身心锻炼对睡眠质量影响的系统综述

doi:10.3969/j.issn.1006-9771.2023.02.009

摘要/Abstract

摘要：

目的系统综述身心锻炼对睡眠质量的影响，梳理身心锻炼干预方案的影响因素。方法采用主题词检索方法，在PubMed、Web of Science、Science Direct、Cochrane Library、中国知网、维普和万方数据库，检索身心锻炼影响睡眠的相关文献，检索时间为建库至2022年6月1日。经筛后从文献中提取作者、国家、发表时间、研究对象、研究方法、干预过程、测量工具和结局指标，并采用物理治疗证据数据库(PEDro)量表进行方法学质量评价。结果最终纳入英文文献14篇，均为随机对照试验，整体研究质量较好。身心锻炼方式包括太极拳、气功和八段锦，研究被试多为老年人、患病人群。身心锻炼干预时长10~12周、单次时间为60 min且每周至少2~3次的方案可最大程度改善睡眠质量，被试健康状态是影响干预效果的重要因素。结论身心锻炼改善睡眠质量，且可以缓解焦虑、减轻抑郁、促进心理健康水平提高。

关键词: 身心锻炼, 睡眠质量, 神经机制, 情绪调节, 系统综述

Abstract:

Objective To systematically review the effects of mind-body exercise on sleep quality, and to sort out the influencing factors of mind-body exercise intervention program. Methods Literatures about the effects of mind-body exercise on sleep were searched in PubMed, Web of Science, Science Direct, Cochrane Library, CNKI, VIP and Wanfang data from establishment to June 1, 2022. The author, country, publication time, study object, study method, intervention process, measurement tool and outcome index were extracted from the selected literature. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality. Results A total of 14 English literatures were included, all of which were randomized controlled trails, and the overall research quality was good. Mind-body exercise methods included Taijiquan, Qigong and Baduanjin. Most of the subjects were old and sick people. Physical exercise intervention with a duration of ten to twelve weeks, a single time of 60 minutes and at least two to three times a week could improve sleep quality to the greatest extent. The health status of the participants was an important factor affecting the effect of the intervention. Conclusion Mind-body exercise can improve sleep quality, relieve anxiety and depression, and promote mental health.

Key words: mind-body exercise, sleep quality, neural mechanism, emotion regulation, systematic review

中图分类号:

R749.7

王骏昇, 孟皎, 郭子肈, 蒋长好. 身心锻炼对睡眠质量影响的系统综述[J]. 《中国康复理论与实践》, 2023, 29(2): 205-213.

WANG Junsheng, MENG Jiao, GUO Zizhao, JIANG Changhao. Effects of mind-body exercise on sleep quality: a systematic review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 205-213.

图/表 4

图1

表1

纳入文献基本特征"

纳入文献	国家	年龄/岁	研究对象	n	研究设计	干预方式	干预频率	干预效果	测量工具
Xie等^[33](2022)	中国	20~50	慢性疲劳综合征患者	45(干预组)；44(对照组)	RCT	九转延寿气功vs.CBT	每次30 min；每周7次，共12周	改善睡眠质量与焦虑水平	PSQI；HADS
Zhan等^[34](2022)	中国	18~60	一线医护人员	21(干预组)；22(对照组)	RCT	太极拳训练vs.放松训练	每次30 min，每周7次，共2周	改善睡眠质量，减少焦虑情绪	PSQI；BAI
Cheng等^[35](2021)	中国	60~70	老年女性	19(干预组)；20(对照组)	RCT	太极拳vs.无干预	每次60 min，每周3次，共28周	改善睡眠质量，减少焦虑、抑郁情绪	PSQI；POMs
Siu等^[36](2021)	中国	≥ 60	老年失眠症患者	110(太极拳干预组)；105(一般运动组)；105(对照组)	RCT	太极拳vs.常规运动训练	每次60 min，每周3次，共12周	改善睡眠质量	睡眠活动记录仪；PSQI
Cetin等^[37](2020)	土耳其	52.64±9.45	糖尿病患者	17(太极拳组)；17(家庭运动组)	RCT	太极拳vs.一般运动	每次60 min，每周1次，共10周	改善睡眠质量、平衡能力，减少焦虑、抑郁情绪	BBS；PSQI
Yilmaz Gokmen等^[38](2019)	土耳其	30~65	OSA患者	25(干预组)；25(对照组)	RCT	太极拳训练vs.家庭训练计划	每次60 min，每周3次，共12周	改善睡眠质量	PSG；ESS；PSQI；肺功能测试
Zhu等^[39](2018)	中国	33.74±7.11(干预组)；37.76±9.85(对照组)	药物依赖女性	42(干预组)；38(对照组)	RCT	太极拳vs.日常护理	每次60 min，每周3次，共24个月	睡眠时间延长，睡眠质量改善	PSQI；SDS；健康评估
McQuade等^[40](2017)	美国	≥ 18	前列腺癌放疗患者	26(气功干预组)；26(轻度运动组)；24(等待列表对照组)	RCT	为癌症患者开发的简式太极拳vs.轻阻力训练和拉神运动	放疗期间每次40 min，每周3次	短期内增长睡眠时间	PSQI；BFI
Lü等^[41](2017)	中国	60~70	老年膝骨关节炎女性	23(干预组)；23(对照组)	RCT	太极拳vs.健康教育	每次60 min，每周3次，共24周	改善睡眠质量与心理健康水平	PSQI；SF-36；BBS
Chan等^[42](2016)	中国	≥ 60	认知障碍老年人	27(干预组)；25(对照组)	RCT	太极拳vs.健康教育	每次60 min，每周3次，共8周	改善睡眠质量	PSQI；SF-12；
Caldwell等^[43](2016)	美国	18~40	年轻人	28(太极拳干预组)；28(太极拳干预联合视频组)；19(对照组)	RCT	太极拳训练vs.焦虑管理教育	每次60 min，每周2次，共10周	降低焦虑水平，改善睡眠质量	PSQI；STAI
Irwin等^[44](2014)	美国	≥ 55	老年人	50(太极拳组)；48(CBT组)；25(健康教育)	RCT	太极拳vs. CBT vs. 健康教育	每周120 min，共16周	改善睡眠质量	PSG；PSQI
Chen等^[45](2012)	中国	≥ 60	老年人	28(干预组)；28(对照组)	RCT	八段锦训练vs.无干预	每次30 min，每周3次，共12周	改善睡眠质量	PSQI
Irwin等^[46](2008)	美国	59~86	老年人	59(干预组)；53(对照组)	RCT	太极拳vs.健康教育	每次40 min，每周3次，共25周	改善睡眠质量	PSQI

