| dc.contributor.advisor | 楊建銘 | zh_TW |
| dc.contributor.author (作者) | 黃冠豪 | zh_TW |
| dc.creator (作者) | 黃冠豪 | zh_TW |
| dc.date (日期) | 2007 | en_US |
| dc.date.accessioned | 19-九月-2009 11:56:30 (UTC+8) | - |
| dc.date.available | 19-九月-2009 11:56:30 (UTC+8) | - |
| dc.date.issued (上傳時間) | 19-九月-2009 11:56:30 (UTC+8) | - |
| dc.identifier (其他 識別碼) | G0927520191 | en_US |
| dc.identifier.uri (URI) | https://nccur.lib.nccu.edu.tw/handle/140.119/37083 | - |
| dc.description (描述) | 碩士 | zh_TW |
| dc.description (描述) | 國立政治大學 | zh_TW |
| dc.description (描述) | 心理學研究所 | zh_TW |
| dc.description (描述) | 92752019 | zh_TW |
| dc.description (描述) | 96 | zh_TW |
| dc.description.abstract (摘要) | 本研究嘗試檢視原發性失眠 (Primary insomnia) 患者在接受完認知行為治療後，其生理激發系統與恆定系統相關生理指標的改變，並探討其主、客觀睡眠改善與生理指標變化之間的關聯，藉以瞭解不同的生理系統在影響原發性失眠患者其主、客觀睡眠改善程度上可能的重要性。本研究透過醫師轉介，共18名原發性失眠患者 (男5人，女13人，平均年齡37.4歲) 接受7週6次的失眠認知行為治療，在接受治療的前後，分別進行一個晚上的多頻道睡眠記錄檢查與主、客觀睡眠評估。再進一步分析高頻率腦波Beta波 (14~35Hz) ，用來反應其中樞神經系統的激發，低頻率腦波Delta波 (0.5~2.5Hz) 則用來反應個案的恆定系統；另外，透過心跳變異率分析得出的參數，包括低頻率 (Low frequency，簡稱LF) 功率與高頻率 (High frequency，簡稱HF) 功率，以LF/HF的比率值測量其交感神經系統的活動，而HF/ (LF+HF) 則是測量副交感神經系統的活動。研究結果顯示個案的失眠問題在主觀睡眠評估指標上有顯著改善，而客觀睡眠評估指標與睡眠結構於入睡時間與入睡後清醒時間有顯著降低，其餘則無顯著改善。而各項生理系統指標，僅後半夜階段二的腦波的Delta波有顯著上升，其餘均無顯著地改善，而LF/HF的下降與失眠嚴重度的下降有顯著地關聯。因此，本研究顯示原發性失眠患者接受認知行為治療前後，其交感神經系統的下降與失眠嚴重度之改善有明顯關聯，推論失眠認知行為治療對於原發性失眠患者的交感神經活動的改善，可能是使其失眠嚴重度改善的關鍵。 | zh_TW |
| dc.description.abstract (摘要) | The present study evaluated the changes in beta and delta ranges of electroencephalogram (EEG) power and heart rate variability (HRV) after cognitive behavioural therapy for insomnia (CBT-I) to understand the effect of CBT-I on arousal system and homeostatic system. The study also examined the correlations between change of sleep measurement and the physiological index to clarify underlying mechanisms of sleep improved by CBT-I. Eighteen primary insomnia patients (5 males, 13 female, mean age = 37.4) participated in this study. The participants were scheduled to come to the sleep laboratory for polysomnographic (PSG) recording twice, one prior to CBT-I and one following CBT-I. A course of 6-session CBT-I was conducted during a period of seven weeks. Subjects’ changes in subjective ratings of sleep quality and quantity and sleep parameters in PSG were calculated. Spectrum analyses were conducted for their EEG and electrocardiogram (EKG). Beta EEG activity (14~35 Hz) was used to indicate the central nervos system (CNS) arousal level and Delta EEG activity (0.5~2.5 Hz) for the intensity of homeostatic system. Low frequency power (LF) and high frequency power (HF) of the R-R interval were calculated for heart rate variability (HRV). LF/HF ratio was used as a index of sympathetic nervous system activity and the HF/ (LF+HF) ratio as a index of parasympathetic nervous system activity. The results show subjective sleep quality of subjects were significantly improved after CBT-I. PSG shows shortened sleep onset latency and decreased wake time after sleep onset, but not in the other measures. For EEG spectrum and HRV parameters, only Delta EEG activity in stage2 of the second half of the night was significantly improved. In addition, the decrease of LF/HF significantly correlated with the improvement of the insomnia severity index. Thus, the results suggests that sleep improvements by CBT-I may be associated with the reduction of sympathetic arousal. | en_US |
