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A cross-sectional study of Hong Kong Chinese population investigating the association of insomnia and daily nutrient intake. / 香港中國人的失眠與日常營養攝取狀態的現況調查 / Xianggang Zhongguo ren de shi mian yu ri chang ying yang she qu zhuang tai de xian kuang diao chaJanuary 2013 (has links)
養分與睡眠的關聯是一個在睡眠科學上極具爭議性的課題。減低攝取蛋白質和碳水化合物會導致失眠,增加攝取總脂肪和油份會導致失眠。維生素和礦物質也被認為與失眠有關。此論文嘗試通過研究一般香港中國人的食習慣和失眠情況,進一步了解營養物質與失眠之間的關聯。此論文將會深入探討營養成分對失眠的影響。 / 背景和目標: 失眠是常見的睡眠障礙和公共衛生問題。失眠可分為三個亞型:難以啟動睡眠(DIM)、難以維持睡眠(DMS) 和過早覺醒類型(EMA)。然而,有關的研究多着重於外國人口。針對研究香港中國人口的失眠情況與營養成分關聯的資料相對比較少。此研究目的是找出在香港中國人口失眠與營養成分之間的關聯,有助研究失眠與營養成分之間的機制。據推測,失眠與營養成分之間於香港中國人口有關聯。香港中國人口失眠症患者的食特點跟其他地區人口會有所不同。失眠的三個亞型和營養成分之間的關聯會有所不同。 / 研究方法: 十三間學校被邀請進行了橫斷面研究。一百三十八位青少年(六十一男、七十七女) 以及一百七十三位成年人(八十四男、 八十九女)應邀參加這項研究。有關日常營養攝取量的資料,以自行申報的三天膳食記錄表取得。有關失眠症狀的評估,以自行申報的標準睡眠問卷(ISI)獲得。有關焦慮和抑鬱的評估,以自行申報的醫院焦慮抑鬱量表(HADS)取得。 / 研究結果與結論:分析顯示,失眠與減低攝取維生素A有關聯(成年人組別p = 0.02、青少年組別p = 0.01),與減低攝取維生素D有關聯(成年人組別p = 0.02、青少年組別p = 0.01)和與減低攝取維生素E有關聯(成年人組別p = 0.02、青少年組別p = 0.01)。失眠綜合症與難以啟動睡眠(DIM)、難以維持睡眠(DMS) 和過早覺醒類型(EMA) 與減低攝取飽和脂肪、碳水化合物、維生素A 、維生素D、和維生素E有關聯。此研究證實了香港中國人口的失眠與營養成分之間有關聯。證實了香港中國人口失眠症患者的食特點跟其他地區人口有不同。證實了失眠的三個亞型和營養成分之間的關聯有不同。我們於這項研究成功找到與失眠有關的營養成分,有助研發以天然營養物質來解決香港中國人的失眠問題。 / The association of nutrients and sleep is a debatable question in sleep science. Some literatures suggest that sleep is enhanced by certain nutrients, while some other literatures suggest that sleep is deprived by certain nutrients causing insomnia. This dissertation attempts to address the association between nutrients and insomnia of Hong Kong Chinese Population. / Background and Objective: Insomnia is a common sleep disorder and a major public health issue. Insomnia could be classified into three subtypes: Difficulty in Initiating Sleep (DIS), Difficulty in Maintaining Sleep (DMS), and Early Morning Awakening (EMA). Vitamins and minerals are thought to be associated with insomnia. From literature reviews, studies in western population and in Asian population found that protein and carbohydrates, fat and oil are associated with insomnia. Insomnia could be affected by the availability of nutritional substances in individual’s diet. However, limited studies are done in Hong Kong Chinese population on the association between insomnia and nutrient components. The aim of this study is to find out the association between insomnia and nutrient components in-take in Hong Kong Chinese population. / Hypothesis: It is hypothesized insomnia and nutrient components would also have association in Hong Kong Chinese population. It is hypothesized the dietary characteristic of insomniac in Hong Kong Chinese population would be different from that of non-Hong Kong Chinese population, and it is hypothesized each insomnia subtype and nutrient components would have different association. / Method: A community-based cross-sectional study is conducted in 13 schools. There are 138 adolescents (61 male and 77 female) and 