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 doa-

Nya 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 teman-

teman 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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