| dc.description.tableofcontents | 第一章、文獻探討………………………………………………………………1 第一節、原發性失眠的中樞神經系統過度激發病理…….........3 第二節、原發性失眠的自主神經系統病理…………………………..7 第三節、原發性失眠的恆定機制失調病理…………………………8 第四節、原發性失眠的認知行為治療…………………………………9 第五節、研究目的………………………………………………..……12第二章、研究方法…………………………………………….……………..15 第一節、受試者………………………………………………….………15 第二節、程序……………………………………………………………16 第三節、研究工具與測量…………………………………………………18 第四節、統計分析…………………………………………………………23第三章、研究結果…………….…………………………...……………...25 第一節、受試者的基本人口學資料與治療效果…………………………25 第二節、生理系統指標的前後改變………………………………………27 第三節、生理系統指標改變與各項主客觀睡眠評估指標改善間的關聯32第四章、討論………………………………………………………………………36 第一節、CBT-I的療效…………............................36 第二節、生理指標前後的改變…………………………………………37 第三節、生理系統改變與各項主客觀睡眠評估改善間的關聯………40 第四節、研究限制與未來方向…………………………………..……43參考文獻………………………………………………………………………..45附錄 附錄1 失眠嚴重度量表…………………………………………….….53 附錄2 睡前激發程度量表……………………………………………….54 附錄3 匹茲堡睡眠品質量表…………………………………………….55 附錄4 研究個案的人口學資料表………………………………….……57 表目錄表1. 接受CBT-I前後測的各項療效指標之t檢定摘要表…………........26表2. 前後測PSG檢查之睡眠結構摘要表…………………….………..….…26表3. Delta波前後測的t檢定摘要表……….………………………….……28表4. Beta-1波前後測的t檢定摘要表………………….………………….…29表5. Beta-2波前後測的t檢定摘要表……...………………………….….29表6.心跳變異率分析LF/HF、HFn.u.前後測的t檢定摘要表……..……..30表7.療效有無分組Delta波前後測改變的Wilcoxon signed ranks test 摘要表……..............................................30表8.療效有無分組Beta-1波前後測改變的Wilcoxon signed ranks test 摘要表……..............................................31表9.療效有無分組Beta-2波前後測改變的Wilcoxon signed ranks test 摘要表…….............................................31表10.療效有無分組心跳變異率分析LF/HF、HFn.u.前後測改變的Wilcoxon signed ranks test摘要表…………………………………………….32表11.Delta波改變與各療效指標改變之關聯分析摘要表……..........34表12. Beta-1波改變與各療效指標改變之關聯分析摘要表………..….….34表13. Beta-2波改變與各療效指標改變之關聯分析摘要表…………………35表14.心跳變異率分析LF/HF、HFn.u.改變與各療效指標改變之關聯分析摘要 表…..………………………………………………………………………35圖目錄圖1心理行為因素透過神經生理調節機制影響睡眠的概念模式…………....3圖2 Perlis的原發性失眠神經認知模式……………………………………….5 | zh_TW |
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| dc.language.iso | en_US | - |
| dc.source.uri (資料來源) | http://thesis.lib.nccu.edu.tw/record/#G0927520191 | en_US |
| dc.subject (關鍵詞) | 原發性失眠 | zh_TW |
| dc.subject (關鍵詞) | 失眠認知行為治療 | zh_TW |
| dc.subject (關鍵詞) | 中樞神經系統 | zh_TW |
| dc.subject (關鍵詞) | 交感神經系統 | zh_TW |
| dc.subject (關鍵詞) | 副交感神經系統 | zh_TW |
| dc.subject (關鍵詞) | 恆定系統 | zh_TW |
| dc.subject (關鍵詞) | Primary insomnia | en_US |
| dc.subject (關鍵詞) | cognitive behavioural therapy for insomnia | en_US |
| dc.subject (關鍵詞) | central nervous system | en_US |
| dc.subject (關鍵詞) | sympathetic nervous system | en_US |
| dc.subject (關鍵詞) | parasympathetic nervous system | en_US |
| dc.subject (關鍵詞) | homeostatic system | en_US |
| dc.title (題名) | 失眠認知行為治療前後生理指標的改變與療效的關係 | zh_TW |
| dc.title (題名) | The Relationships of change in physiological measures and sleep improvement following cognitive behavioral therapy for insomnia | en_US |
| dc.type (資料類型) | thesis | en |
| dc.relation.reference (參考文獻) | 台灣精神醫學學會 (民90)。MINI 台灣版 (2.0.0th ed.)，台北。 | zh_TW |
| dc.relation.reference (參考文獻) | 林詩淳、楊建銘、許世杰 (民95年3月)。失眠嚴重度量表、睡前激發程度量表及睡眠失功能信念及態度量表中譯版之信效度研究。台灣睡眠醫學會，台北榮民總醫院。 | zh_TW |
