進階搜尋


   電子論文尚未授權公開,紙本請查館藏目錄
(※如查詢不到或館藏狀況顯示「閉架不公開」,表示該本論文不在書庫,無法取用。)
系統識別號 U0026-1608201104552100
論文名稱(中文) Mu節律訓練對失眠者睡眠影響之探討
論文名稱(英文) Effects of mu rhythm training on sleep in insomnia
校院名稱 成功大學
系所名稱(中) 認知科學研究所
系所名稱(英) Institute of Cognitive Science
學年度 99
學期 2
出版年 100
研究生(中文) 葉新新
研究生(英文) Hsin-Hsin Yeh
學號 u76981036
學位類別 碩士
語文別 中文
論文頁數 80頁
口試委員 指導教授-蕭富仁
口試委員-梁勝富
口試委員-廖敏如
中文關鍵字 慢性失眠  神經回饋  Mu節律  過度激發 
英文關鍵字 Chronic Insomnia  Neurofeedback  Mu rhythm  Hyperarousal 
學科別分類
中文摘要 失眠是一種睡眠障礙,早期研究多半著重生理和認知的覺醒的部分,近年來研究則發現皮質過度激發會影響入睡延滯時間與睡眠的維持。因此,從中樞神經系統角度切入的失眠改善方式是值得探討的。
12個失眠受試者隨機分派至隨機回饋(控制組,7人)與mu節律回饋(實驗組,7人)神經回饋訓練。在神經回饋訓練前後均接受多頻道睡眠、失眠嚴重度量表、匹茲堡睡眠量表、睡前激發程度量表、貝克憂慮量表、貝克焦慮量表、簡易智力測驗、字彙配對測驗、反向數字廣度測驗、2-back測驗檢查。並且在一個月的神經回饋訓練期間配戴活動紀錄手錶以了解訓練期間睡眠的變化。
經過一個月的神經回饋訓練後,所有失眠受試者皆在主觀上睡眠品質皆有改善,但只有接受mu節律回饋訓練的受試者在客觀的睡眠檢查中有縮短入睡延滯時間和入睡後醒來時間以及增加睡眠效率的情形。此外,也只有mu節律回饋組在睡前激發程度量表生理部份有降低的現象。
綜合以上結果顯示,mu節律回饋訓練不僅可以提昇失眠者主觀上的睡眠品質,還可以有效的改善客觀上的睡眠。
未來研究可以朝將mu節律回饋訓練系統發展為可攜式設備,提供失眠者在家中自行練習以改善睡眠效率。
英文摘要 Insomnia is a sleeping disorder, usually studied from a behavioural perspective, with a focus on somatic and cognitive arousal. Recent studies have suggested cortical hyperarousal might interfere with normal sleep onset and sleep maintenance. As such, a treatment modality focusing on CNS arousal might be of interest.
Twelve insomniacs were randomly assigned to either a random-neurofeedback (control group, n = 7) or a mu rhythm-neurofeedback (experiment group, n = 7) protocol. A polysomnography, ISI, PSQI, PSAS, BDI, BAI, MMSE, word-pair test, backward digit span test and 2-back task were performed pre and post neurofeedback training. And actiwatch was recorded during training period to study sleep changes with neurofeedback training.
After 1 month neurofeedback training, all subjects are improve subjective sleep quality, however only mu rhythm-neurofeedback protocol shortened sleep onset latency, wake after sleep onset and enhanced sleep efficiency in polysomnography measurement. Furthermore, PSAS-Somatic scores decreased only in the mu rhythm-neurofeedback group.
The mixed results showed that mu rhythm-neurofeedback not only improve subjective report of sleep quality, but also effectively in improve objectively measured sleep.
The future study can be work on made portable equipment for insomnia can improve sleep efficiency through practice mu rhythm-neurofeedback by oneself at home.
