背景:
睡眠困擾是老年人很普遍的健康問題，長期睡眠品質差可能導致罹患心血管疾病率與死亡率增加。改善睡眠困擾之非藥物治療措施中，身體活動是無需專業人員即可以自行執行的方法，實證研究指出中等強度身體活動與有氧運動可以改善睡眠困擾，但是一般老人很難達到足量的中等強度身體活動。走路是台灣社區老人最普遍的身體活動，有少數研究提到可以改善社區老人睡眠困擾，但是走多久與如何走才能改善睡眠困擾？目前尚無定論。
目的:
本研究目的為探討社區老人走路活動(包含頻率、強度與時間)與睡眠困擾之間的關係。
方法:
本研究為方便取樣之橫斷面相關研究，以研究者長期投入之台南市社區，65歲(含)以上長者，至少已經3個月以上未從事中度身體活動或運動，但平時有走路習慣的長者為研究對象，排除精神疾病、憂鬱症病史與認知障礙，以及三個月內有重大生活事件者。同意加入研究之長輩，共計218人。以一對一問卷訪談收集資料，包含：人口學資料與基本健康情形，老年社會支持量表中文版了解其社會支持情形，走路活動調查表紀錄每周走路頻率、強度與時間等，簡短老年憂鬱量表(Short form of the Geriatric Depression Scale, SF-GDS)評估其憂鬱症狀以及匹茲堡睡眠品質量表(Pittsburgh Sleep Quality Index, PSQI)評估研究對象睡眠情形。
結果:
以多元羅吉斯迴歸分析睡眠困擾與走路活動之關係，研究結果顯示，有47.2%的社區老人睡眠品質差(PSQI> 5)。睡眠品質的重要預測變項為每天走路頻率與每週走路總時間。每周走路總時間低於210分的長者，睡眠差的機率比大於210分者高，勝算比為2.7；每天走路一次者，睡眠差的機率比每天走路超過一次者高，勝算比是2.2。
結論與臨床應用:
此結果可做為推廣社區老人走路活動之實證依據，鼓勵無法達到中等強度身體活動與運動的社區老人，每天多增加走路次數以及維持每周走路總時數超過210分鐘，以改善睡眠困擾。

Background:
Sleep disturbance is a common health problem for the elderly. Long-term poor sleep quality increases cardiovascular disease risk, which can lead to morbidity and mortality. Among non- pharmacological treatments to improve sleep disturbance, Physical activity is a method that can be performed without a professional. Empirical studies indicate that moderate-intensity physical activity and aerobic exercise can improve sleep disturbance, but it is difficult for the elderly to reach a sufficient amount of moderate-intensity physical activity. The most common physical activity among community-dwelling older people is walking, which carries real benefits to health. The effects, however, of specific features of walking activity upon sleep disturbance is still unclear.
Purpose:
This study explored the relationship between frequency, intensity, and time of walking activities, and sleep disturbance among community-dwelling elderly.
Methods:
Convenience sampling of cross-sectional correlation study was conducted in this research, with adults aged 65 years and older in a city in southern Taiwan as participants. The selected participants were those who have not been engaged in moderate-intensity physical activity or exercise for at least three months but have walking habit. He or she should not have had a history of mental illness, depression, or cognitive impairment, and or have any major life event in the past 3 months. A total of 218 people were recruited. Several questionnaires were distributed and collected, and they included information on demographics and health conditions, the Chinese version of the geriatric social support scale for understanding their social support, a walking activity questionnaire recorded their frequency, intensity, and time of walking activities per week , the short form of the Geriatric Depression Scale to assess the participants depressed symptoms, and the Pittsburgh Sleep Quality Index for collecting their sleeping data for further study.
Results:
Analyzing the relationship between sleep disturbance and walking activities was based on multivariate logistic regression, study showed that 47.2% of the community-dwelling elderly had sleep disturbance (Pittsburgh Sleep Quality Index score of > 5). The main keys for predictor variable in sleep disturbance were frequency and total time of walking activities pre week. For those who walked less than 210 minutes per week, the probability of getting sleep disturbance was higher than those who walked over 210 minutes per week, and the odds ratio was 2.7. Participants who walked once per day only, the probability of getting sleep disturbance was higher than those who walked more than once a day, and the odds ratio was 2.2.
Conclusions/Implications for Practice:
The findings of this study suggested that community-dwelling elderly can, without conducting other physical exercise, receive benefits of improving their sleep quality by conducting low-intensity walking activity longer than 210 minutes per week, and more than once a day. These findings can be applied for designing community walking programs that will improve the sleep disturbance for the community-dwelling elderly.

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