| dc.relation.reference (參考文獻) | Agnew, H. W., Webb, W. B., & Williams, R. L. (1966). The first night effect: an EEG study of sleep. Psychophysiology, 2, 263-266. | zh_TW |
| dc.relation.reference (參考文獻) | Akselrod, S., Gordon, D., Ubel, F.A., Shannon, D.C., Barger A.C. & Cohen, R.J. (1981). Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat to beat cardiovascular control. Science, 213, 220-222. | zh_TW |
| dc.relation.reference (參考文獻) | American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. Fourth edition. Washington, DC: American Psychiatric Association. | zh_TW |
| dc.relation.reference (參考文獻) | Bastien, C. H., Vallieres, A. & Morin, C. M. (2001). Validation of the Insomnia Severity Index | zh_TW |
| dc.relation.reference (參考文獻) | as an outcome measures for insomnia research. Sleep Medicine, 2(4), 297-307. | zh_TW |
| dc.relation.reference (參考文獻) | Bootzin, R. R., & Epstein, D. R. (2000). Stimulus control. In K. L. Lichstein, & C.M. Morin (Eds). Treatment of late-life insomnia (pp. 167-184). Thousand Oaks, Ca.: Sage Publications. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (1992). Caffeine use as a model of acute and chronic insomnia. Sleep, 15(6), 526-536. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (1994). The impact of level of physiological arousal on estimates of sleep latency. In: Ogilvie R. D,, Harsh, J. R, (Eds). Sleep Onset: Normal and Abnormal Processes. Washington, DC: American Psychological Association, 127-140. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine | zh_TW |
| dc.relation.reference (參考文獻) | reviews, 1, 97-108. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (1998). Heart Rate Variability in Insomniacs and Matched Normal Sleepers. Psychosomatic Medicine, 60, 610-615. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (1999). Level of arousal and the ability to maintain wakefulness. Journal Sleep Research, 8, 247-254. | zh_TW |
| dc.relation.reference (參考文獻) | Bonnet, M. L., & Arand, D. L. (2000). Activity, arousal, and the MSLT in patients with insomnia. Sleep., 23(2), 205-212. | zh_TW |
| dc.relation.reference (參考文獻) | Busek, P., Vankova, J., Opavsky, J., Salinger, J. & Nevsimalova, S. (2005). Spectral Analysis of heart rate variability in sleep. Physiology Research, 54, 369-376. | zh_TW |
| dc.relation.reference (參考文獻) | Buysse, D. J., Reynolds Ⅲ, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). Pittsburgu Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28, 193-213. | zh_TW |
| dc.relation.reference (參考文獻) | Carlson, C. R., & Hoyle, R. H. (1993). Efficacy of abbreviated progressive muscle relaxation training: a quantitive review of behavioral medicine research. Journal of Consulting and Clinical psychology, 61(6), 1059-1067. | zh_TW |
| dc.relation.reference (參考文獻) | Cervena, K., Dauvilliers, Y., Espa, F., Touchon, J., Matousek, M., Billiard, M., & Besset, A. | zh_TW |
| dc.relation.reference (參考文獻) | (2004). Effect of cognitive behavioural therapy for insomnia on sleep architecture and sleep EEG power spectra in psychophysiological insomnia. Journal of Sleep Research, 13, 385-394. | zh_TW |