173 adults (84 male and 89 female) participated in this study. Information of daily nutrient intake is obtained by a self-administrated 3-day food diary, the assessment of insomnia symptom is obtained by a standard sleep questionnaire Insomnia Severity Index (ISI), and the assessment of anxiety and depression is obtained by Hospital Anxiety and Depression Scale (HADS). / Results and Conclusion: Agree with the hypothesis, insomnia and nutrient component have association in Hong Kong Chinese population. The dietary characteristic of insomniac in Hong Kong Chinese population is different from that of non-Hong Kong Chinese population. Each insomnia subtype and nutrient component has different association. Multivariance analysis shows insomnia subtype Difficult Initiating Sleep (DIS), Difficult Maintaining Sleep (DMS), Early Morning Awakening (EMA), and overall insomnia syndrome associate with decreased in-take of vitamin A, vitamin D and vitamin E in both adults and adolescents. Decreased intake of saturated fat associates with insomnia subtype DMS and decreased intake of carbohydrate associates with insomnia subtype EMA in this study. Information from this study shines lights on the relationship of insomnia and nutrients in-take in the general population of Hong Kong Chinese. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Lau, Yin Wah Vivien. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 82-90). / Abstracts also in Chinese. / Abstract: --- p.i-iv / Acknowledgements: --- p.v / Table of contents: --- p.vi-viii / List of Lists: --- p.ix / List of Tables: --- p.ix / List of Figures: --- p.ix / Objective --- p.1 / Chapter Chapter 1: --- Introduction / Chapter 1.1 --- Sleep Research --- p.2 / Chapter 1.1.1 --- Background and History of Sleep Research --- p.2-3 / Chapter 1.1.2 --- Sleep Function and Consequence --- p.3-4 / Chapter 1.1.3 --- Neurotransmitters and Neuromodulators --- p.4-5 / Chapter 1.2 --- Insomnia --- p.5 / Chapter 1.2.1 --- The Definition of Insomnia --- p.6 / Chapter 1.2.1.1 --- Many Different Definitions of Insomnia Diagnostic Criteria --- p.6 / Chapter 1.2.1.2 --- Diagnostic Criteria used for Insomnia in This Study --- p.6-8 / Chapter 1.2.1.3 --- Symptoms and Syndrome of Insomnia --- p.9-10 / Chapter 1.2.2 --- The Cost of Insomnia --- p.10-11 / Chapter 1.2.3 --- The Common Causes of Insomnia --- p.11 / Chapter 1.2.4 --- Cognitive-Behavioral Model of Insomnia --- p.12 / Chapter 1.2.5 --- Treatments of Insomnia --- p.14 / Chapter 1.2.6 --- Confounding Factors of Insomnia --- p.14 / Chapter Chapter 2: --- Age, Education and Body Mass Effect on Sleep Pattern / Chapter 2.1 --- Age --- p.16 / Chapter 2.2 --- Education --- p.17 / Chapter 2.3 --- Body Mass --- p.17 / Chapter Chapter 3: --- Mood, Pain, Sleep Hygiene, Drug, Caffeine and Alcohol Effect on Sleep Pattern / Chapter 3.1 --- Mood --- p.18 / Chapter 3.2 --- Pain --- p.18 / Chapter 3.3 --- Sleep Hygiene --- p.18 / Chapter 3.4 --- Drug --- p.20 / Chapter 3.5 --- Caffeine --- p.20 / Chapter 3.6 --- Alcohol --- p.20 / Chapter Chapter 4: --- Nutrient Components / Chapter 4.1 --- Macro-nutrient --- p.21 / Chapter 4.1.1 --- Carbohydrate --- p.21-22 / Chapter 4.1.2 --- Fatty Acid --- p.22-23 / Chapter 4.1.3 --- Protein --- p.23-24 / Chapter 4.2 --- Micro-nutrient --- p.24 / Chapter 4.2.1 --- Vitamin B₁ (Thiamine) --- p.24 / Chapter 4.2.2 --- Vitamin B₂ (Riboflavin) and Vitamin B₃ (Niacin) --- p.24-25 / Chapter 4.2.3 --- Vitamin B₆ (Pyridoxine) --- p.25 / Chapter 4.2.4 --- Vitamin B₁₂ (Cobalamin, Folate) --- p.25-26 / Chapter 4.2.5 --- Vitamin A and Vitamin D --- p.26-27 / Chapter 4.2.6 --- Tryptophan, Tyrosine, Choline and Phosphatidylcholine (Lecithin) --- p.27-28 / Chapter 4.2.7 --- Vitamin E and Vitamin C --- p.30 / Chapter 4.2.8 --- Iron --- p.30 / Chapter Chapter 5: --- Nutrient Components and Insomnia / Chapter 5.1 --- Introduction --- p.32 / Chapter 5.2 --- Social Perspective of Insomnia and Nutrients --- p.33 / Chapter 5.3 --- Biochemical Perspective of Insomnia and Nutrients --- p.33-34 / Chapter Chapter 6: --- Material and Method / Chapter 6.1 --- Sampling Method --- p.35 / Chapter 6.1.1 --- Background --- p.35 / Chapter 6.1.2 --- Method --- p.35 / Chapter 6.1.3 --- Population --- p.35 / Chapter 6.1.4 --- Questionnaire --- p.36 / Chapter 6.1.5 --- Food Diary --- p.36 / Chapter 6.2 --- Participant Recruitment Criteria --- p.38 / Chapter 6.2.1 --- Major Inclusion Criteria for This Study --- p.38 / Chapter 6.2.2 --- Major Exclusion Criteria for This Study --- p.38 / Chapter 6.2.3 --- Ethical Considerations --- p.38 / Chapter 6.3 --- Statistic Analysis --- p.39 / Chapter 6.4 --- Quality Assessment and Data Extraction --- p.39 / Chapter 6.5 --- Hypothesis --- p.40 / Chapter Chapter 7: --- Results / Chapter 7.1 --- Demographic Data --- p.41 / Chapter 7.2 --- Overall Insomnia --- p.43 / Chapter 7.2.1 --- Difficult Initiating Sleep (DIS) --- p.52 / Chapter 7.2.2 --- Difficulty Maintaining Sleep (DMS) --- p.52 / Chapter 7.2.3 --- Early Morning Awakening (EMA) --- p.61 / Chapter 7.2.4 --- Insomnia Syndrome --- p.61 / Chapter Chapter 8: --- Discussion and Limitation / Chapter 8.1 --- Age and Insomnia --- p.71 / Chapter 8.2 --- Alcohol and Insomnia --- p.72 / Chapter 8.3 --- Caffeine and Insomnia --- p.72 / Chapter 8.4 --- Carbohydrate and Insomnia --- p.72-73 / Chapter 8.5 --- Vitamin E and Insomnia --- p.73 / Chapter 8.6 --- Vitamin A and Insomnia --- p.74 / Chapter 8.7 --- Vitamin D and Insomnia --- p.74 / Chapter 8.8 --- Saturated Fat and Insomnia --- p.75 / Chapter 8.9 --- Summary --- p.76 / Chapter Chapter 9: --- Limitation and Implications / Chapter 9.1 --- Limitation of This Study --- p.77 / Chapter 9.2 --- Implication to Further Study --- p.77-78 / Chapter 9.3 --- Implication to Clinical Intervention --- p.78-79 / Chapter Chapter 10: --- Executive Summary --- p.80-81 / Bibliography --- p.82-90
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