青少年之睡眠問題

「睡眠問題」是當代青少年經常遭遇的困擾，不僅會影響生理和心理的健康，也會影響人際關係和社會功能。青少年上課日的睡眠時數隨著年齡增長而減少，假日的睡眠時數並沒有相同的趨勢，因此「睡眠債」會隨著年齡增長而增多。評估青少年睡眠問題時，除了蒐集睡眠史和做身體檢查外，還應瞭解睡眠本身、睡眠相關問題、以及睡眠問題的影響；常用的評估工具有許多，主觀性的評估工具包括睡眠日誌、睡眠習慣問卷（SHQ）、兒童睡眠問卷（PSQ）、兒童睡眠習慣問卷（CSHQ）、兒童日間嗜睡問卷（PDSS）、匹茲堡睡眠品質指標（PSQI）、Epworth 嗜睡量表（ESS）；客觀性的評估工具有多項式睡眠生理檢查（PSG）、睡眠活動記錄器（actigraphy）等。有研究指出，青少年的睡眠問題會影響其行為、情緒、和認知等。導致睡眠問題的因素有很多，在個人生理因素方面包含年齡、性別、睡眠中樞、腦功能、身體健康狀況等，在個人的心理行為方面包含情緒、思考、工作、作息、物質使用等；在家庭方面包含父母規範和家人關係等；在學校及同儕方面包含開始上課的時間、課業負荷、課外活動等。因此，在實務上必須全面評估睡眠的量與質，才能規劃合宜的介入策略，協助青少年改善睡眠品質。在研究上，除持續深化個人層面的探討外，也應加強人際、社會、文化等多重層面的分析，才能更廣泛地瞭解青少年的睡眠問題，藉此對當代青少年提供最適切的協助及服務。

Sleep problems, which can have a negative impact not only on the physical and psychological aspects of one's life but also on interpersonal relationships and social well-being, remain one of the most prevalent health issues among contemporary adolescents. With increasing age, weekday sleep duration decreases and sleep debt increases. Total sleep time on weekends remains unchanged with age. Regarding time of going to sleep, adolescents go to sleep later with increasing age and this trend is also much more obvious on weekends. As for time of getting up, they awake earlier with increasing age on weekdays. To evaluate adolescent sleep thoroughly, it is necessary to get data on sleep history and perform complete physical examinations, together with information about sleep per se, sleep-related problems, and the impact arising from such sleep problems. The common assessment tools include sleep diaries, Sleep Habits Questionnaire (SHQ), Pediatric Sleep Questionnaire (PSQ), Child Sleep Habits Questionnaire (CSHQ), Pediatric Daytime Sleepiness Scale (PDSS), Polysomnography, and actigraphy. Evidence clearly confirms that sleep problems have a negative impact on behavior, emotion, and cognition in adolescents. The determinants of adolescents sleep problems are individual physical factors (age, gender, homeostatic system and as circadian rhythm system, brain function, and physical condition), individual psychological factors (emotions, thought, work, daily activities, and substance use), family factors (parental regulations and quality of relationship with family members), school and peer factors (school start time, scholastic performance, and extracurricular activities). It is mandatory to consider quantity and quality of sleep, factors contributing to sleep problems, as well as interactions between risk factors, in order to adopt applicable interventional strategies. Aside from further research on factors at an individual level, both interpersonal and sociocultural factors related to adolescent sleep problems should also be taken into consideration.