論文目次 緒論 1
失眠的定義 2
慢性失眠的表徵與影響 2
失眠的病因理論 3
生理過度激發與失眠 4
失眠的治療方式 5
神經回饋訓練的歷史與發展 8
神經回饋訓練頻率 9
研究問題與假設 10
方法 10
受試者 10
研究工具與測量 13
基本資料表 14
睡前激發程度量表 14
匹茲堡睡眠品質量表 14
失眠嚴重度量表 16
簡易智力測驗 17
字彙配對測驗 17
反向數字廣度測驗 18
2-back測驗 18
貝克憂鬱量表第二版 19
貝克焦慮量表 19
神經回饋訓練系統 20
多功能睡眠檢查儀 21
活動記錄手錶 21
實驗程序 21
分析方法 23
腦波訊號 23
睡眠分析 23
心率變異率分析 24
問卷量表分析 26
認知作業分析 26
結果 26
腦波訊號分析結果 26
主觀睡眠參數分析結果 27
問卷量表分析結果 27
客觀睡眠參數分析結果 28
心率變異分析結果 29
認知作業分析結果 30
討論 31
神經回饋訓練介入之影響 31
結論 32
研究限制與未來走向 32
參考文獻 33
參考文獻 Adrian, E. D., & Matthews, B. H. (1934). The interpretation of potential waves in the cortex. J Physiol, 81(4), 440-471.
Andersen, P., & Andersson, S. A. (1968). Physiological basis of the alpha rhythm. New York: Appleton-Century-Crofts.
Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53(3), 737-740.
Barry, R. J., Clarke, A. R., Johnstone, S. J., Magee, C. A., & Rushby, J. A. (2007). EEG differences between eyes-closed and eyes-open resting conditions. Clinical Neurophysiology, 118(12), 2765-2773.
Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297-307.
Beck, A. T., & Steer, R. A. (1993). Beck anxiety inventory manual. San Antonio, TX: Psychological Corporation.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
Berner, I., Schabus, M., Wienerroither, T., & Klimesch, T. (2006). The significance of sigma neurofeedback training on sleep spindles and aspects of declarative memory. Applied Psychophysiology & Biofeedback, 31(2), 97-114.
Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine Reviews, 1(2), 97-108.
Bonnet, M. H., & Arand, D. L. (1998). Heart rate variability in insomniacs and matched normal sleepers. Psychosomatic Medicine, 60, 610-615.
Bootzin, R. R. (1972). Stimulus control treatment for insomnia. Proceedings of the American Psychologacal Association, 7, 395-396.
Boudrot, R. (1972). An alpha detection and feedback control system. Psychophysiology, 9(4), 461-466.
Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996). Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biological Psychiatry, 39(6), 411-418.
Cheng, Y., Lee, P. L., Yang, C. Y., Lin, C. P., Hung, D., & Decety, J. (2008). Gender differences in the mu rhythm of the human mirror-neuron system. PLoS One, 3(5), e2113.
Choi, J. B., Hong, S., Nelesen, R., Bardwell, W. A., Natarajan, L., Schubert, C., & Dimsdale, J. E. (2006). Age and ethnicity differences in short-term heart-rate variability. Psychosomatic Medicine, 68(3), 421-426.
Cortoos, A., Valck, E. D., Arns, M., Breteler, M. H. M., & Cluydts, R. (2010). An exploratory study on the effects of tele-neurofeedback and tele-biofeedback on objective and subjective sleep in patients with primary insomnia. Applied Psychophysiology & Biofeedback, 35(2), 125-134.
Cortoos, A., Verstraeten, E., & Cluydts, R. (2006). Neurophysiological aspects of primary insomnia: Implications for its treatment. Sleep Medicine Reviews, 10, 255-266.
Daly, J. J., & Wolpaw, J. R. (2008). Brain-computer interfaces in neurological rehabilitation. The Lancet Neurology, 7(11), 1032-1043.
Dias, A. M., & van Deusen, A. (2011). A new neurofeedback protocol for depression. Span J Psychol, 14(1), 374-384.
Drake, C. L., Roehrs, T., & Roth, T. (2003). Insomnia causes, consequences, and therapeutics: An overview. Depression & anxiety, 18, 163-176.
Egner, T., & Gruzelier, J. H. (2001). Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans. NeuroReport, 12(18), 4155-4159.
Egner, T., Zech, T. F., & Gruzelier, J. H. (2004). The effects of neurofeedback training on the spectral topography of the electroencephalogram. Clinical Neurophysiology, 115(11), 2452-2460.
Gammack, J. K. (2008). Light therapy for insomnia in older adults. Clinics in Geriatric Medicine, 24(1), 139-149, viii.
Grunwald, M., Weiss, T., Krause, W., Beyer, L., Rost, R., Gutberlet, I., & Gertz, H. J. (2001). Theta power in the EEG of humans during ongoing processing in a haptic object recognition task. Brain Research Reviews, 11(1), 33-37.
Gruzelier, J. (2009). A theory of alpha/theta neurofeedback, creative performance enhancement, long distance functional connectivity and psychological integration. Cognitive Processing, 10 Suppl 1, S101-109.
