睡眠對於修復身體機能起著重要的作用，幫助能量的恢復，並增強自身的免疫力，是人一天當中不可或缺的寶貴時光。然而年齡的增長會導致生理機能變化，睡眠的量與品質會逐漸下降。睡眠狀況變得不理想，除了影響日常生活外，也會對社會經濟造成負面衝擊。過去許多文獻指出失眠與勞工在職場上的表現之間存在關聯，或是勞工在職場的經歷導致其失眠問題的出現。睡眠問題引發的精神不濟促使勞工缺勤、工作效率低下，進而造成經濟成本上升。文獻也表示若勞工有失眠的情形，更容易不繼續參與勞動力市場。
　　因此本文利用健康與退休研究 (Health and Retirement Study) 的資料探討美國中老年人如果經歷失眠的問題，對約兩年與八年後的勞動力狀態有什麼影響。勞動力狀態分為勞動力人口、提前退休人口及無工作者三個組別。提前退休的定義是根據美國社會安全局對正常退休年齡的設置，如果在正常退休年齡前退休即為提前退休。失眠主要由難以入睡、夜間醒來、過早醒且無法再次入睡及非恢復性睡眠組成，並且使用中老年人是否至少每週參與一次宗教儀式作為工具變數來檢驗前期失眠與未來勞動力狀態是否存在內生性問題。結果顯示部分模型不具內生問題，可以直接參考外生結果。
　　經由Multinomial probit分析並計算邊際效果後發現，控制社會人口特徵的情況下，男性中老年人主要會因為非恢復性睡眠與失眠分數越高的困擾導致約兩年後留在勞動市場的機率減少，提前退休或是成為無工作者的機率提升。然而隨著控制變數的增加，失眠問題不再是影響男性勞動力狀態的主因。女性中老年人在控制社會人口特徵下，有難以入睡、過早醒且無法再次入睡、失眠、失眠症狀越多及失眠分數越高的情況，皆會因此減少約兩年後留在勞動市場的機率，並增加提前退休或是成為無工作者的機率。隨著控制變數的增加，失眠依舊顯著影響女性的勞動力狀態。由上述可知，短期睡眠問題對於女性的勞動力狀態影響相較於男性更為顯著。而長期睡眠問題則會使全體中老年人約八年後成為無工作者的機率增加。

   Sleep plays an important role in restoring the body's functions, replenishing energy, and strengthening the immune system. It is an essential and valuable time in a person's day. However, as we age, physiological changes can lead to a decline in the quantity and quality of sleep. Suboptimal sleep not only affects daily life but also negatively impacts on the social and economic aspects of society. Previous literature has indicated a link between insomnia and job performance or experiences in the workplace. Lack of energy caused by sleep problems leads to labor absenteeism and low work efficiency, which in turn leads to increased economic costs. Furthermore, the literature suggests that individuals experiencing insomnia are more likely to disengage from the labor market.
    Therefore, this thesis uses data from the Health and Retirement Study to explore the impact of insomnia on the labor force status of middle-aged and older adults in the United States after approximately two and eight years. The labor force status is divided into three groups: labor force population, premature retirement population, and non-workers. The definition of premature retirement is based on the normal retirement age set by the US Social Security Agency. If you retire before the normal retirement age, it is considered premature retirement. Insomnia mainly consists of difficulty falling asleep, waking up at night, waking up too early to fall asleep again, and non-restorative sleep. Whether a person participates in religious ceremonies every week at least once is used as an instrumental variable to test whether there are endogeneity issues between premature insomnia and future labor status. The results show that some models do not encounter endogenous problems and can directly refer to exogenous results.
   Through multinomial probit analysis and marginal effects calculations, it was found that with the inclusion of control variables, sleep issues are no longer the main factor affecting the labor force status of males. However, insomnia continues to influence the labor force status of females significantly. Therefore, it can be concluded that sleep problems have a more pronounced effect on the labor force status of females than males. Long-term sleep issues, on the other hand, are associated with an increased likelihood of middle-aged and older adults becoming non-workers approximately eight years later.

