身體活動量對更年期潛在高血壓婦女合併睡眠問題的心血管功能及睡眠品質之影響

Abstract

更年期婦女由於女性荷爾蒙分泌的改變，導致罹患心血管疾病的風險提升；已知運動可改善心血管及睡眠功能等，但過去研究鮮少探討運動訓練過程中更年期婦女之生理變化，且長期的資料收集有一定的困難性。目的：以資料雲端化的方式記錄長時間的生理數值變化，了解身體活動的介入對更年期潛在高血壓婦女在心血管功能及睡眠品質的影響。方法：招募23位更年期潛在高血壓婦女 (收縮壓 > 120 mmHg or 舒張壓 > 80 mmHg)，年齡為56-71歲，分為實驗組及控制組。實驗組進行四週有氧運動，每週至少健走三次，每次至少三十分鐘。每天早、晚需量測血壓，每週進行一次24小時自律神經檢測。控制組則不額外做身體活動的介入。統計分析以成對樣本T檢定分析及95%信賴區間做差異比較，顯著水準定為p<.05。結果：實驗組之早上收縮壓與舒張壓皆於身體活動介入後第二週顯著下降，收縮壓下降9.85.3 mmHg、舒張壓下降8.41.3 mmHg；晚上收縮壓與舒張壓則在第三週顯著下降，收縮壓下降9.86.3 mmHg、舒張壓7.30.3 mmHg及心率沒有明顯改變。早上副交感神經活性及晚上交感神經活性於第三週顯著下降；早上交感神經活性及晚上副交感神經活性於第三週顯著上升。睡眠品質PSQI兩組前測與後測結果並無顯著差異，而ESS嗜睡量表則是運動組於第一週後就有顯著下降。結論：四週提升身體活動的介入可以改善更年期潛在高血壓婦女的血壓；心律變異性早晚之差異變大，表示身體狀況變好，越能夠有效適應外在環境的變化。 關鍵詞：自律神經功能、雲端記錄、身體活動、更年期婦女、血壓、睡眠Purpose: To investigate the effects of physical activity on cardiovascular functions and sleep quality in menopausal women with prehypertension. Also, to understand the changes of physiological parameters during the exercise training process. Methods: Menopausal women (n=23) with prehypertension (systolic blood pressure, SBP > 120 mmHg or diastolic blood pressure, DBP > 80 mmHg) ranging from 56 to 71 yrs were recruited. Participants were be divided into two groups: Control and Experimental (EXP), the EXP group were be asked to follow 3 weeks physical activity (3 times/week, 30 minutes/times). The physiological signals (blood pressure: twice daily, autonomic nervous activity: once per week for 24hrs) were recorded. Paired-sample T test were used to compare the differences ( p<.05). Results: The morning decreased (SBP: 9.85.3 mmHg；DBP: 8.41.3 mmHg, p <.05) and evening (SBP: 9.86.3 mmHg；DBP: 7.30.3 mmHg, p <.05) blood pressure of participants decreased after two and three weeks of physical activity, respectively. The autonomic functions improved at the third week. PSQI sleep quality have no significant in two groups. ESS sleepiness score decreased in EXP group after one week of physical activity. Conclusions: A 4 weeks aerobic exercise can improve cardiovascular functions in menopausal women with prehypertension. The obvious difference between day time and night time heart rate variability reflect physical condition change better and can respond effectively to external changes. Key words: autonomic functions, cloud computing system, physical activity, menopausal women, blood pressure