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2种不同运动方式对原发性失眠患者睡眠质量的干预效果

Intervention Effect of Two Different Exercise Modes on Sleep Quality of Patients with Primary Insomnia

    摘要
  • 摘要:
      目的  探讨2种不同运动方式对原发性失眠（PI）患者睡眠质量的干预效果，为治疗失眠症提供新的视角和途径。
      方法  采用便利抽样法随机选取2017—2018年在中国人民解放军第169医院就诊的PI患者（男性16例，女性24例）为研究对象。采用单盲试验入组，分为有氧训练（AT）组、有氧联合抗阻训练（AR）组，每组20人，利用预先制定的运动处方进行为期4个月的干预。
      结果  ① 与干预前相比，干预后AT组和AR组睡眠总时间，睡眠效率，睡后觉醒次数，快速眼动睡眠潜伏期，非快速眼动睡眠Ⅰ、Ⅱ、Ⅲ-Ⅳ期，快速眼动睡眠期等指标差异有统计学意义（P < 0.01），表现为睡眠总时间延长、睡眠效率提高、觉醒次数减少、快速眼动睡眠潜伏期缩短。②干预后AT组和AR组之间的快速眼动睡眠潜伏期，睡后觉醒次数，非快速眼动睡眠Ⅰ、Ⅱ期，最低血氧饱和度等指标差异无统计学意义（P>0.05）；但睡眠总时间、非快速眼动睡眠Ⅲ-Ⅳ期、快速眼动睡眠期等指标差异有统计学意义（P < 0.05或P < 0.01），表现为睡眠总时间增加、深度睡眠时间延长。③干预后患者血清白细胞介素（IL）-1β、IL-6、肿瘤坏死因子（TNF）-α含量与干预前相比均有较大程度下降，差异有统计学意义（P < 0.01）。④干预后AT组和AR组之间血清IL-1β、TNF-α含量差异无统计学意义（P>0.05），但AT组血清IL-6含量高于AR组，差异有统计学意义（P < 0.01）。
      结论  ① 大部分PI患者睡眠结构基本正常，属于主观性失眠。运动主要通过调节紧张、焦虑等不良情绪，抑制过度觉醒状态而使患者睡眠质量提高。②抗阻训练过程中骨骼肌释放的IL-6可能参与机体免疫调节，减轻炎症反应，从而在一定程度上改善患者的睡眠质量。③无论是有氧训练还是有氧联合抗阻训练都可提升PI患者睡眠质量，后者作用更为突出，主要表现为睡眠总时间进一步延长。

     

    Abstract:
      Objective  To explore the effect of two different exercise modes on sleep quality of patients with primary insomnia(PI), and to provide a new perspective and approach for the treatment of insomnia.
      Methods  By convenient sampling, a total of 16 male and 24 female insomniacs were randomly selected from No. 169 PLA Hospitals from 2017 to 2018. A single blind trial was conducted and aerobic training (AT) group and aerobic combined resistance training (AR) group were divided. Twenty people in each group were given exercise prescription for 4 months.
      Results  ① Compared with pre-experiment, there were significant differences in total sleep time, sleep efficiency, wake-up times, rapid eye movement(REM) sleep latency, non-REM sleep stageⅠ, Ⅱ, Ⅲ-Ⅳ and REM sleep between AT group and AR group after the experiment, showing the prolonged total sleep time, improved sleep efficiency, reduced number of awakenings and shortened latency of REM sleep. ② No significant difference between AT group and AR group was found in sleep latency, wake-up times after sleep, stage Ⅰ and Ⅱof non-REM sleep and lowest oxygen saturation; while there were significant differences in the non-REM sleep stageⅢ-Ⅳ and REM sleep stages with an increased total sleep time and the longer deep sleep time. ③ The serum levels of IL-1β, IL-6 and TNF-α in the patients after the experiment were significantly lower than that before the experiment. ④After the experiment, there was no significant difference in serum IL-1βand TNF-α between the AT group and the AR group, while significant difference was found in IL-6.
      Conclusions  ① Most of PI patients have normal sleep structure, which belongs to subjective insomnia. Exercise can improve the sleep quality of patients by regulating the bad emotions such as tension and anxiety and inhibiting the over-awakening state. ② During resistance training, IL-6 released by skeletal muscle is involved in the immune regulation of the body and reduces the inflammatory response, thus improving the sleep quality of patients to a certain extent. ③ Both aerobic training and aerobic combined resistance training have a good effect on the improvement of sleep quality of PI patients; the latter is more prominent, mainly manifested in the further extension of the total sleep time.

     

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