H., Leister, C. A., Martin, P. T., Furlan, P. M., & Mangano, R. (2000). Comparison of the effects of zaleplon, zolpidem, and triazolam on memory, learning, and psychomotor performance. Journal of clinical psychopharmacology, 20, 328-37.
81. Tseng, H.Y., Yu, S.H., Lee, C.Y., Huang, W.H., Huang, S.L., Wu, C.S., Chiu, Y.F., & Hsiung, C. A. (2018). Sedative–hypnotic drug use among community-dwelling elderly in Taiwan. International psychogeriatrics, 30, 957-65.
82. Uzun, S., Kozumplik, O., Jakovljević, M., & Sedić, B. (2010). Side effects of treatment with benzodiazepines. Psychiatria Danubina, 22, 90-93.
Vermeeren, A. (2004). Residual effects of hypnotics. CNS drugs, 18, 297-328.
83. Wang, L.J., Chen, Y.C., Chen, C.K., Chou, W.J., & Chou, M.C. (2014). Trends in anxiolytic-hypnotic use and polypharmacy in Taiwan, 2002–2009: A nationwide, population-based survey. Psychiatric Services, 65, 208-14.
84. Weymann, D., Gladstone, E. J., Smolina, K., & Morgan, S. G. (2017). Long-term sedative use among community-dwelling adults: a population-based analysis. CMAJ open, 5, e52.
85. Wikler, A. (1948). Recent progress in research on the neurophysiologic basis of morphine addiction. American Journal of Psychiatry, 105, 329-38.
86. Yang, W., Dollear, M., & Muthukrishnan, S. R. (2005). One rare side effect of zolpidem—sleepwalking: a case report. Archives of physical medicine rehabilitation, 86, 1265-66.
87. Zandstra, S., Van Rijswijk, E., Rijnders, C., Van De Lisdonk, E., Bor, J., Van Weel, C., & Zitman. (2004). Long-term benzodiazepine users in family practice: differences from short-term users in mental health, coping behaviour and psychological characteristics. Family Practice, 21, 266-69.
描述 碩士
國立政治大學
心理學系
104752023
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0104752023
資料類型 thesis
dc.contributor.advisor 楊建銘zh_TW
dc.contributor.advisor Yang, Chien-Mingen_US
dc.contributor.author (Authors) 李昇晃zh_TW
dc.contributor.author (Authors) Lee, Shen-Kwangen_US
dc.creator (作者) 李昇晃zh_TW
dc.creator (作者) Lee, Shen-Kwangen_US
dc.date (日期) 2019en_US
dc.date.accessioned 7-Aug-2019 16:33:34 (UTC+8)-
dc.date.available 7-Aug-2019 16:33:34 (UTC+8)-
dc.date.issued (上傳時間) 7-Aug-2019 16:33:34 (UTC+8)-
dc.identifier (Other Identifiers) G0104752023en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/124860-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學系zh_TW
dc.description (描述) 104752023zh_TW
dc.description.abstract (摘要) 研究目的：過去文獻建議短期使用安眠藥，但臨床上不難發現部分患者會發展成長期使用者，而這群人有較高的藥物副作用與依賴風險，是個不容小覷的臨床議題。過往探討安眠藥使用行為機制時，多將安眠藥使用行為簡易區分為短期或長期使用，然而，此區分方式尚不足以描述安眠藥使用者間的用藥行為個別差異，導致後續研究出現異質性。同時過往研究多採用橫斷研究進行探討，凸顯了長期追蹤資料的需求。因此，本研究目的以安眠藥使用頻率的軌跡發展切入，探索個別差異，接著透過人口變項、心理相關變項與睡眠相關變項來了解軌跡差異的可能原因，最後建立初步預測的模型，提供臨床處遇參考。

