02原著-1.indd

Size: px

Start display at page:

Download "02原著-1.indd"

てるえわかはら
5 years ago
Views:

1 J. Jpn. Acad. Midwif., Vol. 22, No. 2, , 2008 原著妊娠末期から産後 4 ヶ月の母親の睡眠覚醒リズム等の変化 Longitudinal study on changes of sleep-wake rhythm in mothers from late pregnancy to 4 month postpartum using sleep log Tsubura INUI 1 Mieko SHIMADA 1 Mako HAYASE 1 Tosiko OGATA 2 Akie TOKIMOTO 2 Maki HOJOH 2 Haruko SHINKAWA 1 抄録目的 4 対象と方法結果 p 0.001p p p : 226 : p p 結論 Osaka University School of Health Science 2 Takatsuki General Hospital J. Jpn. Acad. Midwif., Vol. 22, No. 2,

2 4 キーワード : Abstract Purpose This study was to clarify the characteristics and changes of the sleep-wake rhythm in mothers from late pregnancy to four months postpartum. Methods Participants were 57 women in late pregnancy to four months postpartum. The subjects were 57 mothers after 35 weeks of pregnancy who gave informed consent to participate. Of these, forty-seven mothers 1 month postpartum and thirty-four at 4 months postpartum, were surveyed longitudinally at. Participant recorded 24 hours sleep-and-wakefulness using a day-by-day plot method on Sleep Log at intervals of 30 minutes for one week. We calculated sleep parameters: total sleep time (TST), nocturnal sleep time (NST), diurnal sleep time (DST), longest sustained sleep period (LSP), LSP onset and offset times, numbers of total sleep hours and diurnal sleep hours, time of waking after sleep onset (WASO), number of WASO and sleep-wake cycle. Results TST were 7.79 hours in late pregnancy, 6.73 hours 1 month postpartum and 6.91 hours in 4 month after delivery (F=18.21, p<0.001). NST were 6.75 hours, 5.85 hours and 6.36 hours (F=12.27, p<0.001) respectively. LSP were 6.39 hours, 3.46 hours and 4.13 hours (F=87.61, p<0.001). TST, NST and LSP in postpartum were shorter than those late pregnancy. WASO were 0.42 hours, 1.70 hours and 1.14 hours (F=45.42, p<0.001). Number of WASO were 0.3 times, 1.7 times and 1.5 times (F=78.60, p<0.001). WASO in postpartum was longer than those late pregnancy, and number of WASO in postpartum was larger than those late pregnancy. It was found that LSP showed significant negative correlation with LSP onset in late pregnancy (r=-0.481, p<0.001), and 4 months postpartum (r=-0.396, p<0.05). In addition, LSP were predominantly between 0:22 and 6:50, while cycle of sleep-and-wakefulness rhythm was approximately 24 hours, which showed a range of hours to in the mothers in this study. Conclusion The sleep-wakefulness rhythm in mothers is disturbed from late pregnancy to postpartum, although TSP, NSP, LSP decrease and WASO increases. The mothers who go to bed early are able to sleep longer during nighttime hours and sleep-and-wakefulness was approximately 24 hours cycle in all mothers. Key words: sleep-wake rhythm, late pregnancy, postpartum mother, WASO (waking after sleep onset), LSP (longest sustained sleep period). Ⅰ. 緒言 Doi, 2001 ; Yoon, 2003 Feinsilver, Shinkoda, 1999 Hedman, /

3 Shinkoda, Ⅱ. 研究方法 1. 対象 T 調査方法 Shimada, 1999 Weissbluth, authorize 分析方法 IAC Standard Error SE 8:00 19:59 20:00 7:5912:00 11: Tukey PearsonSPSS J for Windows Ver 倫理的配慮 546 J. Jpn. Acad. Midwif., Vol. 22, No. 2,