目錄
第一章  緒論	1
第一節  研究背景與動機	1
第二節  研究目的	2
第三節  研究方法與架構	3
第二章  文獻回顧	4
第一節  睡眠與勞動市場	4
第二節  睡眠與健康行為	6
第三節  睡眠與健康狀態、疾病	7
第三章  資料來源與變數定義	9
第一節  資料來源	9
第二節  樣本篩選	10
第三節  變數定義	12
第四節  敘述統計	16
第四章  實證模型設定	25
第一節  多項機率模型	25
第二節  Control function approach	26
第五章  實證結果分析	27
第一節  失眠對勞動力狀態的影響之外生結果	27
第二節  模型的內生性檢驗結果	36
第三節  結合外生與檢定內生後結果	57
第四節  長期結果	76
第六章  結論與研究限制	90
參考文獻	92
附錄	98

表目錄
表3-1 男性敘述統計表(已調整權重)-短期	19
表3-2 女性敘述統計表(已調整權重)-短期	21
表3-3 全體敘述統計表(已調整權重)-長期	23
表5-1 不同模型下男性勞動市場狀態之睡眠變數的短期邊際效果	30
表5-2 不同模型下男性勞動市場狀態之失眠症狀個數的短期邊際效果	31
表5-3 不同模型下男性勞動市場狀態之失眠加總分數的短期邊際效果	32
表5-4 不同模型下女性勞動市場狀態之睡眠變數的短期邊際效果	33
表5-5 不同模型下女性勞動市場狀態之失眠症狀個數的短期邊際效果	34
表5-6 不同模型下女性勞動市場狀態之失眠加總分數的短期邊際效果	35
表5-7 不同模型下檢定工具變數相關性-短期	38
表5-8 不同模型下檢定工具變數排除性的個別檢定-短期	39
表5-9 控制全部變數下檢定工具變數排除性的個別檢定-短期	40
表5-10 不同模型下檢定工具變數排除性的聯合檢定-短期	41
表5-11 控制全部變數下檢定工具變數排除性的聯合檢定-短期	42
表5-12 男性內生性檢定模型-控制社會人口特徵的短期結果	43
表5-13 男性內生性檢定模型-控制社會人口特徵與健康行為的短期結果	45
表5-14 女性內生性檢定模型-控制社會人口特徵的短期結果(1)	47
表5-15 女性內生性檢定模型-控制社會人口特徵的短期結果(2)	49
表5-16 女性內生性檢定模型-控制社會人口特徵與健康行為的短期結果(1)	51
表5-17 女性內生性檢定模型-控制社會人口特徵與健康行為的短期結果(2)	53
表5-18 兩性內生性檢定模型-控制全部變數的短期結果	55
表5-19 男性勞動市場狀態的短期邊際效果-控制社會人口特徵	61
表5-20 男性勞動市場狀態的短期邊際效果-控制社會人口特徵與健康行為	63
表5-21 女性勞動市場狀態的短期邊際效果-控制社會人口特徵(1)	65
表5-22 女性勞動市場狀態的短期邊際效果-控制社會人口特徵(2)	67
表5-23 女性勞動市場狀態的短期邊際效果-控制社會人口特徵與健康行為(1)	69
表5-24 女性勞動市場狀態的短期邊際效果-控制社會人口特徵與健康行為(2)	71
表5-25 兩性勞動市場狀態的短期邊際效果-控制全部變數	73
表5-26 不同模型下全體勞動市場狀態之睡眠變數的長期邊際效果	77
表5-27 不同模型下檢定工具變數相關性-長期	78
表5-28 不同模型下檢定工具變數排除性的個別檢定-長期	79
表5-29 不同模型下檢定工具變數排除性的聯合檢定-長期	80
表5-30 全體內生性檢定模型-控制社會人口特徵的長期結果(1)	81
表5-31 全體內生性檢定模型-控制社會人口特徵的長期結果(2)	83
表5-32 全體內生性檢定模型-控制社會人口特徵與健康行為的長期結果	85
表5-33 全體內生性檢定模型-控制全部變數的長期結果	88
附錄表1 不同模型下檢定工具變數相關性-係數的短期結果	98
附錄表2 男性內生性檢定模型-控制社會人口特徵的短期結果(1)	99
附錄表3 男性內生性檢定模型-控制社會人口特徵的短期結果(2)	101
附錄表4 男性內生性檢定模型-控制社會人口特徵與健康行為的短期結果(1)	103
附錄表5 男性內生性檢定模型-控制社會人口特徵與健康行為的短期結果(2)	105
附錄表6 男性內生性檢定模型-控制全部變數的短期結果(1)	107
附錄表7 男性內生性檢定模型-控制全部變數的短期結果(2)	110
附錄表8 女性內生性檢定模型-控制社會人口特徵的短期結果	113
附錄表9 女性內生性檢定模型-控制社會人口特徵與健康行為的短期結果	115
附錄表10 女性內生性檢定模型-控制全部變數的短期結果(1)	117
附錄表11 女性內生性檢定模型-控制全部變數的短期結果(2)	120
附錄表12 不同模型下檢定工具變數相關性-係數的長期結果	123

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