表1

表2

表3

参考文献 63

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纳入研究	资格标准	随机分配	分配隐藏	基线相似	治疗师施盲	评估者施盲	被试流失率≤ 15%	意向性分析	组间统计比较	点估计和变异性测量	总分
Xie等^[33](2022)	√	√	√	√			√	√	√	√	7
Zhan等^[34](2022)	√	√	√	√			√	√	√	√	7
Cheng等^[35](2021)	√	√	√	√				√	√	√	6
Siu等^[36](2021)	√	√	√	√			√	√	√	√	7
Cetin等^[37](2020)	√	√		√				√	√	√	5
Yilmaz Gokmen等^[38](2019)	√	√		√		√	√		√	√	6
Zhu等^[39](2018)	√	√	√		√			√	√	√	6
McQuade等^[40](2017)	√	√	√	√		√			√	√	6
Lü等^[41](2017)	√	√	√	√			√	√	√	√	7
Chan等^[42](2016)	√	√	√	√	√			√	√	√	7
Caldwell等^[43](2016)	√	√	√	√		√			√	√	6
Irwin等^[44](2014)	√	√	√	√	√		√	√	√	√	8
Chen等^[45](2012)	√	√	√	√			√	√	√	√	7
Irwin等^[46](2008)	√	√		√	√		√	√	√	√	7

纳入研究	睡眠质量	睡眠时间	入睡时间	睡眠效率	睡眠障碍	催眠药物	日间功能障碍	总分
Xie等^[33](2022)	< 0.05	< 0.05	< 0.05	> 0.05	< 0.05	> 0.05	< 0.05	< 0.05
Zhan等^[34](2022)	-	-	-	-	-	-	-	< 0.05
Cheng等^[35](2021)	-	-	-	-	-	-	-	< 0.05
Siu等^[36](2021)	-	-	-	-	-	-	-	< 0.05
Cetin等^[37](2020)	-	-	-	-	-	-	-	< 0.05
Yilmaz Gokmen等^[38](2019)	< 0.05	> 0.05	> 0.05	< 0.05	> 0.05	> 0.05	< 0.05	< 0.05
Zhu等^[39](2018)	> 0.05	< 0.05	> 0.05	> 0.05	> 0.05	< 0.05	< 0.05	> 0.05
McQuade等^[40](2017)	-	-	-	-	-	-	-	> 0.05
Lü等^[41](2017)	> 0.05	< 0.05	< 0.05	> 0.05	> 0.05	> 0.05	< 0.05	< 0.05
Chan等^[42](2016)	> 0.05	< 0.05	> 0.05	< 0.05	> 0.05	> 0.05	-	< 0.05
Caldwell等^[43](2016)	< 0.05	< 0.05	< 0.05	> 0.05	< 0.05	> 0.05	< 0.05	< 0.05
Irwin等^[44](2014)	-	-	-	-	-	-	-	< 0.05
Chen等^[45](2012)	< 0.05	< 0.05	< 0.05	< 0.05	< 0.05	< 0.05	< 0.05	< 0.05
Irwin等^[46](2008)	< 0.05	> 0.05	< 0.05	< 0.05	< 0.05	> 0.05	> 0.05	< 0.05