近年來睡眠醫學逐漸受到重視，其中以睡眠呼吸暫止症最為嚴重，其後遺症會對人體造成精神及心臟心血管方面不良的影響。而心臟的週期性運動在人體循環上扮演很重要的角色，可藉由心電圖協助我們瞭解心臟跳動的情形。一般而言，心率變異是由自主神經系統控制以維持生理狀態的平衡，因此期待能從心率變異度找出對應自主神經系統之作用與睡眠呼吸障礙疾病所造成的生理機制改變。
本論文嘗試以心電圖生理訊號，來建立心率變異度與呼吸暫止與淺呼吸指數(AHI)之相關性，透過統計的方法來分析呼吸暫止症對交感與副交感神經調控情形的影響。本研究將偵測到的RRI序列作頻譜分析，得到每個人的高低頻功率比(LF/HF)，進而與受測者的年齡、BMI及AHI建立多元線性迴歸分析，作一個有系統的統計分析。分析結果當AHI小於45時並無明顯線性關係，而AHI大於45時皆存在一定程度的線性關係，亦即交感與副交感神經系統的調控情形嚴重失去平衡，使得LF/HF漸增。若LF/HF與AHI呈現較佳的線性關係時，即可應用在臨床診斷上，以便增加其診斷呼吸暫止症的重要參考指標。

In recent years, sleep medicine has attracted many interests. Among many sleep disorder problems, the sleep apnea syndrome is of great importance. One of its side effects is its negative influences on cardiovascular system whose function can be monitored by ECG.
The regulation of the heart rate is extremely important for human body. In general, the heart rate variability is controlled by the balance of the sympathetic and the parasympathetic systems whose functions can be influenced by sleep apnea.
This work tries to establish the relation between the heart rate variability and AHI (Apnea & hypopnea index). Through the statistical methods, we analyze how the sleep apnea influences the low frequency (LF) and high frequency components of the RR intervals. With BMI, age and AHI as the independent variables, we set up the regression model to predict LF/HF
Our results demonstrate that, for men, the linear relationship between the LF/HF and AHI is statistically significant when AHI is higher than 45. This results may shed some light on developing HRV based diagnosis method for sleep apnea.

論文審定書........................................................................i
誌謝.................................................................................ii
目錄................................................................................iii
圖目錄..............................................................................v
表目錄.............................................................................vi
摘要................................................................................vii
Abstract.........................................................................viii
第一章 緒論......................................................................1
1.1 前言...........................................................................1
1.2 文獻回顧.....................................................................2
1.3 研究動機與目的...........................................................4
1.4 論文架構.....................................................................5
第二章 研究背景與基本原理...............................................7
2.1 生理訊號簡介..............................................................7
2.2 心電圖原理.................................................................8
2.2.1 心電圖波形與RR-Interval............................................9
2.3 心率變異度................................................................11
2.3.1 HRV之頻域分析......................................................11
2.4 睡眠呼吸暫止............................................................13
2.4.1 睡眠檢查................................................................15
2.4.2 呼吸暫止與淺呼吸指數(AHI).....................................16
2.5 多元線性迴歸............................................................17
2.5.1 多元線性迴歸之判定................................................18
第三章 分析步驟與方法....................................................23
3.1 資料庫的來源............................................................23
3.2 消除ECG訊號基線飄移...............................................24
3.3 以小波轉換偵測QRS波...............................................26
3.4 心率變異度之頻域分析...............................................27
3.5 建立多元線性迴歸模式...............................................28
第四章 統計分析與結果....................................................30
4.1 LF/HF與AHI的相關性.................................................30
4.2 進階分析...................................................................34
4.2.1 縮小資料庫LF/HF與AHI的相關性..............................34
4.2.2 比較LF/HF與不同的AHI區間之相關性........................36
第五章 結論與未來展望....................................................41
參考文獻........................................................................43

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