4 Ⅲ. 結果対象者の属性 33.1 SD SD 睡眠指標の妊娠末期から産後 4 ヶ月の比較 F 18.21, df 2, p Tukey p Tukey p F 51.20, df 2, p Tukey p Tukey p F 12.27, df 2, p Tukey p Tukey p F 87.61, df 2, p Tukey p Tukey p Tukey p F 45.42, df 2, p Tukey p Tukey p Tukey p F 78.60, df 2, p Tukey p Tukey p 表 1 妊娠末期から産後 4 ヶ月の睡眠指標 one-way 妊娠末期 (n=57) 産後 1 ヶ月 (n=47) 産後 4 ヶ月 (n=34) ANOVA Tukey の多重比較 mean ± SE mean ± SE mean ± SE F 値 p 値妊娠末期と 1 ヶ月妊娠末期と 4 ヶ月総睡眠時間 *** *** *** n.s 総睡眠回数 *** *** *** n.s 昼睡眠時間 ** n.s ** n.s 昼睡眠回数 * n.s n.s n.s 夜睡眠時間 *** *** n.s * 夜睡眠割合 (%) * n.s * * 中途覚醒時間 ( 時間 ) *** *** *** ** 中途覚醒回数 *** *** *** n.s 最長睡眠時間 *** *** *** * 最長睡眠の入眠時刻 ( 時 ) n.s n.s n.s n.s 最長睡眠の覚醒時刻 ( 時 ) *** *** *** n.s 睡眠覚醒のリズム周期 ( 時間 ) n.s n.s n.s n.s 1 ヶ月と 4 ヶ月 ***: p<0.001, **: p<0.01, *: p<0.05, n.s.: not significant

5 F 45.34, df 2, p Tukey p Tukey p 各時期における睡眠指標の相関 r0.326, p r0.309, p 0.05 r0.534, p r0.382, p r0.757, p r 0.481, p r0.396, p r 表 2-1 睡眠指標の関連妊娠末期 n=57 総睡眠時間夜睡眠時間中途覚醒時間中途覚醒回数最長睡眠時間総睡眠時間 ( 時間 ) 夜睡眠時間 ( 時間 ) *** 中途覚醒時間 ( 時間 ) n.s * 中途覚醒回数 n.s n.s *** 最長睡眠時間 ( 時間 ) *** *** *** *** 最長睡眠の入眠時刻最長睡眠の入眠時刻 ( 時 ) n.s *** ** n.s *** 最長睡眠の覚醒時刻最長睡眠の覚醒時刻 ( 時 ) ** n.s n.s *** *** *** 睡眠覚醒のリズム周期睡眠覚醒のリズム周期 ( 時間 ) n.s n.s n.s n.s n.s n.s n.s Pearson *: p 0.05, **: p 0.01, ***: p 0.001, n.s.: not significant 表 2-2 睡眠指標の関連産後 1 ヶ月 n=47 総睡眠時間夜睡眠時間中途覚醒時間中途覚醒回数最長睡眠時間総睡眠時間 ( 時間 ) 夜睡眠時間 ( 時間 ) *** 中途覚醒時間 ( 時間 ) n.s * 中途覚醒回数 n.s n.s ** 最長睡眠時間 ( 時間 ) *** ** ** *** 最長睡眠の入眠時刻最長睡眠の入眠時刻 ( 時 ) * *** n.s n.s n.s 最長睡眠の覚醒時刻最長睡眠の覚醒時刻 ( 時 ) n.s * n.s *** ** *** 睡眠覚醒のリズム周期睡眠覚醒のリズム周期 ( 時間 ) n.s n.s n.s n.s n.s n.s n.s Pearson *: p 0.05, **: p 0.01, ***: p 0.001, n.s.: not significant J. Jpn. Acad. Midwif., Vol. 22, No. 2,

