探討週期性光照對早產兒住院期間睡眠變化之影響

Exploring the Effects of Cycled Lighting on Sleep Patterns in Premature Infants During Hospitalization

背景睡眠是人類的基本需求，也是新生兒主要的行為狀態，對大腦的成熟與發展很重要，尤其影響早產兒的成長。然而，早產兒在加護病房期間的睡眠常被干擾及中斷，卻鮮少研究關注早產兒住院期間睡眠的改善措施。
目的探討早產兒於住院期間接受週期性光照對其睡眠品質之影響。
方法為隨機對照試驗，採重複測量設計，收案出生週數28–36週之早產兒68位。實驗組於住院期間達32週時，給予週期性光照，對照組提供常規照護。兩組早產兒運用睡眠活動紀錄器進行資料收集，於早產兒介入前及出院前測量，並以廣義估計方程式進行資料分析。
結果在組別與時間的交互作用下，實驗組夜間睡眠總時間前後測變化量，較對照組顯著增加64.52分鐘（B = 64.52, p = .031），且實驗組夜間睡眠效率前後測變化量，較對照組顯著增加8.92%（B = 8.92, p =.032）。
結論／實務應用結果顯示週期性光照能提升早產兒夜間總睡眠時間及睡眠效率，改善早產兒住院期間睡眠品質。期能以此作為臨床照護之依據，加強護理人員對早產兒住院期間的睡眠照護，藉由週期性光照協助早產兒建立睡眠週期，促進其發展，提升照護品質。

Background: Sleep, a fundamental human need and the primary behavioral state of newborns, plays a critical role in brain maturation and development and, in particular, influences the growth of premature infants. However, sleep in premature infants is frequently disturbed and interrupted during their stay in intensive care units, and interventions designed to improve sleep quality during hospitalization have been inadequately investigated.
Purpose: This study was designed to examine the impact of cyclic light exposure on sleep quality in premature infants during hospitalization.
Methods: This randomized controlled trial was conducted using a repeated measures design on a sample of 68 premature infants born between 28 to 36 weeks of gestation. The experimental group was exposed to cyclic lighting starting at 32 weeks of gestation during their NICU stay, while the control group received standard care. The sleep data were collected using actigraphy, with measurements taken at two time points: pre-intervention (pre-test) and immediately prior to discharge (post-test). Data analysis was conducted using generalized estimating equations.
Results: The intervention group reported a significantly greater pre-test / post-test increase in terms of total nighttime sleep duration than the control group (B = 64.52, p = .031). Moreover, the improvement in nighttime sleep efficiency between the two time points in the intervention group (8.92%, p = .032) was significantly greater than in the control group.
Conclusion/ Implications for Practice: The findings suggest cyclic lighting enhances both total nighttime sleep duration and sleep efficiency in premature infants, improving sleep quality during hospitalization. These results informs clinical practice through encouraging healthcare providers to prioritize sleep care for hospitalized premature infants. Implementing cyclic lighting may support the development of more-optimal sleep cycles in premature infants, fostering overall infant development and improving quality of care.