Hagewoud, R., Havekes, R., Novati, A., Keijser, J. N., Van Der Zee, E. A., & Meerlo, P. (2009). Sleep deprivation impairs spatial working memory and reduces hippocampal AMPA receptor phosphorylation. Journal of sleep research, 19(2), 280-288.
Hammond, D. C. (2005). Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America, 14(1), 105-123.
Hari, R. (2006). Action-perception connection and the cortical mu rhythm. Progress in Brain Research, 159, 253-260.
Harvey, A. G., & Tang, N. K. J. (2003). Cognitive behaviour therapy for insomnia: Can we rest yet? Sleep Medicine Reviews, 7, 237-262.
Hauri, P. J. (1981). Treating psychophysiologic insomnia with biofeedback. Archives of General Psychiatry, 38, 752-758.
Hauri, P. J., Percy, L., Hellekson, C., Hartmann, E., & Russ, D. (1982). The treatment of psychophysiologic insomnia with biofeedback: a replication study. Biofeedback & Self Regulation, 7(2), 223-235.
Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. (1996). European Heart Journal, 17(3), 354-381.
Hoedlmoser, K., Pecherstorfer, T., Gruber, G., Anderer, P., Doppelmayr, M., Klimesch, W., & Schabus, M. (2008). Instrumental conditioning of human sensorimotor rhythm (12-15 Hz) and its impact on sleep as well as declarative learning. Sleep, 31(10), 1401-1408.
Jacobs, G. D., Benson, H., & Friedman, R. (1993). Home-based central nervous system assessment of a multifactor behavioral intervention for chronic sleep-onset insomnia. Behavior Therapy, 24(1), 159-174.
Jaeggi, S. M., Buschkuehl, M., Perrig, W. J., & Meier, B. (2010). The concurrent validity of the N-back task as a working memory measure. Memory, 18(4), 394-412.
Jensen, A. R., & Figueroa, R. A. (1975). Forward and backward digit span interaction with race and IQ: Predictions from Jensen’s theory. Journal of Educational Psychology, 67(6), 882-893.
Jensen, O., Gelfand, J., Kounios, J., & Lisman, J. E. (2002). Oscillations in the alpha band (9-12 Hz) increase with memory load during retention in a short-term memory task. Cerebral Cortex, 12(8), 877-882.
Karavidas, M. K., Lehrer, P. M., Vaschillo, E., Vaschillo, B., Marin, H., Buyske, S., . . . Hassett, A. (2007). Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Applied Psychophysiology & Biofeedback, 32(1), 19-30.
Kayiran, S., Dursun, E., Dursun, N., Ermutlu, N., & Karamursel, S. (2010). Neurofeedback intervention in fibromyalgia syndrome; a randomized, controlled, rater blind clinical trial. Applied Psychophysiology & Biofeedback, 35(4), 293-302.
Klimesch, W. (1999). EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Research Reviews, 29(2-3), 169-195.
Li, J., & Zhang, L. (2010). Bilateral adaptation and neurofeedback for brain computer interface system. Journal of Neuroscience Methods, 193(2), 373-379.
Lichstein, K. L., Stone, K. C., Donaldson, J., Nau, S. D., Soeffing, J. P., Murray, D., . . . Aguillard, R. N. (2006). Actigraphy validation with insomnia. Sleep, 29(2), 232-239.
Martinez-Gonzalez, D., Obermeyer, W. H., & Benca, R. M. (2002). Comorbidity of insomnia with medical and psychiatric disorders. Primary Psychiatry, 9, 37-49.
Mimeault, V., & Morin, C. M. (1999). Self-help treatment for insomnia: Bibliotherapy with and without professional guidance. Journal of Consulting & Clinical Psychology, 67, 511-519.
Morin, C. M. (1996). Insomnia: Psychological assessment and management. New York: The Guilford Press.
Morin, C. M., & Azrin, N. H. (1987). Stimulus control and imagery training in treating sleep-maintenance insomnia. Journal of Consulting & Clinical Psychology, 55, 260-262.
Morin, C. M., Culbert, J. P., & Schwartz, S. M. (1994). Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry 151, 1172-1180.
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999). Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep, 22, 1134-1156.
Mulholland, T., & Evans, C. R. (1966). Oculomotor function and the alpha activation cycle. Nature, 211(5055), 1278-1279.
Murtagh, D. R., & Greenwood, K. M. (1995). Identifying effective psychological treatments for insomnia: a meta-analysis. Journal of Consulting and Clinical Psychology, 63(1), 79-89.