研究方法與結果： 研究受試者為144名曾經或目前正服用安眠藥的患者，待完成一份心理社會相關問卷後，便進行一年半的電話追蹤（第0、1、3、6、12和第18個月），收集其安眠藥的使用頻率。所收集的追蹤資料先進行群體基礎軌跡模型分析，將安眠藥使用頻率軌跡型態劃分成『穩定高頻使用』、『穩定低頻使用』、『快速降頻使用』、『慢速降頻使用』與『稀有使用』等，五種軌跡型態，其人數比例分別為42.6%、12.4%、12.5%、17.8%、以及14.7%。所有軌跡型態的受試者中，穩定高頻使用的年齡最高、服藥後的失眠嚴重程度最高、安眠藥渴求程度最高，與其他軌跡呈現差異；穩定低頻使用的脆弱樣貌與穩定高頻使用類似，唯有在渴求程度明顯較低。稀有使用則與穩定高頻使用明顯相反，平均年齡最低、服藥後失眠嚴重程度最低、安眠藥渴求程度最低。而下降軌跡分成快速降頻與慢速降頻兩種型態，他們皆有較高的服藥後失眠嚴重程度，不同的是快速降頻使用的平均年齡較低、渴求程度也較低，而慢速降頻使用的樣貌可與穩定高頻使用媲美，唯有在對安眠藥的失控感上明顯低於穩定高頻使用。

結論： 本研究設計以臨床情境為平台，建立了追蹤18個月的安眠藥使用頻率軌跡發展模型。此軌跡模型呈現5種不同的安眠藥使用頻率軌跡，呈現個別差異，且安眠藥渴求程度、服藥後的失眠嚴重程度，被凸顯為安眠藥使用行為相當重要的課題。		zh_TW
dc.description.abstract (摘要) Objective: Hypnotics is recommended for short-term use but is commonly prescribed for prolonged period of time in clinical settings. However, past research suggested that there were individual differences in the pattern of hypnotic use and have not been studied over an extended time period. Therefore, the current study aims to categorize the developmental patterns of hypnotic use through trajectory analysis, and to examine the differences in the psychosocial factors associated with the different trajectories.

Methods and Results: 144 Insomnia patients with history of hypnotic use were recruited to participate in the study. They completed a package of questionnaires regarding psychosocial variables and were followed up at 6 points of time (0, 1, 3, 6, 12 and 18 months) to collect their frequency of hypnotic use. All data were used to estimate trajectories of hypnotic use frequency from group-based trajectory modeling and identified five different trajectories among users, they are “stable high users” (42.6%), “stable low users” (12.4%), “fast decline users” (12.5%), “slow decline users” (17.8%) and “rarely users” (14.7%). Among hypnotic use frequency trajectories, MANOVA results showed that “stable high users” were older, had greater insomnia severity with medication and hypnotic-urge level, meanwhile “stable low users” tend to have a similar profile with “stable high users” except for a lower hypnotic-urge level. “Rarely users” had the protective profile which were younger, had lesser insomnia severity with medication and hypnotic-urge level. Interestingly, both “fast decline users” and “slow decline users” showed greater insomnia severity with medication than the “stable low users”and “rarely users”. However, they could be differentiated by the hypnotic-urge level. Specifically, “fast decline users” were much lower and “slow decline users” were as high as “stable high users” in hypnotic-urge level except for the compelling desire to use hypnotic scores.

