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題名 以EEG頻譜分析探討高低睡眠脆弱性者的睡眠擾醒反應及恢復歷程
Arousal Reaction and Recovery Processes during Sleep in Individuals with Different Levels of Sleep Vulnerability: Investigation with EEG Spectral Analysis作者 丁琳
Ting, Ling貢獻者 楊建銘
Yang, Chien-Ming
丁琳
Ting, Ling關鍵詞 睡眠脆弱性
睡眠擾醒
過度激發
腦波頻譜分析
Sleep vulnerability
Sleep arousal
Hyperarousal
EEG spectral analysis日期 2025 上傳時間 1-Jul-2025 14:11:42 (UTC+8) 摘要 研究目的：過度激發理論已是目前最被廣為接受的失眠病理模型之一，該理論認為失眠主要不是因睡眠機制有問題，而是生理、認知與情緒等層面處於過度覺醒的狀態，因而干擾了睡眠。過去透過腦波頻譜分析、事件相關電位及腦造影等方式的研究提供了失眠患者大腦皮質的過度激發的實徵證據，然而這些研究反映的為整體的激發狀態，缺乏針對睡眠受外在刺激干擾後的反應及恢復歷程的研究；此外，大腦皮質過度激發的現象在失眠病程上扮演的角色也較少被探討。因此，本研究透過聲音引發睡眠當中的擾醒，藉以分析受試者在睡眠擾醒前後的反應及恢復歷程，並比較高、低壓力下睡眠脆弱性的健康受試者，以探究大腦皮質過度激發與失眠之前置特質的關聯性。 研究方法：本研究於校園招募年輕健康受試者，且於「壓力下失眠反應量表（Ford Insomnia Response to Stress Test, FIRST）」得分落在前1/3（23分及以上）或後1/3（18分及以下）者，篩檢後共納入44位受試者，其中有3位未能符合規律作息、1位因AHI過高而被排除，剩下40位受試者分別作為高FIRST組（n=19）及低FIRST組（n=21）。受試者皆在實驗室進行一整夜的多頻道睡眠生理檢測（polysomnography, PSG），過程中由研究人員在確認受試者進入穩定睡眠後，持續於整晚給予多次聲音刺激以誘發睡眠擾醒，每次嘗試次至少間隔10分鐘。聲音刺激採用1秒之1000Hz純音刺激，由40dB起逐漸增強，每次增加10dB，且每次嘗試次至多給予6個聲音刺激，若在任一刺激中成功誘發擾醒則停止給予刺激。腦波數據皆以頻譜分析技術（EEG spectral analysis）進行處理，睡眠擾醒則分成兩階段分析，分別為反應及恢復歷程：反應歷程包含反應程度、反應耗時、刺激反應時間；恢復歷程則包含恢復程度及恢復耗時。其餘睡眠擾醒相關指標，包含睡眠擾醒時長、擾醒閾值等亦會納入分析。 研究結果：兩組在擾醒反應（反應耗時、反應程度、給予刺激到反應的耗時）與擾醒恢復（恢復程度、恢復耗時）共5個歷程指標上皆無顯著差異，兩組差異主要反應在被擾醒後身體動作的比例，即高FIRST族群在受到外界干擾後，可能較容易進入伴隨顯著身體動作的擾醒狀態。在擾醒閾值及擾醒時長上，亦未觀察到顯著的組間差異。 結論：本研究旨在探討睡眠擾醒歷程在不同睡眠脆弱性族群中是否會呈現不同激發狀態，結果顯示在睡眠擾醒反應及恢復歷程上腦波反應皆無顯著差異，在睡眠擾醒閾值及時長亦相當，然高FIRST組睡眠受到干擾後更常出現身體動作，顯示該族群有更高的傾向出現更為強烈的反應，而非停留在半夢半醒、通常不涉及個體意識的擾醒狀態。此行為反應或許是失眠早期階段的表現形式之一，隨病程進展才會進一步展現其他面向的過度激發現象。未來研究可參考本研究之擾醒操弄方法，進一步探討失眠族群在擾醒歷程上的激發狀態，以期對失眠病理機制有更全面的了解。
Objective: The hyperarousal theory is currently one of the most widely accepted etiological models for insomnia. It posits that insomnia arises not from a dysfunction of sleep mechanisms per se, but from an elevated state of arousal across physiological, cognitive, and emotional domains that interferes with the ability to sleep. Empirical evidence of cortical hyperarousal in insomnia patients has been found through methods such as EEG spectral analysis, event-related potentials, and neuroimaging. However, these studies have typically examined overall arousal levels, with relatively few investigating how the brain responds to and recovers from external disruptions during sleep. In addition, the role of cortical hyperarousal in the developmental course of insomnia remains unclear. This study aimed to address these gaps by using auditory stimuli to induce sleep arousals and analyzing both the reaction and recovery processes. By comparing healthy individuals with high versus low sleep vulnerability, this study seeks to clarify the relationship between cortical hyperarousal and the pre-dispositional characteristics of insomnia. Methods: A total of 44 healthy young participants were recruited from college campus, with a total score on the Ford Insomnia Response to Stress Test (FIRST) within the top one-third (≥23) or bottom one-third (≤18) of the population representing the high and low FIRST groups. Three participants who failed to maintain regular sleep schedules and one participant with and apnea-hypopnea index (AHI) of 26.5 were excluded. The final sample included 40 participants: 21 in the low FIRST group and 19 in the high FIRST group. Participants underwent overnight polysomnography (PSG) in a sleep laboratory, during which repeated auditory stimuli were delivered throughout the night once stable sleep was observed. Pure-tone stimuli (1000 Hz, 1 second duration) were presented beginning at 40 dB and increased by 10 dB increments, up to a maximum of six stimuli per trial, with at least a 10-minute interval between trials. If a stimulus successfully induced a sleep arousal, the trial was terminated. EEG spectral analysis was conducted to analyze the EEG data across the arousal events, and the overall arousal process was divided into two distinct phases: the reaction phase (including reaction intensity, reaction duration, and stimulus-to-response latency) and the recovery phase (including recovery magnitude and recovery duration). Additional sleep arousal indicators, including arousal threshold and arousal duration, were also analyzed. Results: No significant group differences were found in the five process-related indicators of sleep arousal—reaction duration, reaction intensity, latency from stimulus to arousal, recovery capacity, and recovery time. However, group differences were observed in the proportion of arousals accompanied by body movements, with the high FIRST group showing more frequent body movements following arousal. No significant differences were found between groups in arousal threshold or arousal duration. Conclusion: This study explored whether individuals with different levels of sleep vulnerability exhibit different activation patterns of sleep arousal. Results showed no significant differences in either the arousal reaction or recovery phases, nor in arousal threshold or duration. However, individuals in the high FIRST group exhibited more frequent body movements following sleep disruption, suggesting a greater tendency toward stronger arousal responses rather than remaining in a brief, partial arousal state that typically lacks conscious awareness. 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EEG spectral analysis in insomnia disorder: A systematic review and meta-analysis. Sleep Medicine Reviews, 59, 101457. https://doi.org/10.1016/j.smrv.2021.101457 描述 碩士
國立政治大學
心理學系
110752014資料來源 http://thesis.lib.nccu.edu.tw/record/#G0110752014 資料類型 thesis dc.contributor.advisor 楊建銘 zh_TW dc.contributor.advisor Yang, Chien-Ming en_US dc.contributor.author (Authors) 丁琳 zh_TW dc.contributor.author (Authors) Ting, Ling en_US dc.creator (作者) 丁琳 zh_TW dc.creator (作者) Ting, Ling en_US dc.date (日期) 2025 en_US dc.date.accessioned 1-Jul-2025 14:11:42 (UTC+8) - dc.date.available 1-Jul-2025 14:11:42 (UTC+8) - dc.date.issued (上傳時間) 1-Jul-2025 14:11:42 (UTC+8) - dc.identifier (Other Identifiers) G0110752014 en_US dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/157655 - 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) 110752014 zh_TW dc.description.abstract (摘要) 研究目的：過度激發理論已是目前最被廣為接受的失眠病理模型之一，該理論認為失眠主要不是因睡眠機制有問題，而是生理、認知與情緒等層面處於過度覺醒的狀態，因而干擾了睡眠。過去透過腦波頻譜分析、事件相關電位及腦造影等方式的研究提供了失眠患者大腦皮質的過度激發的實徵證據，然而這些研究反映的為整體的激發狀態，缺乏針對睡眠受外在刺激干擾後的反應及恢復歷程的研究；此外，大腦皮質過度激發的現象在失眠病程上扮演的角色也較少被探討。因此，本研究透過聲音引發睡眠當中的擾醒，藉以分析受試者在睡眠擾醒前後的反應及恢復歷程，並比較高、低壓力下睡眠脆弱性的健康受試者，以探究大腦皮質過度激發與失眠之前置特質的關聯性。 研究方法：本研究於校園招募年輕健康受試者，且於「壓力下失眠反應量表（Ford Insomnia Response to Stress Test, FIRST）」得分落在前1/3（23分及以上）或後1/3（18分及以下）者，篩檢後共納入44位受試者，其中有3位未能符合規律作息、1位因AHI過高而被排除，剩下40位受試者分別作為高FIRST組（n=19）及低FIRST組（n=21）。受試者皆在實驗室進行一整夜的多頻道睡眠生理檢測（polysomnography, PSG），過程中由研究人員在確認受試者進入穩定睡眠後，持續於整晚給予多次聲音刺激以誘發睡眠擾醒，每次嘗試次至少間隔10分鐘。聲音刺激採用1秒之1000Hz純音刺激，由40dB起逐漸增強，每次增加10dB，且每次嘗試次至多給予6個聲音刺激，若在任一刺激中成功誘發擾醒則停止給予刺激。