研究目的：以酒助眠是許多人認為可幫助睡眠的一種方式，但許多研究發現，飲酒後雖然在睡眠初期似有鎮靜鬆弛、縮短入睡時間的效果，但在入睡後的睡眠品質卻不一定良好，出現淺眠易醒的現象。但人體對酒精的反應存有明顯的個別差異，部分會對酒精產生敏感反應，出現頭暈、臉紅、心悸、噁心和嘔吐等不舒服的症狀，研究認為造成此種酒精敏感性（alcohol sensitivity）差異的原因主要來自一種乙醛脫氫酶（ALDH2）的基因型變異，導致個體在酒精代謝的過程中形成不同程度的乙醛堆積，進而影響到酒精攝取行為上的差異。然而不同個體對酒精敏感反應上的差異，是否也會影響到酒精造成睡眠狀況的變化，進而影響到個體對於酒精助眠效果的主觀感受的個別差異。因此，本研究的目的在於比較不同ALDH2基因型者，在飲酒和未飲酒的情境下，對睡眠的主觀知覺和實質睡眠參數測量的改變程度是否有差異，以了解ALDH2基因型對於酒精作用於睡眠歷程的影響。
研究方法：本研究共募集20位受試者，經基因型鑑定排除對酒精過於敏感的ALDH2*2/*2者和睡眠品質不佳者後，共14位納入正式分析。分別在睡前飲用中低劑量酒精（每公斤體重0.3克酒精）和非酒精飲料的情境下，採用多頻道睡眠記錄儀等儀器測量客觀的各項生理和睡眠指標，以及使用自填式量表評估睡前和早晨主觀的生理與心理感受。
研究結果：研究發現ALDH2*1/*1者飲酒後有入睡耗時、醒覺指數增加，以及Stage 2 睡眠潛伏期縮短的現象；ALDH2*1/*2者則有REM睡眠潛伏期延後的現象。在主觀感受上，飲酒後兩者皆在睡前誘發了明顯的生理負向感覺，早晨醒後則僅ALDH2*1/*2者有較高的生理激發程度。
結論：在給予中低劑量的酒精後，不同ALDH2基因型者其睡眠型態呈現不同的特性，也產生了生理心理反應上的差異，未來可再與睡眠相關的神經系統測量結合，釐清酒精和乙醛在影響人體睡眠中的角色，進一步了解酒精代謝對中樞神經的影響。 / Background: The effects of alcohol on sleep have been well documented. While alcohol consumption may decrease sleep onset latency, it may also lower sleep quality. Sleep problems, including prolonged sleep latency and decreased total sleep time, are more common among alcoholics than among nonalcoholics. But the effect of alcohol consumption has individual difference in the sensitivity of physiological reaction to alcohol, as reflected in facial flushing, palpitation, nausea, and other uncomfortable symptoms. The degree of physiological reaction was found to be associated with the efficiency in ethanol metabolism. Aldehyde dehydrogenase (ALDH) is the major enzymes involved in ethanol metabolism in humans. Homozygosity of the variant ALDH2*2 allele almost fully protects East Asian populations against the development of alcoholism. However, how the individual difference of alcohol sensitivity influence sleep pattern after alcohol consumption remains unknown. In this study, we aim to compare the changes of subjective report and objective measure of sleep following alcohol ingestion on variant ALDH2 genotypes.
Methods: Fourteen nonalcohol-dependent subjects were recruited. After passing screening tests for ALDH2*2/*2 genotype and poor-sleep quality on PSG, subjects were required to complete two nights of PSG recording under the controlled condition (nonalcoholic beverage) and experimental condition (alcoholic beverage). Questionnaires were also used to evaluate subjective feelings before sleep and in the morning.
Results: Decreased sleep onset latency and stage 2 latency as well as higher arousal index were observed in ALDH2*1/*1 subjects after challenge with a moderate dose of ethanol (0.3 g/kg of body weight), while only longer REM latency was showed in ALDH2*1/*2 individuals. As for subjective feelings, both genotypes showed more intense negative physiological responses before sleep, while only ALDH2*1/*2 individuals showed increased physical arousal the next morning.
Conclusions: The variation of ALDH2*2 allele contributes to individual differences of alcohol sensitivity. The results indicate that sleep patterns and subjective perceptions following by alcohol administration were also affected by ALDH2 genotypes. This study suggests that sleep-related psychological factors may be crucial for the development of alcoholism.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0097752007 |
| Creators | 王依凡 |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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