Natale, V., Plazzi, G., & Martoni, M. (2009). Actigraphy in the assessment of insomnia: a quantitative approach. Sleep, 32(6), 767-771.
Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale. Behaviour Research & Therapy, 23, 263-271.
NIH State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults statement. (2005). J Clin Sleep Med, 1(4), 412-421.
Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004). Functional neuroimaging evidence for hyperarousal in insomnia. American Journal of Psychiatry, 161(11), 2126-2128.
Oberman, L. M., Ramachandran, V. S., & Pineda, J. A. (2008). Modulation of mu suppression in children with autism spectrum disorders in response to familiar or unfamiliar stimuli: the mirror neuron hypothesis. Neuropsychologia, 46(5), 1558-1565.
Palva, S., & Palva, J. M. (2007). New vistas for alpha-frequency band oscillations. Trends in Neurosciences, 30(4), 150-158.
Perlis, M. L., Giles, D. E., Mendelson, W. B., Bootzin, R. R., & Wyatt, J. K. (1997). Psychophysiological insomnia: The behavioural model and a neurocognitive perspective. Sleep Medicine Reviews, 6, 179-188.
Perlis, M. L., Smith, M. T., Andrews, P. J., Orff, H., & Giles, D. E. (2001). Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Sleep, 24(1), 110-117.
Pfeiffer, A. E., & Usselman, L. B. (1970). A versatile amplitude analyzer for EEG signals to provide feedback stimuli to the subject. Medical and Biological Engineering, 8(2), 209-211.
Pfurtscheller, G. (2003). Induced oscillations in the alpha band: functional meaning. Epilepsia, 44 Suppl 12, 2-8.
Pfurtscheller, G., Stancak, A., Jr., & Neuper, C. (1996). Event-related synchronization (ERS) in the alpha band--an electrophysiological correlate of cortical idling: a review. International Journal of Psychophysiology, 24(1-2), 39-46.
Pignotti, M., & Steinberg, M. (2001). Heart rate variability as an outcome measure for Thought Field Therapy in clinical practice Journal of Clinical Psychology, 57(10), 1193-1206.
Pineda, J. A. (2005). The functional significance of mu rhythms: translating "seeing" and "hearing" into "doing". Brain Research Reviews, 50(1), 57-68.
Pineda, J. A., & Hecht, E. (2009). Mirroring and mu rhythm involvement in social cognition: are there dissociable subcomponents of theory of mind? Biological Psychology, 80(3), 306-314.
Rasch, B., Buchel, C., Gais, S., & Born, J. (2007). Odor cues during slow-wave sleep prompt declarative memory consolidation. Science, 315, 1426-1429.
Ray, W. J., & Cole, H. W. (1985). EEG alpha activity reflects attentional demands, and beta activity reflects emotional and cognitive processes. Science, 228(4700), 750-752.
Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M., & Nissen, C. (2010). The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews, 14, 19-31.
Ritter, P., Moosmann, M., & Villringer, A. (2009). Rolandic alpha and beta EEG rhythms' strengths are inversely related to fMRI-BOLD signal in primary somatosensory and motor cortex. Human Brain Mapping, 30(4), 1168-1187.
Roth, T. (2007). Insomnia: definition, prevalence, etiology, and consequences. Journal of Clinic Sleep Medicine, 3(5 Suppl), S7-10.
Sauseng, P., Klimesch, W., Doppelmayr, M., Pecherstorfer, T., Freunberger, R., & Hanslmayr, S. (2005). EEG alpha synchronization and functional coupling during top-down processing in a working memory task. Human Brain Mapping, 26(2), 148-155.
Saxby, E., & Peniston, E. G. (1995). Alpha-theta brainwave neurofeedback training: an effective treatment for male and female alcoholics with depressive symptoms. Journal of Clinical Psychology, 51(5), 685-693.
Schurmann, M., & Basar, E. (2001). Functional aspects of alpha oscillations in the EEG. International Journal of Psychophysiology, 39(2-3), 151-158.
Shaw, F. Z. (2007). 7-12 Hz high-voltage rhythmic spike discharges in rats evaluated by antiepileptic drugs and flicker stimulation. Journal of Neurophysiology, 97(1), 238-247.
Shekleton, J. A., Rogers, N. L., & Rajaratnam, S. M. (2010). Searching for the daytime impairments of primary insomnia. Sleep Medicine Reviews, 14(1), 47-60.
Skinner, B. F. (1938). The behavior of organisms: an experimental analysis. Oxford, England: Appleton-Century.