腦波數據皆以頻譜分析技術（EEG spectral analysis）進行處理，睡眠擾醒則分成兩階段分析，分別為反應及恢復歷程：反應歷程包含反應程度、反應耗時、刺激反應時間；恢復歷程則包含恢復程度及恢復耗時。其餘睡眠擾醒相關指標，包含睡眠擾醒時長、擾醒閾值等亦會納入分析。 研究結果：兩組在擾醒反應（反應耗時、反應程度、給予刺激到反應的耗時）與擾醒恢復（恢復程度、恢復耗時）共5個歷程指標上皆無顯著差異，兩組差異主要反應在被擾醒後身體動作的比例，即高FIRST族群在受到外界干擾後，可能較容易進入伴隨顯著身體動作的擾醒狀態。在擾醒閾值及擾醒時長上，亦未觀察到顯著的組間差異。 結論：本研究旨在探討睡眠擾醒歷程在不同睡眠脆弱性族群中是否會呈現不同激發狀態，結果顯示在睡眠擾醒反應及恢復歷程上腦波反應皆無顯著差異，在睡眠擾醒閾值及時長亦相當，然高FIRST組睡眠受到干擾後更常出現身體動作，顯示該族群有更高的傾向出現更為強烈的反應，而非停留在半夢半醒、通常不涉及個體意識的擾醒狀態。此行為反應或許是失眠早期階段的表現形式之一，隨病程進展才會進一步展現其他面向的過度激發現象。未來研究可參考本研究之擾醒操弄方法，進一步探討失眠族群在擾醒歷程上的激發狀態，以期對失眠病理機制有更全面的了解。 zh_TW dc.description.abstract (摘要) Objective: The hyperarousal theory is currently one of the most widely accepted etiological models for insomnia. It posits that insomnia arises not from a dysfunction of sleep mechanisms per se, but from an elevated state of arousal across physiological, cognitive, and emotional domains that interferes with the ability to sleep. Empirical evidence of cortical hyperarousal in insomnia patients has been found through methods such as EEG spectral analysis, event-related potentials, and neuroimaging. However, these studies have typically examined overall arousal levels, with relatively few investigating how the brain responds to and recovers from external disruptions during sleep. In addition, the role of cortical hyperarousal in the developmental course of insomnia remains unclear. This study aimed to address these gaps by using auditory stimuli to induce sleep arousals and analyzing both the reaction and recovery processes. By comparing healthy individuals with high versus low sleep vulnerability, this study seeks to clarify the relationship between cortical hyperarousal and the pre-dispositional characteristics of insomnia. Methods: A total of 44 healthy young participants were recruited from college campus, with a total score on the Ford Insomnia Response to Stress Test (FIRST) within the top one-third (≥23) or bottom one-third (≤18) of the population representing the high and low FIRST groups. Three participants who failed to maintain regular sleep schedules and one participant with and apnea-hypopnea index (AHI) of 26.5 were excluded. The final sample included 40 participants: 21 in the low FIRST group and 19 in the high FIRST group. Participants underwent overnight polysomnography (PSG) in a sleep laboratory, during which repeated auditory stimuli were delivered throughout the night once stable sleep was observed. Pure-tone stimuli (1000 Hz, 1 second duration) were presented beginning at 40 dB and increased by 10 dB increments, up to a maximum of six stimuli per trial, with at least a 10-minute interval between trials. If a stimulus successfully induced a sleep arousal, the trial was terminated. EEG spectral analysis was conducted to analyze the EEG data across the arousal events, and the overall arousal process was divided into two distinct phases: the reaction phase (including reaction intensity, reaction duration, and stimulus-to-response latency) and the recovery phase (including recovery magnitude and recovery duration). Additional sleep arousal indicators, including arousal threshold and arousal duration, were also analyzed. Results: No significant group differences were found in the five process-related indicators of sleep arousal—reaction duration, reaction intensity, latency from stimulus to arousal, recovery capacity, and recovery time. However, group