青少年靜態行為與睡眠之系統性文獻回顧

A systematic review on sedentary behavior and sleep among adolescents

緒論：青少年經常從事靜態行為與面臨睡眠不足的問題，研究顯示靜態行為與睡眠問題對於青少年生理與心理有負面影響。然而，目前鮮少研究針對靜態行為與睡眠不足的實徵性研究進行系統性的文獻回顧。因此，本研究旨在應用系統性回顧探討青少年之靜態行為與睡眠之間的關係。方法：本研究搜尋中文及英文期刊論文電子資料庫（2015年1月至2019年1月），最後篩選出符合指標19篇有關青少年靜態行為與睡眠之量化期刊論文。結果：19篇論文中，靜態行為型式主要為看電視與使用電腦／網路較多（各7篇）；有4篇包含非螢幕靜態行為型式（講電話（非螢幕式）、做功課、閱讀、聽音樂、聊天以及玩卡片）；有10篇探討總靜態或總螢幕行為。有關睡眠的測量方式，只有1篇採用客觀測量睡眠參數（腕動儀），其餘均為主觀式自陳報告；至於睡眠參數部份，多數以睡眠時間為主（12篇），其次為睡眠潛伏期及睡眠困擾／夜間醒來（各4篇），延遲就寢與失眠各3篇，少數提及睡眠品質、日間嗜睡、或睡眠效率。結論：花費在靜態行為（特別是電腦與網路）時間愈多者，睡眠時間不足、睡眠困擾、失眠等風險較高，且顯著延遲就寢時間。而靜態行為與睡眠效率、睡眠品質、日間嗜睡／日間疲憊等睡眠參數間之關係，則鑒於研究篇數過少，無法提供確切之結論。未來研究應透過實驗設計與長期追蹤研究設計分析客觀測量之靜態行為與各種睡眠參數之關係，進一步了解其關聯之機轉及靜態行為對睡眠問題與廣泛健康結果之影響。

Introduction: Adolescents often engage in sedentary behavior and encounter sleep problems. Numerous studies have shown that both sedentary behavior and sleep problems negatively impact physical and mental health among adolescents. However, no studies exist that systematically summarize empirical findings of sedentary behavior and sleep problems on adolescents. The purpose of this systematic review was to explore empirical findings concerning the associations between sedentary behavior and sleep on adolescents. Methods: Major electronic databases in English and Chinese were searched from January 2015 to January 2019. Nineteen quantitative studies met the criteria for reporting the association between sedentary behavior and sleep on adolescents. Results: Among 19 articles, the modes of sedentary behavior were mainly TV watching and computer/internet use (7 studies each). There were 4 studies including non-screen sedentary behavior (non-screen telephone, reading, doing homework, listening to music, chatting, or playing cards). Total sedentary behavior or total screen behavior were collected in 10 studies. Regarding the measures of sleep, only 1 study used objective measure (actigraphy) and the others were self-reported. The sleep parameters included sleep duration (12 studies), sleep onset latency (4 studies), sleep disturbance/awakening (4 studies), delayed bedtime (3 studies), and insomnia (3 studies). A few studies mentioned sleep quality, daytime sleepiness, or sleep efficiency. Conclusion: Adolescents who spent more time on sedentary behavior (especially computer and internet use) had higher risks of insufficient sleep duration, sleep disturbance, insomnia, and delayed bedtime. No conclusion could be made about the association between sedentary behavior types and sleep efficiency, sleep quality, daytime sleepiness and/or fatigue due to limited research. Future research should investigate the associations between different modes of objectively derived sedentary behavior and various sleep parameters with experimental and longitudinal study design to better understand the mechanisms of associations and the impacts of sedentary behavior on sleep problems and wider health outcomes.