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. The American Journal of Psychiatry, 159(1), 5-11.
Spielman, A. J. (1986). Assessment of insomnia. Clinical Psychology Review, 6(1), 11-25.
Sterman, M. B., & Egner, T. (2006). Foundation and practice of neurofeedback for the treatment of epilepsy. Applied Psychophysiology & Biofeedback, 31(1), 21-35.
Sterman, M. B., & Friar, L. (1972). Suppression of seizures in an epileptic following sensorimotor EEG feedback training. Electroencephalography & Clinical Neurophysiology, 33(1), 88-95.
Sterman, M. B., Howe, R. D., & Macdonald, L. R. (1970). Facilitation of spindle-burst sleep by conditioning of electroencephalographic activity while awake. Science, 167, 1146-1148.
Stickgold, R. (2005). Sleep-dependent memory consolidation. Nature, 437, 1272-1278.
Tan, G., Thornby, J., Hammond, D. C., Strehl, U., Canady, B., Arnemann, K., & Kaiser, D. A. (2009). Meta-analysis of EEG biofeedback in treating epilepsy. Clinical EEG & Neuroscience, 40(3), 173-179.
Thase, M. E. (2006). Depression and sleep: pathophysiology and treatment. Dialogues in Clinical Neuroscience, 8(2), 217-226.
Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., & Fang, S. C. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14(8), 1943-1952.
Tsuji, H., Larson, M. G., Venditti, F. J., Jr., Manders, E. S., Evans, J. C., Feldman, C. L., & Levy, D. (1996). Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation, 94(11), 2850-2855.
Vernon, D., Egner, T., Cooper, N., Compton, T., Neilands, C., Sheri, A., & Gruzelier, J. (2003). The effect of training distinct neurofeedback protocols on aspects of cognitive performance. The International Journal of Psychophysiology, 47(1), 75-85.
Wangler, S., Gevensleben, H., Albrecht, B., Studer, P., Rothenberger, A., Moll, G. H., & Heinrich, H. (2010). Neurofeedback in children with ADHD: Specific event-related potential findings of a randomized controlled trial. Clinical Neurophysiology.
Wyatt, J. K., Bootzin, R. R., Allen, J. J., & Anthony, J. L. (1997). Mesograde amnesia during the sleep onset transition: replication and electrophysiological correlates. Sleep, 20(7), 512-522.
Yang, C. M., Spielman, A. J., & Glovinsky, P. (2006). Nonpharmacologic strategies in the management of insomnia. Psychiatric Clinics of North America, 29(4), 895-919.
Zambotti, M. D., Covassin, N., Tona, G. D. M., Sarlo, M., & Stegagno, L. (2010). Sleep onset and cardiovascular activity in primary insomnia. Journal of Sleep Research.
Zammit, G. K. (2007). The prevalence, morbidities, and treatments of insomnia. CNS & Neurological Disorders Drug Targets, 6(1), 3-16.
Zammit, G. K., Weiner, J., Damato, N., Sillup, G. P., & McMillan, C. A. (1999). Quality life in people with insomnia. Sleep, 22, s379-s385.
Zoefel, B., Huster, R. J., & Herrmann, C. S. (2011). Neurofeedback training of the upper alpha frequency band in EEG improves cognitive performance. Neuroimage, 54(2), 1427-1431.
李宇宙. (2005). 失眠症的臨床評估與處置. 臺灣醫學, 93, 346-353.
林惠珠. (2009). 淺談失眠問題之心理暨社會處遇. 醫療品質雜誌, 3(4), 36-38.
林詩淳, 楊建銘, & 許世杰. (2006). 失眠嚴重度量表、睡前激發程度量表及睡眠失功能信念及態度量表中譯版之信效度研究. Paper presented at the 臺灣睡眠醫學學會九十五年度會員大會, 臺北榮民總醫院.
邱南英. (2009). 失眠的原因和安眠藥的用藥安全. 醫療品質雜誌, 3(4), 24-32.
陳昌偉, & 楊建銘. (2006). 失眠病因理論與認知行為治療療效因子:理論與實務的對應. 臨床心理學刊, 3(1), 1-12.
楊建銘. (2000). 失眠的行為及心理治療. 臺灣醫學, 4(6), 694-703.
臺灣睡眠醫學會. (2009). 國人睡眠趨勢大調查.
劉昀玲. (2009). 慢性失眠患者之生理回饋治療的療效研究. 碩士, 中原大學, 桃園.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2016-08-24起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw