探討運動介入對睡眠失常下的血糖調控效應：文獻回顧

Effects of exercise intervention on glycaemic control in the context of sleep deprivation

緒論：立即性及長期睡眠失常皆會對血糖控制產生負面影響，當血糖調控異常時會增加心血管及二型糖尿病的發生率。研究發現單次和長期運動對血糖調控有正面效益，因此本文獻回顧將針對運動介入對睡眠失常後的血糖調控進行討論，並提出可能機制和未來研究方向。方法：使用PubMed電子資料庫，搜尋運動對睡眠失常下的血糖調控相關研究，研究需同時包含睡眠失常和運動介入，並分析介入前後的血糖或胰島素濃度變化，收尋期間為1980年1月起至2024年8月。結果：共7篇文章符合此文獻回顧，3篇為單次睡眠控制，4篇為多天睡眠控制，研究參與族群主要為年輕健康男性。結果顯示單次睡眠失常造成的餐後胰島素阻抗，因高強度間歇運動介入而有所改善。連續天數睡眠失常下，進行連續天數的中等強度有氧或高強度間歇運動，則能降低因睡眠失常造成的血糖或胰島素調控的負面影響。結論：中等強度有氧運動或高強度間歇運動介入，似乎能改善睡眠失常對血糖調控的負面影響，可能機制包含運動對骨骼肌的直接作用、降低粒線體損壞程度和抑制發炎反應等，但目前僅有7篇相關研究，且研究主要以年輕男性為主，因此確切影響機制和不同類型運動的可能效益需更多研究確認。未來可針對不同運動強度（最低強度閾值）、運動種類（如：阻力運動）或不同族群（例如：女性、年長者或代謝異常者）進行探討。

Introduction: Acute and chronic sleep deprivation have been shown to impair glycemic control in humans. Previous research has indicated that both acute and chronic exercise interventions can enhance glycemic regulation; however, to date, the impact of exercise on glycemic control following sleep deprivation has not been reviewed, which is the focus of the present study. Methods: A systematic search was conducted utilizing the PubMed database to compile studies pertaining to the regulation of blood glucose after exercise in the context of sleep deprivation. The search encompassed the period from January 1980 to August 2024. The inclusion criteria required studies address both sleep deprivation and exercise while examining alterations in blood glucose or insulin levels. Results: A total of 57 studies were identified, of which 7 were relevant to the research topic. 3 of these studies focused on single-day sleep deprivation, while the remaining 4 examined multi-day sleep deprivation. High-intensity interval exercise was found to ameliorate postprandial insulin resistance associated with single-day sleep deprivation. In the context of multi-day sleep deprivation, both moderateintensity aerobic exercise and high-intensity interval exercise interventions were effective in mitigating the adverse effects of sleep deprivation on blood glucose and insulin regulation. Conclusion: Our findings suggest that both moderate-intensity aerobic exercise and high-intensity interval training may mitigate the adverse effects of sleep deprivation on glycemic control. The underlying mechanisms may be associated with the direct effects of exercise on skeletal muscle, reduction of mitochondrial damage, and decreased inflammation. Currently, there are only 7 studies, and the potential mechanisms by which exercise influences glycemic control after sleep disturbances require further investigation. Future research should explore various exercise intensities (e.g., minimum intensity thresholds), types of exercise (e.g., resistance training), and diverse populations (e.g., women and the elderly).