| dc.relation.reference (參考文獻) | Dijk, D. J., Hayes, B., & Czeisler, C. A. (1993). Dynamics of electroencephalographic sleep spindles and slow wave activity in men: effect of sleep deprivation. Brain research., 626, 190-199. | zh_TW |
| dc.relation.reference (參考文獻) | Edinger, J. D., Sullivan, R. J., Bastian, L. A., Hope, T. V., Young, M., Shaw, E., et al. (2000) Insomnia and the eye of the beholder: Are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? Journal of Consulting and Clinical psychology, 68, 586-593. | zh_TW |
| dc.relation.reference (參考文獻) | Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E. (2001). Does cognitive-behavioral therapy alter insomnia dysfunctional beliefs about sleep? Sleep, 24(5), 591-599. | zh_TW |
| dc.relation.reference (參考文獻) | Freedman, R. (1986). EEG power in sleep onset insomnia. Electroencephalograph | zh_TW |
| dc.relation.reference (參考文獻) | Clinical Neurophysioly, 63, 408-413. | zh_TW |
| dc.relation.reference (參考文獻) | Gallup Organization. (1991) Sleep in America. Gallup Organization, Princeton. NJ. | zh_TW |
| dc.relation.reference (參考文獻) | Harvey, A. D. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869-893. | zh_TW |
| dc.relation.reference (參考文獻) | Hauri, P. (1981). Treating Psychophysiologic Insomnia With Biofeedback. Archives of General Psychiatry, 38, 752-758. | zh_TW |
| dc.relation.reference (參考文獻) | Hauri, P., & Olmstead, E. M. (1989). Reverse first night effect in insomnia. Sleep, 12, 97-105. | zh_TW |
| dc.relation.reference (參考文獻) | Hauri, P. (1991). Sleep hygiene, relaxation therapy, and cognitive interventions. In: Hauri P, editor. Case studies in insomnia. New York: Plenum, 65-84. | zh_TW |
| dc.relation.reference (參考文獻) | Hoch, C. C., Reynold lll C. F., Buysse, D. J., Monk, T. H., Nowell, P., Begley, A. E. et al. (2001). Protecting sleep quality in latter life: a pilot study of bed restriction and sleep hygiene. Journal of gerontology. Series B, Psychological sciences and social sciences. 56(1), 52-59. | zh_TW |
| dc.relation.reference (參考文獻) | Jacobs, G. D., Benson, H., & Friedman, R. (1993). Home-based central nervous | zh_TW |
| dc.relation.reference (參考文獻) | system assessment of a multifactor behavioral intervention for chronic sleep-onset insomnia. Behavior Therapy, 24, 159-174. | zh_TW |
| dc.relation.reference (參考文獻) | Jasper, H. H. (1958). The ten twenty electrode system of the International Federation. Electroencephalography and. Clinical neurophysiology, 10, 371-375. | zh_TW |
| dc.relation.reference (參考文獻) | Kales, A., Caldwell, A. B., Preston, T. A. et al. (1976). Personality patterns in insomnia. Archives of general psychiatry, 33, 1128-1134. | zh_TW |
| dc.relation.reference (參考文獻) | Krystal, A. D., Edinger, J. D., Wohlgemuth, W. K., & Marsh, G. R. (2002). NREM Sleep EEG Frequency Spectral Correlates of Sleep Complaints in Primary Insomnia Subtypes. Sleep, 25, 630-640. | zh_TW |
| dc.relation.reference (參考文獻) | Lichstein, K. L., & Rosenthal, T. L. (1980). Insomnia’s perceptions of cognitive versus | zh_TW |
| dc.relation.reference (參考文獻) | somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89, 105-107. | zh_TW |
