KARYA TULIS AKHIR
HUBUNGAN KUALITAS TIDUR DENGAN INDEKS MASSA TUBUH BERLEBIH PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG
Oleh : YULIAN RYANDRA NIM 201110330311109
FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG 2015
KATA PENGANTAR
Puji syukur penulis panjatkan kehadirat Allah SWT, karena atas rahmat dan hidayah-Nya, penulis telah berhasil menyelesaikan Karya Tulis Akhir ini yang berjudul “Hubungan
Kualitas Tidur Dengan Indeks Massa Tubuh
Berlebih Pada Mahasiswa Fakultas Kedokteran Universitas Muhammadiyah Malang”. Penulisan ini dilakukan dalam rangka memenuhi salah satu syarat untuk mencapai gelar sarjana Kedokteran jurusan Pendidikan Dokter pada Fakultas Kedokteran Universitas Muhammadiyah Malang. Penulis menyadari bahwa penyusunan tugas akhir ini kemungkinan jauh dari sempurna, walaupun demikian penulis telah berusaha semaksimal mungkin serta mendapatkan bantuan dan bimbingan dari Dosen Pembimbing dalam rangka penyusunan. Tanpa bantuan dan dorongan dari berbagai pihak, sangantlah tidak mudah menjalani masa perkuliahan hingga pada penyusunan tugas akhir ini. Oleh karena itu pada kesempatan ini penulis menyampaikan ucapan terima kasih kepada : 1. dr. Irma Suswati, M.Kes selaku Dekan Fakultas Kedokteran Universitas Muahammadiyah Malang. 2. dr. Moch. Ma’roef, Sp.OG selaku Pembantu Dekan 1 Fakultas Kedokteran Universitas Muhammadiyah Malang. 3. dr. Rahayu, Sp.S selaku Pembantu Dekan 2 Fakultas Kedokteran Universitas Muhammadiyah Malang.
4. dr. Iwan Sys Indrawanto, Sp.KJ selaku Pembantu Dekan 3 Fakultas Kedokteran Universitas Muhammadiyah Malang. 5. dr. Annisa Hasanah, M.si selaku Pembimbing I atas bimbingan, pelajaran, dukungan, saran dan bantuan yang telah diberikan dalam penyusunan karya tulis akhir ini. 6. dr. Gita Sekar Prihanti, MPD. Ked selaku pembimbing II atas kesabaran dan ketelitiannya dalam membimbing dan memberi saran dalam penyususnan karya tulis akhir ini. 7. dr. Bambang Mulyawan, Sp.A selaku penguji atas ketelitiannya dalam memberi saran dan masukan dalam penyusunan karya tulis akhir ini. 8. Orang tuaku tercinta papah Asep Jatiyono, ST dan mamah Dra.Astuti yang selalu memberikan semangat, dukungan moral maupun materil, serta doaNya selama ananda menuntut ilmu. 9. Kakak terbaik Reiza Praselanova terima kasih atas bantuan doa dan semangatnya. 10. Sahabat-sahabatku Hesty, Indrawan, Salsa, Putra, Risyu, Isla, teman yang selalu memberi dukungan semangat faris, fahmi, elvira dan semua temanteman yang tidak bisa disebutkan satu per satu terima kasih atas semua bantuannya, selalu mengingatkan dan memberi semangat, semoga kita semua bisa sukses dan menjadi dokter yang berguna dan bermanfaat bagi diri sendiri, kedua orangtua, keluarga, dan masyarakat. 11. Staf TU, Pak Yono, Bu Endang, Mas Didit, Mas Faisal terima kasih atas bantuan dan kemudahan dalam urusan administrasi dan tugas akhir ini.
12. Teman-teman
Fakultas
Kedokteran
Universitas
Universitas
Muhammadiyah Malang angkatan 2011 yang menjadi teman seperjuangan selama menempuh pendidikan ini. 13. Semua pihak yang turut membantu dalam menyelesaikan karya tulis ini juga mendoakan demi suksesnya karya tulis ini yang tidak bisa penulis sebutkan satu-persatu. Akhir kata penulis berharap semoga penelitian ini dapat menambah wawasan dan bermanfaat bagi semua pihak.
