中高生を中心とした子供の睡眠習慣に関する科学的知見の整理分科会 第1回 配付資料その2
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2 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%
3 (%) ~21:00 21:00 ~21:30 2*** :00 ~22: :00 ~23:30 24:00~ (%) ~21:00 21:00 ~21:30 4*** :00 ~22: :00 ~23: :00~ (%) ~21:00 21:00 ~21:30 6*** :00 ~22: :00 ~23: :00~
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5 () 22:10 22:00 21:50 21:40 21:30 21:20 21:10 21:00 () 6:15 6:05 5:55 5:45 *** Pre Pre *** Self: d = Post Self: d = Post () ** Pre Self: d = Post ***; p < 0.001, **; p < 0.01 (Cohen, 1988) 0.20 < d 小さい, 0.50 < d 中程度, 0.80 < d 大きい
6 (%) Pretreatment Sleep education Control * (%) Post-treatment 2 Sleep education Control * * Pretreatment Post-treatment 2 (%) Sleep education Control ** *** Pretreatment Post-treatment 2 (%) ** Sleep education Control *** Pretreatment Post-treatment 2 ***; P < 0.001, **; P < 0.01, *; P < 0.05 β β.342*.647**.252* R ( Adjusted R 2 ).437 (.167)**.647 (.410)*** ** p <.01, * p <.05
7 β β β -.396***.268* -.298**.240* R ( Adjusted R 2 ).529 (.298)***.446 (.161)*** -.250*.393*** ** R ( Adjusted R 2 ) ** p <.01, * p <.05, p < *.485 (.199)***.286*.363 (.118)***.446 (.161)*** β β.243*.238*.231* R ( Adjusted R 2 ).337 (.087)** (.079)** * p <.05, p <.1
8 16.1%-32.2% QOL Moore et al. J Pediatr Psychology 2009; Kaneita et al. SBR 2010 Gradisar et al. Sleep Med 2011; P-Lloret et al. JCSM e.g. Tan et al. BMC Pediatrics
9 n=118 B
10 (National Sleep Foundation ; Beebe et al. Sleep 2013) (Khalsa et al. J Physiol. 2003; Crowly & Carskadon. Chronobiol Int. 2010) (Fukuda & Ishihara. J Clin Psychiatry 2002; Kaneita et al. SBR 2010) (2012) (National Sleep Foundation 2006; Morin et al. Sleep 2006 ) ()
11 *** d = 2.37 a 17 *** *** a =, b= b d = 0.62 *** p <.001, 2-way rep ANOVA
12 *** 16.5 *** 7.0 * *** 16.4 *** 3.9 * ** 5.8 * *** 32.6 *** ** *** 50.2 *** 12.3 *** ** *** 26.3 *** *** 76.0 *** 13.0 *** * :22 23:08 22:53 22:39 22:24 22:10 21:56 a *** d = 0.65 a =, b= b ** 23:36 23:28 23:19 23:11 23:02 22:53 22:45 22:36 22:27 ** d = 0.25 *** p <.001, 2-way rep ANOVA
13 d = 0.65 * d = 0.51 *** *** p<.001, * p<.05; 2-way rep ANOVA * d = 0.19 * * p <.05; McNemar * p<.05; 2-way rep ANOVA
14 *** (National Sleep Foundation: NSF, 2006) *** p<.001; McNemar NSF t χ 2 n =118 n = (49.2) 6.23 (45.0) (3.13) (3.23) 22:54 (50) 22:53 (48) 6:22 (42) 6:23 (29) 7:17 (63) 7:12 (55) 23:11 (61) 23:12 (42) 8:01 (68) 8:16 (87) 8:30 (93) 8:29 (82) 77.0 (20.8) 77.1 (19.8) 72.1 (22.2) 71.7 (20.3) [N (%)] 96 (82.1) 84 (75.7) 0.73 n.s n.s n.s n.s n.s n.s n.s n.s n.s n.s n.s. Mean (SD)
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21 睡眠力チェッ ク 睡眠や日中の状態を 認識できるもの 意欲が出るも の 変化がわかるもの 自分で確認 できるよう に工夫 その日の就寝時刻 起床時刻が 確認できるように工夫 計算間違いを 少なくするための工夫 感想記入欄を 設けた 好ましい生活習慣が 得られている すでにできている 3点 頑張ればできそう 2点 できない 1点 授業前後の生徒の変化 明らかな変化がみられた項目 ①平日 休日共にほぼ決まった時間に起 きる ⑩メールを含む携帯電話の使用を1日30分 まで ⑰布団の中で考え事をしない など顕著に改善 決まって起きる 7 寝つき 5 自分で起きる 4 決まって寝る 悩み事しない すっきり目覚め 3 2 朝食 1 授業前 授業後 0 リラックス 体の調子 夜食 気分すっきり ストレス 気持ち切り替え 運動 テレビ2時間以上 1回目 2回目
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26 Kripke, D.F., Garfinkel, L., Wingard, D. L., Klauber, M.R., Marler, M.R. Mortality associated with sleep duration and insomnia. Archives of General Psychiatry. 2002; 59:
27 HDL Kaneita, Y., Uchiyama, M., Yoshiike, N., and Ohida, T. Associations of Usual Sleep Duration with Serum Lipid and Lipoprotein Levels. Sleep, 31, 5, (Fukuda & Hozumi, 1987) 8 8
28 y = x r = t =2.821, p <0.02 Fukuda, K., Hozumi, N. A case of mild school refusal: Rest-activity cycle and filial violence. Psychological Reports, 1987, 60, Fukuda, K. and Hozumi, N. A case of school refusal: rest-activity cycle and filial violence. Psychological Reports, 1987, 60,
29 absence period since the onset of school refusal no rhythm disturbance 187 disturbed rhythm 279 reversed rhythm Momoi, M. et al., Sleep rhythm disturbances in school refusers. The Japanese Journal of Psychiatry and Neurology, 1992, 46, 1, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% within 1year 2-3years over 4years reversed rhythm (present) reversed rhythm (past) disturbed rhythm (present) disturbed rhythm (past) no rhythm disturbance 2-3
30 OK Okawa,M. et al. Circadian rhythm disorders in sleep-waking and body temperature in elderly patients with dementia and their treatment. Sleep, 1991, Vol. 14, No. 6,
31 (Fukuda & Ishihara, 1997) Pattern A, Full Term Infant Pattern A, Preterm Infant Autocorrelation Autocorrelation Lag in Hours Lag in Hours A Pattern B, Full Term Infant Autocorrelation Pattern B, Preterm Infant Lag in Hours Lag in Hours B 24 Pattern C, Preterm Infant Pattern C, Full Term Infant Autocorrelation Patterns of autocorrelation functions classified by cluster analysis. Patterns of full term infants and preterm infants are shown in left and right column, respectively. Patterns A, B, and C are shown in the upper, middle, and lower part. Takaya, R., Fukuda, K., Uehara, H., Kihara, H., Ishihara, K. Emergence of circadian sleep-wake rhythm might depend on conception not on birth timing. Sleep and Biological Rhythms, 2009, 7, Autocorrelation 0.00 Autocorrelation Lag in Hours Lag in Hours C
32 National Sleep Foundation Final report of 2004 sleep in America poll.
33 ActiWatch 16
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