| dc.relation.reference (參考文獻) | Lichstein, K. L., Riedel, B. W., Wilson, N. M., Lester, K. W., Aguillard, R. N. (2001). Relaxation and sleep compression for late-life insomnia: a placebo- controlled trial. Journal of Consulting and Clinical psychology, 69(2), 227-239. | zh_TW |
| dc.relation.reference (參考文獻) | Malliani, A., Pagani, M., & Lombardi, F. (1996). Methodological aspects of non-invasive analysis of autonomic regulation of cardiovascular variability. Clinical laboratory science: journal of the American Society for Medical Technology. 91 (Suppl), 68-71. | zh_TW |
| dc.relation.reference (參考文獻) | Means, M. K., Lichstein, K. L., Epperson, M. T., & Johnson, C. T. (2000). Relaxation therapy for insomnia: nighttime and day time effects. Behaviour research and therapy, 38(7), 665-678. | zh_TW |
| dc.relation.reference (參考文獻) | Mellinger, G. D., Balter, M. B., & Uhlenhuth, E. H. (1985). Insomnia and its treatment: prevalence and correlates. Archives of general psychiatry, 42, 225-232. | zh_TW |
| dc.relation.reference (參考文獻) | Mercia, H., & Gaillard, J. M. (1992). The EEG of the sleep onset period in insomnia:a | zh_TW |
| dc.relation.reference (參考文獻) | discriminant analysis. Physiology & behavior, 52, 199-204. | zh_TW |
| dc.relation.reference (參考文獻) | Mercia, H., Blois, R., & Gaillard, J. M. (1998). Spectral characteristics of sleep EEG in | zh_TW |
| dc.relation.reference (參考文獻) | chronic insomnia. European Journal of Neuroscience, 10, 1826-1834. | zh_TW |
| dc.relation.reference (參考文獻) | Monroe, L. J. (1967). Psychological and physiological differences between good and | zh_TW |
| dc.relation.reference (參考文獻) | poor sleepers. Journal of Abnormal Psychology, 72, 255-264. | zh_TW |
| dc.relation.reference (參考文獻) | Morin, C. M., Gaulier, B., Barry, T., & Kowatch, R. A. (1992). Patients’acceptance of psychological and pharmacological therapies for insomnia. Sleep, 15(4), 302-305. | zh_TW |
| dc.relation.reference (參考文獻) | Morin, C. M. (1993a). Insomnia: psychological assessment and management. New York: Guilford. | zh_TW |
| dc.relation.reference (參考文獻) | Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993b). Dysfunctional beliefs and attitudes about sleep among olders adults with and without insomnia complaints. Psychology and Aging, 8, 463-467. | zh_TW |
| dc.relation.reference (參考文獻) | 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: the journal of the American Medical Association, 281, 991-999. | zh_TW |
| dc.relation.reference (參考文獻) | 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 and Therapy, 23, 263-271. | zh_TW |
| dc.relation.reference (參考文獻) | Nofzinger, E. A., Nowell, P. D., Buysee, D. J., Vasco, R. C., Thase, M. E., Frank, E., Kupfer, | zh_TW |
| dc.relation.reference (參考文獻) | D. J., & Reynolds, C. F. (1999). Towards a Neurobiology of Sleep Disturbance in Primary Insomnia and Depression: a Comparison of Subjective, Visually Scored, Period Amplitude, and Power Spectral Density Sleep Measures. Sleep, 22:s99. | zh_TW |
| dc.relation.reference (參考文獻) | Nomura, K., Yamaoka, K., Nakao, M., & Yano, E. (2005). Impact of insomnia on individual | zh_TW |
| dc.relation.reference (參考文獻) | health dissatisfaction in Japan, South Korea, and Taiwan. Sleep, 28(10), 1328-1332. | zh_TW |