Malang, 26 Februari 2015
Penulis
DAFTAR ISI HALAMAN JUDUL ................................................................................................ i LEMBAR PENGESAHAN ..................................................................................... ii LEMBAR PENGUJIAN .......................................................................................... iii KATA PENGANTAR .............................................................................................. iv ABSTRAK ................................................................................................................ vii ABSTRACT .............................................................................................................. viii DAFTAR ISI ............................................................................................................. ix DAFTAR TABEL ................................................................................................... xi DAFTAR GAMBAR ............................................................................................... xii DAFTAR SINGKATAN .......................................................................................... xiii DAFTAR LAMPIRAN ............................................................................................ xv BAB 1 PENDAHULUAN ........................................................................................ 1 1.1. Latar Belakang .......................................................................................... 1 1.2. Rumusan Masalah ..................................................................................... 4 1.3. Tujuan Penelitian ..................................................................................... 4 1.3.1. Tujuan umum .................................................................................. 4 1.3.2. Tujuan khusus ................................................................................. 4 1.4. Manfaat Penelitian ................................................................................... 5 1.4.1. Manfaat akademik ......................................................................... 5 1.4.2. Manfaat masyarakat ...................................................................... 5 1.4.3. Manfaat klinis ................................................................................ 5 BAB 2 TINJAUAN PUSTAKA ............................................................................... 6 2.1. Tidur ....................................................................................................... 6 2.1.1. Definisi tidur ...................................................................................... 6 2.1.2. Fisiologis tidur ................................................................................... 6 2.1.3. Regulasi siklus bangun tidur .............................................................. 12 2.1.4. Faktor yang mempengaruhi kualitas tidur ......................................... 15 2.1.4.1. Kualitas tidur subjektif ............................................................ 16 2.1.4.2. Sleep latency............................................................................ 16 2.1.4.3. Sleep duration ......................................................................... 16 2.1.4.4. Effisiensi tidur ......................................................................... 18 2.1.4.5. Sleep disturbance .................................................................... 18 2.1.4.6. Pemakaian obat tidur ............................................................... 19 2.1.4.7. Disfungsi pada siang hari ........................................................ 20 2.1.5. Faktor-Faktor yang memperbaiki kualitas tidur ................................. 20 2.2. Indeks Massa Tubuh (IMT) ..................................................................... 21 2.2.1. Definisi indeks massa tubuh .............................................................. 21 2.2.2. Klasifikasi indeks massa tubuh .......................................................... 22 2.2.3. Epidemiologi overweight dan obese .................................................. 23 2.2.4. Cara menghitung indeks massa tubuh ................................................ 25 2.2.5. Faktor yang mempengaruhi indeks massa tubuh ............................... 26 2.2.6. Keterkaitan kualitas tidur dengan overweight .................................... 32
BAB 3 KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN ......... 37 3.1. Kerangka Konseptual Penelitian ............................................................. 37 3.2. Hipotesis Penelitian................................................................................. 39