6 表 2-3 睡眠指標の関連産後 4 ヶ月 n=34 総睡眠時間夜睡眠時間中途覚醒時間中途覚醒回数最長睡眠時間総睡眠時間 ( 時間 ) 夜睡眠時間 ( 時間 ) *** 中途覚醒時間 ( 時間 ) n.s n.s 中途覚醒回数 n.s n.s *** 最長睡眠時間 ( 時間 ) *** *** *** *** 最長睡眠の入眠時刻最長睡眠の入眠時刻 ( 時 ) n.s *** * n.s * 最長睡眠の覚醒時刻最長睡眠の覚醒時刻 ( 時 ) n.s n.s * *** *** *** 睡眠覚醒のリズム周期睡眠覚醒のリズム周期 ( 時間 ) n.s n.s n.s n.s n.s n.s n.s Pearson *: p 0.05, **: p 0.01, ***: p 0.001, n.s.: not significant 0.719, p r0.691, p r0.600, p 睡眠指標の時期間での相関 1 1 r 0.413, n 47, p r 0.673, n 34, p r 0.454, n 34, p r 0.413, n 47, p r 0.500, n 34, p r 0.369, n 34, p 0.05 Ⅳ. 考察 4 1. 最長睡眠の入眠時刻と覚醒時刻 Sekine, 2002 Koyama, S4 S4 Sleep log

7 Shimada et al, 睡眠覚醒のリズム周期 Shimada, Takahashi, Hedman Hedman, 夜睡眠の中途覚醒時間と中途覚醒回数臨床への応用 6. 本研究の限界と今後の課題 3. 妊娠末期から産後 4 ヶ月の睡眠時間 Asai, Ⅴ. 結論 1 4 J. Jpn. Acad. Midwif., Vol. 22, No. 2,

8 謝辞 B 文献 Asai, T. Kaneita, Y. Uchiyama, M. et al. (2006). Epidemiological study of the relationship between sleep disturbances and somatic and psychological complaints among the Japanese general population, Sleep and Biological Rhythms, 4, Doi, Y. Minowa, M. Uchiyama, M. et al. (2001). Subjective sleep quality and sleep problems in the general Japanese adult population, Psychiatry and Clinical Neurosciences, 55, Feinsilver, S.T & Hertz, G. (1992). Respiration during sleep in pregnancy, Clinics chest medicine, 13(4), Hedman, C. Pohjasvaara, T. Tolonen, U. et al. (2002). Effect of pregnancy on mothers' sleep, Sleep Medicine, 3, , 10(2), , 14(1), , 28, Kohyama, J. Shiiki, T. Ohinata, J, et al. (2002). Potentially harmful sleep habits of 3-year-old children in Japan. J Dev Behav Pediatr, 23, , 7(1), , 14, pp Sekine M, Yamagami T. et al. (2002). A dose-response relationship between short sleeping hours and childhood obesity: result of the Toyama Birth cohort Study. Child Care, Health & Development, 28(2), Shimada, M. Takahashi, K. Segawa, M. et al. (1999). Emerging and entraining patterns of the sleep-wake rhythm in preterm and term infants, Brain and Devlopment, 21, , 58 (5), , 40, , 65(6), Shinkoda, H. Matsumoto, K. Park, Y.M. (1999). Changes in sleep-wake cycle during the period from late pregnancy to purperium identified through the qrist Actigraph and sleep logs, Psychiatry and Clinical Neurosciences, 53, Actigraph, 27,

9 4, 29, Japanese Society of Psychosomatic Medicine, 36(7), Takahashi, K. Ohi, K. Shimada, K. et al. (1989). Postnatal maternal entrainment of circadian rhythms. Report S.M. ed. Development of circadian rhythmicity and photoperiodism in mammals. Perinatology Press, IHTAKA, New York , 65(4), (pp.31, 144). Weissbluth, M. & Weissbluth L. (1992). Colic, sleep inertia, melatonin and circannual rhythms, Medical Hypotheses, 38, Yoon, I. Y. Kripke, D.F. Youngstedt, S.D. et al. (2003). Actigraphy suggests age-related differences in napping and nocturnal sleep, European Sleep Research Society, Journal of Sleep Research, 12, htm [ ] J. Jpn. Acad. Midwif., Vol. 22, No. 2,

32-1_会告.indd

32-1_会告.indd 原著 Relationship between Urinary Incontinence and Childbirth Among Women who Have Given Birth within the Last Three Years The Role of Midwives in the Prevention and Improvement of Urinary Incontinence