| dc.relation.reference (參考文獻) | Perlis, M. L., Giles, D. E., Mendelson, W. B., Bootzin, R. R., & Wyatt, J. K. (1997). | zh_TW |
| dc.relation.reference (參考文獻) | Psychophysiological insomnia：the behavioural model and a neurocognitive | zh_TW |
| dc.relation.reference (參考文獻) | perspective. Journal of Sleep Research, 6, 179-188. | zh_TW |
| dc.relation.reference (參考文獻) | Perlis, M. L., Smith, M. T., Orff, H., Andrews, P., & Giles, D. E. (2001a). Beta/Gamma | zh_TW |
| dc.relation.reference (參考文獻) | EEG activity in Patients with Primary and Secondary Insomnia and Good Sleeper Controls. Sleep, 24, 110-117. | zh_TW |
| dc.relation.reference (參考文獻) | Perlis, M. L., Merica, H., Smith, M. T., & Giles, D. E. (2001b). Beta EEG activity and | zh_TW |
| dc.relation.reference (參考文獻) | insomnia. Sleep Meddicine Reviews, 5, 365-376. | zh_TW |
| dc.relation.reference (參考文獻) | Pigeon, W. R., & Perlis M. L. (2006). Sleep homeostasis in primary insomnia. Sleep Medicine Reviews, 10, 247-254. | zh_TW |
| dc.relation.reference (參考文獻) | Rechtschaffen, A., & Kales, A. ,eds. (1968). A manual of standardized Terminology: Techniques and Scoring System for Sleep Stages of Human Subjects. Los Angeles, Calif: UCLA Brain Information Service/Brain Research Institute. | zh_TW |
| dc.relation.reference (參考文獻) | Riedel, B., Lichstein, K., Peterson, B. A., Epperson, M. T., Means, M. K., & Aguillard, R. N. (1998). A comparison of the efficacy of stimulus control for medicated and non-medicated insomniacs. Behavior Modification, 22, 3-28. | zh_TW |
| dc.relation.reference (參考文獻) | Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., Buysse, D. J. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. The American Journal of Psychiatry, 159, 5-11. | zh_TW |
| dc.relation.reference (參考文獻) | Spielman, A. J., Saskin, P., Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed. Sleep, 10, 45-56. | zh_TW |
| dc.relation.reference (參考文獻) | Stepanski, E., Zorick, F., Roehrs, T., & Roth, T. (2000). Effects of sleep deprivation on daytime sleepiness in primary insomnia [In process citation]. Sleep., 23, 215-219. | zh_TW |
| dc.relation.reference (參考文獻) | Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). Heart rate variability: standards of measurement, physiological interpretation and clinical use, Circulation, 93, 1043-1065. | zh_TW |
| dc.relation.reference (參考文獻) | Ustun, T. B., Privett, M., Lecrubier, Y. et al. (1996). Form frequency and burden of sleep problems in general health care: a report from the WHO Collaborative Study on Psychological Problems in General Health care. European Psychiatry, 11(suppl 1), 5S-10S. | zh_TW |
| dc.relation.reference (參考文獻) | Vgontzas, A. N., Tsigos, C., Bixler, E. O., Stratakis, C. A., Zachman, K., Kales, A., Vela-Bueno, A., & Chrousos, G. P. (1998). Chronic insomnia and Activity of the stress system：A Preliminary Study. Journal of Psychosomatic Research, 45, 21-31. | zh_TW |
| dc.relation.reference (參考文獻) | Yang, C. M., Spielman, A. J., & Glovinsky, P. (2006). Nonpharmacologic Strategies in the Management of Insomnia. Psychiatric clinics of North America, 29, 895-919. | zh_TW |