differences were observed in the proportion of arousals accompanied by body movements, with the high FIRST group showing more frequent body movements following arousal. No significant differences were found between groups in arousal threshold or arousal duration. Conclusion: This study explored whether individuals with different levels of sleep vulnerability exhibit different activation patterns of sleep arousal. Results showed no significant differences in either the arousal reaction or recovery phases, nor in arousal threshold or duration. However, individuals in the high FIRST group exhibited more frequent body movements following sleep disruption, suggesting a greater tendency toward stronger arousal responses rather than remaining in a brief, partial arousal state that typically lacks conscious awareness. Such behavioral responses may reflect a manifestation of insomnia vulnerability, potentially preceding the emergence of other hyperarousal features as the condition progresses. Future research may adopt this approach of experimentally induced arousal to further investigate the mechanisms of hyperarousal mechanisms in individuals with clinical insomnia, thereby advancing our understanding of the underlying pathophysiology of insomnia. en_US dc.description.tableofcontents 第一章 研究動機 1 第二章 文獻回顧 3 第一節 睡眠的生理調控機制 3 第二節 失眠的定義與病理模型 5 第三節 失眠的過度激發現象 8 第四節 睡眠擾醒的歷程 12 第五節 壓力下的睡眠：睡眠脆弱性 16 第六節 研究問題與假設 18 第三章 研究方法 20 第一節 研究對象 20 第二節 研究流程 20 第三節 研究工具 23 一、中文版失眠嚴重度量表（Insomnia Severity Index-Chinese Version, ISI-C） 23 二、中文版貝克憂鬱量表第二版（Beck Depression Inventory-Chinese Version, BDI-II） 23 三、中文版貝克焦慮量表（Beck Anxiety Inventory, BAI） 24 四、Sleep-50 問卷（Sleep-50 Questionnaire） 24 五、M.I.N.I. 國際神經精神訪談問卷（The Mini International Neuropsychiatric Interview） 25 六、福特壓力下失眠反應量表（Ford Insomnia Response to Stress Test，FIRST） 25 七、睡眠活動記錄腕錶（Fitbit Charge系列） 26 八、睡眠日誌（Sleep log） 26 九、睡前問卷 27 十、多頻道睡眠生理檢測（Polysomnography, PSG） 27 第四節 資料分析 28 一、多頻道睡眠生理檢測（PSG） 28 二、睡眠結構指標（Sleep Structure Index） 28 三、睡眠腦波頻譜分析（Sleep EEG power spectra analysis，PSA） 28 四、擾醒歷程的分析方式 29 五、其他擾醒相關指標 30 第四章 研究結果 32 第五章 討論 42 第一節 睡眠擾醒操弄指標 42 第二節 其他次要指標的組間差異 48 第三節 總結 49 第四節 研究限制 50 第五節 臨床應用 51 參考文獻 53 附錄一、福特壓力下失眠反應量表 67 附錄二、睡眠日誌 68 附錄三、擾醒紀錄單 69 zh_TW dc.format.extent 3261154 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0110752014 en_US dc.subject (關鍵詞) 睡眠脆弱性 zh_TW dc.subject (關鍵詞) 睡眠擾醒 zh_TW dc.subject (關鍵詞) 過度激發 zh_TW dc.subject (關鍵詞) 腦波頻譜分析 zh_TW dc.subject (關鍵詞) Sleep vulnerability en_US dc.subject (關鍵詞) Sleep arousal en_US dc.subject (關鍵詞) Hyperarousal en_US dc.subject (關鍵詞) EEG spectral analysis en_US dc.title (題名) 以EEG頻譜分析探討高低睡眠脆弱性者的睡眠擾醒反應及恢復歷程 zh_TW dc.title (題名) Arousal Reaction and Recovery Processes during Sleep in Individuals with Different Levels of Sleep Vulnerability: Investigation with EEG Spectral Analysis en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 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，10(4)，447-454。https://doi.org/10.6320/FJM.2006.10(4).05 林一真（譯）（2000）。貝克焦慮量表（中文版）。台北市：中國行為科學社。 林詩純（2008）。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〕。國立政治大學心理學研究所。 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，4(2)，95-104。https://doi.org/10.6550/ACP.200912_4(2).0003 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。臺灣精神醫學，16:4 2002.12[民91.12] ， 301-310。 A Preliminary Report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. 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