Conclusions: The results of the current study suggested that the heterogeneous practice among sleep medication users. At the same time, the predicting model raised the importance of insomnia severity and hypnotic craving as important issues in hypnotic use behavior.		en_US
dc.description.tableofcontents 第一章 緒論 1
第一節 研究動機 1
第二章 文獻探討 5
第一節 安眠藥物治療的定義、盛行率以及延伸的問題 5
第二節 安眠藥使用行為之個別差異與不同歷程之可能性 9
第三節 安眠藥使用頻率之軌跡型態的可能影響因子 14
第四節 研究問題 23
第三章 研究方法 24
第一節 研究受試者 24
第二節 研究流程 25
第三節 測量工具 27
第四節 統計分析 34
第四章 研究結果 37
第一節 受試者人口背景資料與特性 37
第二節 不同安眠藥使用頻率軌跡之軌跡模型建立 38
第三節 安眠藥使用頻率軌跡型態之間的相關因子 46
第五章 綜合討論 59
第一節 研究受試者的樣本類型 59
第二節 安眠藥物使用頻率軌跡型態的概述與探討 59
第三節 安眠藥使用頻率軌跡型態在相關變項的表現 62
第四節 預測安眠藥使用頻率軌跡型態之因素與臨床應用 66
第五節 與過往研究的對應 68
第六節 研究限制與對研究未來發展的建議 69
參考文獻 70		zh_TW
dc.format.extent 2941553 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0104752023en_US
dc.subject (關鍵詞) 失眠zh_TW
dc.subject (關鍵詞) 安眠藥zh_TW
dc.subject (關鍵詞) 群體基礎軌跡分析zh_TW
dc.subject (關鍵詞) BZDzh_TW
dc.subject (關鍵詞) BzRAzh_TW
dc.subject (關鍵詞) Insomniaen_US
dc.subject (關鍵詞) Hypnoticsen_US
dc.subject (關鍵詞) Group-based Trajectory Modelingen_US
dc.subject (關鍵詞) BZDen_US
dc.subject (關鍵詞) BzRAen_US
dc.title (題名) 安眠藥使用頻率的發展軌跡與其相關因子：電話追蹤研究zh_TW
dc.title (題名) The Developmental Trajectories of Hypnotic Use Frequency and the Associated Factors: A phone-call follow-up researchen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 中文部分：
1. 行政院衛生署（2007）。苯二氮平類（Benzodiazepines）藥品用於鎮靜安眠之使用指引。
2. 沈武典（2001）。醫院院所 Benzodiazepine 藥物不當使用的初步分析。行政院衛生署管制藥品管理局九十年度委託科技研究計劃報告。台北市；台北醫院。
3. 李澄賢（2004）。大學生的情緒調節、調節焦點、樂觀與創造力之關係。未出版之碩士論文，國立政治大學，台北市。
4. 吳佳璇（2005）。台灣鎮靜劑安眠藥品使用盛行率以及相關後遺症之研究。行政衛生署管制藥品管理局。
5. 初麗娟、高尚仁（2005）。壓力知覺對負面心理健康影響: 靜坐經驗, 情緒智能調節效果之探討。中華心理學刊，2（47）， 157-79。
6. 車先蕙、盧孟良、陳錫中、張尚文、李宇宙（2006）中文版貝克焦慮量表之信效度。台灣醫學，4（10）， 447-54。
7. 林一真（2000）。貝克焦慮量表中文版。台北市：中國行為科學社。
8. 林詩淳（2007）。慢性失眠者與情境性失眠高危險族群之壓力因應與失眠的關係。未出版之碩士論文，國立政治大學，台北市。
9. 陳昌偉、詹雅雯、楊建銘、林詩淳（2009）。中文版睡眠失功能信念及態度量表之信效度探討。臨床心理學刊，1（4），59-67。
10. 陳昌偉（2014）。安眠藥物長期使用型態之探討。未出版之博士論文，國立政治大學，台北市。
11. 楊建銘、許世杰、林詩淳、周映妤、陳瑩明（ 2009）。失眠嚴重度量表中文版的信, 效度研究。臨床心理學刊， 2（4），95-104。
詹雅雯、陳昌偉、楊建銘、林詩淳（2009）。中文版睡前激發狀態量表之信, 效度探討。臨床心理學刊， 1（4），51-58。
12. 賴羽琁（2016）。以計劃行為理論及渴想探討長期助眠藥物使用之心理因素。未出版之碩士論文，國立政治大學，台北市。
13. 盧孟良、車先蕙, 、張尚文、沈武典 （2002）。中文版貝克憂鬱量表第二版之信度和效度。台灣精神醫學，4（16），301-10.
14. 謝斯婷（2010）。長期使用 Benzodiazepines 與劑量變化之探討。未出版之碩士論文，國立政治大學，台南市。
英文部分：
1. Andersen, A. B. T., & Frydenberg, M. (2011). Long‐term use of zopiclone, zolpidem and zaleplon among Danish elderly and the association with sociodemographic factors and use of other drugs. Pharmacoepidemiology drug safety, 20, 378-85.
2. Ashton, H. (1994). Guidelines for the rational use of benzodiazepines. Drugs, 48, 25-40.
American Psychological Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
3. Bélanger, L., Belleville, G., & Morin, C. M. (2009). Management of hypnotic discontinuation in chronic insomnia. Sleep medicine clinics, 4, 583-92.
4. Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004). Cognitive effects of long-term benzodiazepine use. CNS drugs, 18, 37-48.
5. Bastien, C. H., Vallieres, A., & Morin, C. M. (2004). Precipitating factors of insomnia. Behavioral sleep medicine, 2, 50-62.
6. Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine, 2, 297-307.
7. Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting clinical psychology, 56, 893.
8. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78, 490-98.
9. Billioti de Gage, S., Pariente, A., & Bégaud, B. (2015). Is there really a link between benzodiazepine use and the risk of dementia? Expert opinion on drug safety, 14, 733-47.
10. Bocca, M.-L., Marie, S., Lelong-Boulouard, V., Bertran, F., Couque, C., Desfemmes, T., Berthelon, C., Amato, J.-N., Moessinger, M., & Paillet-Loilier, M. (2011). Zolpidem and zopiclone impair similarly monotonous driving performance after a single nighttime intake in aged subjects. Psychopharmacology, 214, 699-706.
11. Bonnet, M., & Arand, D. (1997). Hyperarousal and insomnia. Sleep medicine reviews, 1, 97-108.
12. Busto, U., & Sellers, E. (1991). Pharmacologic aspects of benzodiazepine tolerance and dependence. Journal of substance abuse treatment, 8, 29-33.
13. Carney, C. E., & Edinger, J. D. (2006). Identifying critical beliefs about sleep in primary insomnia. Sleep, 29, 342-50.
14. Charles, J., Harrison, C., & Britt, H. (2009). Insomnia. Australian Family Physician, 38, 283-283.
Chen, C.W., Yang, C.M., Lin, Y.S., & Tsai, Y.L. (2016). Qualitative Study of Long-Term Sedative-Hypnotic use Patterns. Journal of Sleep Disorders: Treatment Care, doi: 10.4172/2325-9639.1000184
15. Chen, W. J., Chen, H.M., Chen, C.C., Chen, C.C., Yu, W.Y., & Cheng, A. T. (2002). Cloninger`s Tridimensional Personality Questionnaire: psychometric properties and construct validity in Taiwanese adults. Comprehensive Psychiatry, 43, 158-66.
16. Cheung, J., Jarrin, D., Beaulieu-Bonneau, S., Ivers, H., Morin, G., & Morin, C. (2018). 0376 Trajectories of Natural Product and Over-the-Counter Sleep Aid Users: A Five Year Follow-Up. Sleep, 41, A143-A44.
17. Cheung, J. M., Bartlett, D. J., Armour, C. L., Laba, T.L., & Saini, B. (2018). To drug or not to drug: a qualitative study of patients’ decision-making processes for managing insomnia. Behavioral sleep medicine, 16, 1-26.
18. Cloninger, C. R. (1986). A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatric developments, 3, 167-226.
19. Cloninger, C. R. (1987). A systematic method for clinical description and classification of personality variants: A proposal. Archives of general psychiatry, 44, 573-88.
20. Cloninger, C. R., Przybeck, T. R., & Svrakic, D. M. (1991). The tridimensional personality questionnaire: US normative data. Psychological reports, 69, 1047-57.
21. Cloos, J.M., Bocquet, V., Rolland-Portal, I., Koch, P., & Chouinard, G. (2015). Hypnotics and triazolobenzodiazepines-best predictors of high-dose benzodiazepine use: results from the Luxembourg National Health Insurance Registry. Psychotherapy psychosomatics, 84, 273-83.
22. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of health social behavior, 385-96.
23. Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27, 285-91.
24. Fang, S.Y., Chen, C.Y., Chang, I.S., Wu, E. C.H., Chang, C.M., & Lin, K.M. (2009). Predictors of the incidence and discontinuation of long-term use of benzodiazepines: a population-based study. Drug alcohol dependence, 104, 140-46.
25. Flick, U., Garms-Homolová, V., & Röhnsch, G. (2012). “And mostly they have a need for sleeping pills”: Physicians` views on treatment of sleep disorders with drugs in nursing homes. Journal of aging studies, 26, 484-94.
26. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality social psychology, 85, 348-362.
