年長睡眠品質不佳者，不僅自律神經失衡，大腦活性也出現異常。淨化呼吸瑜珈（Sudarshan Kriya Yoga, SKY）由三種特殊的呼吸技術所組成，對於一般人之健康很有助益。過去文獻證實中年人規律練習SKY有助提升睡眠品質及平衡自律神經功能，但在老年人是否也能改善睡眠及自律神經功能，以及其神經生理機制為何，並不清楚。中樞自律神經網路（central autonomic network, CAN）是腦中與呼吸、睡眠以及自律神經系統三者息息相關的神經迴路。本研究假設，老年族群規律練習SKY可改善睡眠品質以及自律神經功能，且與CAN腦區活性及其內部聯結有關。我們招募20位睡眠品質不佳之年長受試者，進行兩個月試驗，在三個時間點（T1, T2及T3）收集實驗數據，包含匹茲堡睡眠品質量表、靜息態磁振造影以及光學式指脈搏測量。第一個月（T1與T1之間）不介入SKY，年長者保持日常生活習慣；第二個月（T2與T3之間）介入SKY。結果顯示，規律練習SKY一個月後，年長者睡眠品質明顯改善，主要是由於睡眠延遲時間減少、睡眠總時間增長及睡眠效率提昇。介入SKY並未顯著改變心率變異之平均參數，但是相關分析發現個別受試長者之睡眠品質提升與心率變異時域參數之SDNN和RMSSD下降相關，睡眠總時間上升則與pNN20下降相關。靜息態磁振造影針對中樞自律神經網路之交感及副交感相關腦區進行分析，發現年長者規律練習SKY一個月後，左腦腹內側前額葉皮質活性下降與睡眠品質提升相關；左腦後側腦島活性提升則與睡眠總時間以及睡眠效率提升相關。心率變異方面，發現左小腦小葉I與左腦楔前葉活性上升及右腦上側顳葉迴活性下降，與SDNN下降相關；左腦楔前葉活性上升及左腦中央前迴活性下降，與RMSSD下降相關。在腦功能連結方面，左腦後側腦島與左腦顳葉緣上回之功能性連結上升，與睡眠總時間上升相關。左腦後側腦島與右腦海馬迴的功能性連結下降，與pNN20下降相關。本研究顯示，年長者規律練習SKY一樣可提昇睡眠品質及改善HRV失衡狀況，此與中樞自律神經網路的腦區活性變化及其功能性連結強度有關。

Elders with insomnia had imbalanced heart rate variability (HRV) and brain activity. Regular practicing of Sudarshan Kriya Yoga (SKY) improves sleep quality and HRV in middle-aged people. The central autonomic network (CAN) is related to sleep, breathing control and autonomic functions. Whether practicing of SKY also improves sleep quality and HRV in elders and modulates brain activities in CAN is unknown. Twenty elders with poor sleep quality were recruited, first month without SKY and second month with SKY intervention. Sleep quality was evaluated by Pittsburgh sleep quality index questionnaire. Finger pulses were monitored by photoplethysmography and for HRV analysis. Resting state-magnetic resonance imaging (rs-fMRI) was used to analyze regional activity (ReHo) and functional connectivity (FC) in CAN. Results showed that SKY intervention improved sleep duration, efficiency and latency. Improvement of sleep quality was associated with decreased RMSSD, SDNN and pNN20 in these elders. Results of rs-fMRI analyses showed that improved sleep quality is correlated with decreased ReHo of left vmPFC and increased ReHo of left posterior insula. Changes of ReHo in left precuneus and four other brain areas in CAN were correlated with changes of SDNN, RMSSD and pNN20. Left posterior insula is the brain area correlated with changes of sleep duration time and pNN20. Further FC analyses revealed that increased FC of left posterior insula with other CAN regions modulate sleep duration time and pNN20. Our results suggest that regular practicing of SKY in elders can modulate brain regions in CAN to improve their sleep quality and HRV.

許庭維 (2019) 淨化呼吸瑜伽再加練習增加迷走神經調節之心律變異與靜息態杏仁核功能性連結, 成大生理所碩士論文
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