BAB 4 METODE PENELITIAN ............................................................................ 40 4.1. Jenis dan Rancangan Penelitian ............................................................... 40 4.2. Lokasi dan Waktu Penelitian ................................................................... 40 4.3. Populasi dan Sampel ................................................................................ 41 4.3.1. Populasi ........................................................................................ 41 4.3.2. Sampel .......................................................................................... 41 4.3.3. Besar sampel ................................................................................ 41 4.3.4. Teknik pengambilan sampel ......................................................... 41 4.4. Karakteristik sampel penelitian ................................................................. 42 4.4.1. Kriteria inklusi .............................................................................. 42 4.4.2. Kriteria ekslusi ............................................................................. 43 4.5. Variabel penelitian .................................................................................... 43 4.5.1. Variabel bebas .............................................................................. 43 4.5.2. Variabel tergantung ...................................................................... 43 4.6. Definisi operasional .................................................................................. 44 4.7. Instrumen Penelitian ................................................................................. 45 4.8. Teknik Pengumpulan Data ........................................................................ 45 4.9. Alur Penelitian ......................................................................................... 46 4.10. Analisis Data .......................................................................................... 46 BAB 5 HASIL PENELITIAN DAN ANALISA DATA ........................................ 47 5.1. Hasil Penelitian ........................................................................................ 47 5.2. Analisa Data ............................................................................................. 55 BAB 6 PEMBAHASAN ........................................................................................... 56 BAB 7 KESIMPULAN DAN SARAN .................................................................... 60 7.1. Kesimpulan .............................................................................................. 60 7.2. Saran ........................................................................................................ 61 DAFTAR PUSTAKA ............................................................................................... 62 LAMPIRAN .............................................................................................................. 68
DAFTAR GAMBAR
Gambar
Halaman
Gambar 2.1 Gambaran Polisomnogram fase tidur........................................ 10 Gambar 2.2 Gambaran EEG (Elektroensefalografi) fase tidur…................. 10 Gambar 2.3 Persentase Status Gizi Penduduk Dewasa (15 Tahun Ke Atas) Menurut IMT dan Provinsi..............................................
24
Gambar 2.4 Prevalensi Status Gizi Kurus, BB Lebih dan Obesitas............ 25 Gambar 3.1 Kerangka Konseptual Penelitian …………………………...... 37
DAFTAR TABEL
Tabel
Halaman
Tabel 2.1 Perbedaan Tahapan REM dan NREM.......................................... 11 Tabel 2.2 Perbedaan Tahapan NREM.......................................................
12
Tabel 2.3 Klasifikasi Gizi berdasarkan Indeks Massa Tubuh ……….......... 22 Tabel 2.4 Neurotransmitter dan Hormon yang Mempengaruhi Pusat Makan dan Pusat Kenyang di Hipotalamus................................................... 29
DAFTAR SINGKATAN
5-HT
: 5-Hydroxy Tryptamine
ACTH
: Adrenal Corticotropin Hormone
BB
: Berat Badan
BSR
: Bulbar Synchronizing Regional
CAMP
: Catabolite Activator Protein
CART
: Cocaine and Amphetamine-Regulated Transcript
CDC
: Centers for Disease Control and Prevention
CNS
: Central Nervous System
CT
: Computed Tomography
DSM
: Diagnostic and Statistical Manual of Mental Disorders
DXA
: Dual Energy x-ray Absorptiometry
EEG
: Elektroensefalografi
EMG
: Elektromiografi
EOG
: Elektrookulografi
GABA
: Gamma Amino Butiric Acid
GERD
: Gastroesophageal Reflux Disease
GH
: Growth Hormone
IMT
: Indeks Massa Tubuh
LDL
: Low Density Lipoprotein
LH
: Luteneizing Hormone
LHA
: Lateral Hipotalamus Area
LVM
: Low Voltage Mix
NPY
: Neuropeptide Y
NREM
: Non Rapid Eyes Movement
OX1R
: Orexin-1 Receptor
OX2R
: Orexin-2 Receptor
PEFR
: Peak Expiratory Flow Rate
PET
: Positron Emission Tomography
POMC
: Proopiomelanocortin
PSQI
: Pittsburgh Sleep Quality Index
RAS
: Reticular Activating System
REM
: Rapid Eyes Movement
RNA
: Ribonukleic Acid
VLPA
: Ventrolateral Preoptic Area
WHO
: World Health Organization
DAFTAR LAMPIRAN
Lampiran
Halaman
Lampiran 1 Permohonan Bersedia Menjadi Responden................... .
69
Lampiran 2 Persetujuan Menjadi Responden......................................
70
Lampiran 3 Angket Kuesioner………………….................................
71
Lampiran 4 Pittsburgh Sleep Quality Index.................................................. 72 Lampiran 5 Data Hasil Penelitian................................................................. 74 Lampiran 6 Data Statistik ............................................................................. 99
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