27. Hajak, G., Müller, W. E., Wittchen, H. U., Pittrow, D., & Kirch, W. (2003). Abuse and dependence potential for the non‐benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data. Addiction, 98(10), 1371-1378.
28. Hall-Porter, J. M., Schweitzer, P. K., Eisenstein, R. D., Ahmed, H. A. H., & Walsh, J. K. (2014). The effect of two benzodiazepine receptor agonist hypnotics on sleep-dependent memory consolidation. Journal of Clinical Sleep Medicine, 10, 27-34.
29. Harnod, T., Lin, C.L., Sung, F.C., & Kao, C.H. (2014). An association between benzodiazepine use and occurrence of benign brain tumors. Journal of the neurological sciences, 336, 8-12.
30. Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour research therapy, 40, 869-93.
31. Healey, E. S., Kales, A., Monroe, L. J., Bixler, E. O., Chamberlin, K., & Soldatos, C. R. (1981). Onset of insomnia: role of life-stress events. Psychosomatic medicine, 45(5), 439-451.
32. Holbrook, A. M., Crowther, R., Lotter, A., Cheng, C., & King, D. (2000). Meta-analysis of benzodiazepine use in the treatment of insomnia. Cmaj, 162, 225-33.
33. Hsiao, F.-Y., Hsieh, P.-H., & Gau, C.-S. (2013). Ten-year trend in prescriptions of z-hypnotics among the elderly: a nationwide, cross-sectional study in Taiwan. Journal of Clinical Gerontology Geriatrics, 4, 37-41.
34. Huedo-Medina, T. B., Kirsch, I., Middlemass, J., Klonizakis, M., & Siriwardena, A. N. (2012). Effectiveness of non-benzodiazepine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. Bmj, 345, e8343.
35. Iqbal, U., Nguyen, P.A., Syed-Abdul, S., Yang, H.C., Huang, C.W., Jian, W.S., Hsu, M.-H., Yen, Y., & Li, Y.C. (2015). Is long-term use of benzodiazepine a risk for cancer? Medicine, 94(6), e483.
36. Isacson, D. (1997). Long-term benzodiazepine use: factors of importance and the development of individual use patterns over time—a 13-year follow-up in a Swedish community. Social science medicine, 44, 1871-80.
37. Ishigooka, J., Sugiyama, T., Suzuki, M., Kobayashi, K., Takeuchi, H., & Murasaki, M. (1998). Survival analytic approach to long‐term prescription of benzodiazepine hypnotics. Psychiatry clinical neurosciences, 52, 541-45.
38. Jen, C.H., Yang, C.M., Chen, C.W., Yu, H.T., Lai, Y.S., Lee, H.C., & Sung, J.Y. (2019). Development and psychometric evaluation of the Hypnotic-Use Urge Scale. Sleep Biological Rhythms, 17, 63-72.
39. Jones, B. L., & Nagin, D. S. (2007). Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociological methods research, 35, 542-71.
40. Kassam, A., & Patten, S. B. (2006). Hypnotic use in a population-based sample of over thirty-five thousand interviewed Canadians. Population health metrics, 4, 15-15.
41. Konopka, A., Pełka-Wysiecka, J., Grzywacz, A., & Samochowiec, J. (2013). Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Progress in Neuro-Psychopharmacology Biological Psychiatry, 40, 229-35.
42. Krakow, B., Ulibarri, V. A., & Romero, E. (2010). Persistent insomnia in chronic hypnotic users presenting to a sleep medical center: a retrospective chart review of 137 consecutive patients. The Journal of nervous mental disease, 198, 734-41.
43. Krystal, A. D., Erman, M., Zammit, G. K., Soubrane, C., Roth, T., & Group, Z. S. (2008). Long-term efficacy and safety of zolpidem extended-release 12.5 mg, administered 3 to 7 nights per week for 24 weeks, in patients with chronic primary insomnia: a 6-month, randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Sleep, 31, 79-90.
44. Krystal, A. D., Walsh, J. K., Laska, E., Caron, J., Amato, D. A., Wessel, T. C., & Roth, T. (2003). Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia. Sleep, 26, 793-99.
45. Liang, K.Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73, 13-22.
46. Lin, F.Y., Chen, P.C., Liao, C. H., Hsieh, Y.W., & Sung, F.C. (2014). Retrospective population cohort study on hip fracture risk associated with zolpidem medication. Sleep, 37, 673-79.
