睡眠障礙和睡眠不足愈來愈常見於現代人的生活，並且可能造成白天嗜睡，進而影響工作及交通安全；長遠來看，睡眠障礙和睡眠不足更與許多慢性疾病有關。目前已知運動可作為非藥物治療的介入方法，對睡眠產生有益的影響，且適合大眾採用，然而，有氧耐力運動對睡眠品質及睡眠結構的研究仍相當缺乏。目的：本研究目的為探討中壯年男性長距離跑者與無規律運動者睡眠品質之差異。方法：1.受試者：招募12名中壯年 (40-60歲) 男性的長距離跑者 (long distance running group, 簡稱LDR組) 及10名中壯年 (40-60歲) 男性的無規律運動者 (control group, 簡稱CON組)；2. 檢測方法：血液指標分析、睡眠多項生理檢查 (polysomnography, 簡稱 PSG)、主觀睡眠問卷 [包含：匹茲堡睡眠品質量表 (The Pittsburg Sleep Quality Index, 簡稱PSQI)、愛普沃斯嗜睡量表 (Eqworth sleep scale, 簡稱ESS)] 之填寫。3. 統計方法：(1) 使用獨立樣本t檢定比較兩組各項指標之間的差異；(2) 以皮爾森積差相關係數篩選出與睡眠多項生理檢查指標有顯著相關的變數；(3) 以逐步回歸分析皮爾遜積差相關達顯著差異之指標 [包括：呼吸中止指數 (apnea hypopnea index, 簡稱AHI)、非快速動眼第三期 (non-rapid eye movement stage III, 簡稱N3)、平均血氧飽和度 (mean oxygen saturation, 簡稱Mean SpO2%)、最低血氧飽和度 (minimum oxygen saturation, 簡稱Minimum SpO2)、血氧飽和度下降指數 (oxygen desaturation index, 簡稱ODI)、打鼾指數 (snore index)] 與各項檢測指標之間的關聯。結果：LDR組的N3%顯著小於CON組 (p<0.05)，但睡眠期間的平均血氧飽和度、最低血氧飽和度、血氧飽和度下降指數及打鼾指數均顯著優於CON組 (p<0.05)。在血液指標方面，LDR組的胰島素、血管硬化指數顯著低於CON組 (p<0.05)。逐步回歸發現，AHI與身體質量指數（body mass index, 簡稱BMI）顯著正相關 (p < 0.05)；N3%與三酸甘油脂顯著正相關 (p < 0.05)；平均血氧飽和度與BMI達顯著負相關 (p < 0.05)；最低血氧飽和度與胰島素、三酸甘油脂達顯著負相關 (p < 0.05)； ODI與BMI顯著正相關 (p < 0.05)；打鼾指數與胰島素有顯著正向關係 (p < 0.05)。結論：LDR組在體型與血液健康指標等方面顯著優於CON組，確認了有氧耐力的長距離跑運動的重要性。睡眠品質的結果顯示LDR組在睡眠期間的呼吸中止指數 (AHI)、血氧飽和度比CON組表現的好，此為本研究的重要發現。

Background: It is known that exercise can be used as an interventional method of non-drug therapy, which is beneficial to sleep. However, the effects of endurance training (e.g. distance running) on sleep quality and sleep structure hasn’t been well investigated yet.
Purpose of this study: To compare sleep quality between middle-aged male long-distance runners and non-regular exercise peers.
Method: Twelve middle-aged (40-60 years old) male long-distance runners (LDR group) and ten middle-aged (40-60 years old) male without regular exercise (CON group) were recruited for the current study. The assessment methods include body size/mass related measurements, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), polysomnography (PSG), and health-related blood indices analyses. Statistical methods include: 1) Descriptive statistics; 2) Independent sample t-test was used to compare the difference between two groups; 3) Pearson's correlation was used to evaluate the linear relationship between various parameters; 4) Stepwise linear regression was used to analyze relationship between PSG indices and other measurements.
Results: N3 in the LDR group was significantly lower than that in the control group whereas average blood oxygen saturation, minimum blood oxygen saturation, blood oxygen saturation decrease index and snore indices of the LDR group were significantly better than the control group (p<0.05). In health-related indices, insulin and vascular sclerosis index of the LDR group were significantly lower than the CON group. Analyses of stepwise linear regression showed that 1) AHI was positively correlated with Body Mass Index (p <0.05); 2) N3 was positively correlated with triglycerides (p <0.05); 3) mean oxygen saturation was negatively correlated with BMI (p <0.05); 4) minimum oxygen saturation was negatively correlated with insulin and triglycerides (p <0.05); 5) oxygen desaturation index was positively correlated with BMI (p <0.05) ; and 6) snoring index was positively correlated with insulin (p <0.05).
Conclusion: In addition to the confirmatory finding in body mass/size and health related measurements. The results of this study showed the frequency and severity of obstructive sleep apnea (OSA) in the LDR group are lower than the CON group, which further verified the benefits of long distance running.

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