47. Lowinson, J. H. (2011). Lowinson and Ruiz`s substance abuse: A comprehensive textbook: Lippincott Williams & Wilkins.
48. Mayer, G., Wang-Weigand, G., Roth-Schechter, B., Lehmann, R., Staner, C., & Partinen, M. (2009). Efficacy and safety of 6-month nightly ramelteon administration in adults with chronic primary insomnia. Sleep, 32, 351-60.
49. Morgan, K., Dallosso, H., Ebrahim, S., Arie, T., & Fentem, P. H. (1988). Prevalence, frequency, and duration of hypnotic drug use among the elderly living at home. British Medical Journal, 296, 601-02.
50. Morin, C. M. (1993). Insomnia: Psychological assessment and management: Guilford Press.
51. Morin, C. M., Bélanger, L., Bastien, C., Vallières, A., & therapy. (2005). Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse. Behaviour research, 43, 1-14.
52. Morin, C. M., Bélanger, L., & Bernier, F. (2004). Correlates of benzodiazepine use in individuals with insomnia. Sleep medicine, 5, 457-62.
53. Morin, C. M., Bélanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A., Mérette, C., Baillargeon, L., & Grégoire, J.-P. (2009). The natural history of insomnia: a population-based 3-year longitudinal study. Archives of internal medicine, 169, 447-53.
54. Morin, C. M., Bastien, C., Guay, B., Radouco-Thomas, M., Leblanc, J., & Vallières, A. (2004). Randomized clinical trial of supervised tapering and cognitive behavior therapy to facilitate benzodiazepine discontinuation in older adults with chronic insomnia. American Journal of Psychiatry, 161, 332-42. 
55. Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. Jama, 281, 991-99.
56. Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep medicine, 7, 123-30.
57. Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology aging, 8, 463-467.
58. Morin, C. M., Vallières, A., & Ivers, H. (2007). Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30, 1547-54.
59. Nagin, D. S., & Odgers, C. L. (2010). Group-based trajectory modeling in clinical research. Annual review of clinical psychology, 6, 109-38.
60. Nagin, D. S., & Tremblay, R. E. (2005). What has been learned from group-based trajectory modeling? Examples from physical aggression and other problem behaviors. The Annals of the American Academy of Political Social Science, 602, 82-117.
61. Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale. Behaviour research therapy, 23, 263-71.
62. O`Connor, K. P., Marchand, A., Bélanger, L., Mainguy, N., Landry, P., Savard, P., Turcotte, J., Dupuis, G., Harel, F., & Lachance, L. (2004). Psychological distress and adaptational problems associated with benzodiazepine withdrawal and outcome: a replication. Addictive Behaviors, 29, 583-93.
63. O’Connor, K., Bélanger, L., Marchand, A., Dupuis, G., Elie, R., & Boyer, R. (1999). Psychological distress and adaptational problems associated with discontinuation of benzodiazepines. Addictive Behaviors, 24, 537-41.
64. Omvik, S., Pallesen, S., Bjorvatn, B., Sivertsen, B., Havik, O. E., & Nordhus, I. H. (2010). Patient characteristics and predictors of sleep medication use. International clinical psychopharmacology, 25, 91-100.
65. Perlis, M. L., McCall, W. V., Krystal, A. D., & Walsh, J. K. (2004). Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia. The Journal of clinical psychiatry, 65, 1128-37.
66. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 165, 125-33.
67. Rhee, S.J., Ko, S.M., Choi, J.W., & Park, H. (2012). High-dose zolpidem dependence and detoxification from withdrawal symptoms using diazepam. Journal of Korean Neuropsychiatric Association, 51, 134-38.
68. Riemann, D., & Perlis, M. L. (2009). The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep medicine reviews, 13, 205-14.
69. Roehrs, T., Bonahoom, A., Pedrosi, B., Rosenthal, L., & Roth, T. (2002). Disturbed sleep predicts hypnotic self-administration. Sleep medicine, 3, 61-66.
70. Roehrs, T., Hollebeek, E., Drake, C., & Roth, T. (2002). Substance use for insomnia in Metropolitan Detroit. Journal of psychosomatic research, 53, 571-76.
71. Roehrs, T., Pedrosi, B., Rosenthal, L., & Roth, T. (1996). Hypnotic self administration and dose escalation. Psychopharmacology, 127, 150-54.
72. Roehrs, T. A., Randall, S., Harris, E., Maan, R., & Roth, T. (2011). Twelve months of nightly zolpidem does not lead to dose escalation: a prospective placebo-controlled study. Sleep, 34, 207-12.
73. Saddichha, S. (2010). Diagnosis and treatment of chronic insomnia. Annals of Indian Academy of Neurology, 13, 94-102.
74. Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13, 307-49.
75. Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine, 4, 487-504.
76. Sharma, A., & Dewan, V. K. (2005). A Case Report of Zolpidem-Induced Somnambulism. Primary care companion to the Journal of clinical psychiatry, 7, 74-74.
Smith, M., Perlis, M., Smith, M., Giles, D., & Carmody, T. (2000). Sleep quality and presleep arousal in chronic pain. Journal of behavioral medicine, 23, 1-13.
76. Soumerai, S. B., Simoni-Wastila, L., Singer, C., Mah, C., Gao, X., Salzman, C., & Ross-Degnan, D. (2003). Lack of relationship between long-term use of benzodiazepines and escalation to high dosages. Psychiatric Services, 54(7), 1006-1011.
77. Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10, 541-53.
Szentkirályi, A., Madarász, C. Z., & Novák, M. (2009). Sleep disorders: impact on daytime functioning and quality of life. Expert review of pharmacoeconomics outcomes research, 9, 49-64.
78. Takaesu, Y., Komada, Y., Asaoka, S., Kagimura, T., & Inoue, Y. (2014). Factors associated with long-term use of hypnotics among patients with chronic insomnia. PloS one, 9(11), e113753.
79. Tiffany, S. T. (1990). A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. Psychological review, 97, 147-168.
80. Troy, S. M., Lucki, I., Unruh, M. A., Cevallos, W. H., Leister, C. A., Martin, P. T., Furlan, P. M., & Mangano, R. (2000). Comparison of the effects of zaleplon, zolpidem, and triazolam on memory, learning, and psychomotor performance. Journal of clinical psychopharmacology, 20, 328-37.
81. Tseng, H.Y., Yu, S.H., Lee, C.Y., Huang, W.H., Huang, S.L., Wu, C.S., Chiu, Y.F., & Hsiung, C. A. (2018). Sedative–hypnotic drug use among community-dwelling elderly in Taiwan. International psychogeriatrics, 30, 957-65.
82. Uzun, S., Kozumplik, O., Jakovljević, M., & Sedić, B. (2010). Side effects of treatment with benzodiazepines. Psychiatria Danubina, 22, 90-93.
Vermeeren, A. (2004). Residual effects of hypnotics. CNS drugs, 18, 297-328.
83. Wang, L.J., Chen, Y.C., Chen, C.K., Chou, W.J., & Chou, M.C. (2014). Trends in anxiolytic-hypnotic use and polypharmacy in Taiwan, 2002–2009: A nationwide, population-based survey. Psychiatric Services, 65, 208-14.
84. Weymann, D., Gladstone, E. J., Smolina, K., & Morgan, S. G. (2017). Long-term sedative use among community-dwelling adults: a population-based analysis. CMAJ open, 5, e52.
85. Wikler, A. (1948). Recent progress in research on the neurophysiologic basis of morphine addiction. American Journal of Psychiatry, 105, 329-38.
86. Yang, W., Dollear, M., & Muthukrishnan, S. R. (2005). One rare side effect of zolpidem—sleepwalking: a case report. Archives of physical medicine rehabilitation, 86, 1265-66.
87. Zandstra, S., Van Rijswijk, E., Rijnders, C., Van De Lisdonk, E., Bor, J., Van Weel, C., & Zitman. (2004). Long-term benzodiazepine users in family practice: differences from short-term users in mental health, coping behaviour and psychological characteristics. Family Practice, 21, 266-69.		zh_TW
dc.identifier.doi (DOI) 10.6814/NCCU201900310en_US