0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100%
(%) 80 60 40 20 0 1.1 0.7 71.1 54.1 ~21:00 21:00 ~21:30 2*** 32.6 22.8 22:00 ~22:30 8.9 3.4 1.6 3.7 23:00 ~23:30 24:00~ (%) 60 40 20 0 0.5 0.3 53.2 39.5 ~21:00 21:00 ~21:30 4*** 45.1 39.1 22:00 ~22:30 11.9 6.5 23:00 ~23:30 0.7 3.2 24:00~ (%) 60 40 20 0 0.3 0.1 20.4 13.3 ~21:00 21:00 ~21:30 6*** 51.6 45.6 22:00 ~22:30 29.8 22.1 23:00 ~23:30 5.6 11.1 24:00~
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
() 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 = 0.44 2 Post Self: d = 0.08 2 Post () 520 510 500 490 480 ** Pre Self: d = 0.35 2 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 1714 2 10
(%) 60 40 20 0 Pretreatment Sleep education Control * (%) 85 75 65 55 45 Post-treatment 2 Sleep education Control * * Pretreatment Post-treatment 2 (%) 100 80 60 40 20 0 Sleep education Control ** *** Pretreatment Post-treatment 2 (%) 80 60 40 20 0 ** 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
β β β -.396***.268* -.298**.240* R ( Adjusted R 2 ).529 (.298)***.446 (.161)*** -.250*.393*** -.207.218 -.363** R ( Adjusted R 2 ) ** p <.01, * p <.05, p <.1 -.244*.485 (.199)***.286*.363 (.118)***.446 (.161)*** β β.243*.238*.231* R ( Adjusted R 2 ).337 (.087)**.202.325 (.079)** * p <.05, p <.1
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 2013 1e.g. Tan et al. BMC Pediatrics 2012 2
2229 1 n=118 B 100 100 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
(National Sleep Foundation. 2006 ; 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 ) 1. 2. 3. 4. 5. () 6. 7. 8. 9. 10.
*** 16 15 14 13 12 18 d = 2.37 a 17 *** *** a =, b= b d = 0.62 *** p <.001, 2-way rep ANOVA
1. 70.3 100 93.2 29.0 *** 16.5 *** 7.0 * 2. 54.2 92.2 83.5 33.1 *** 16.4 *** 3.9 * 3. 78.8 95.1 92.2 8.9 ** 5.8 * 0.7 4. 57.6 99.0 96.1 40.0 *** 32.6 *** 4.0 5. 86.4 99.0 93.2 10.3 ** 2.3 4.5 6. 24.6 95.1 84.6 69.1 *** 50.2 *** 12.3 *** 7. 91.5 100 97.1 8.0 ** 2.8 3.0 8. 66.1 98.1 97.1 27.3 *** 26.3 *** 0.2 9. 10.2 100 87.4 89.0 *** 76.0 *** 13.0 *** 10. 77.1 86.4 88.3 2.4 4.8 * 0.2 23:22 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
90 85 80 75 70 65 d = 0.65 * 500 480 460 440 420 400 380 d = 0.51 *** *** p<.001, * p<.05; 2-way rep ANOVA 90 85 80 75 70 65 85 * 80 75 70 65 d = 0.19 * * p <.05; McNemar * p<.05; 2-way rep ANOVA
60 40 50.0 *** (National Sleep Foundation: NSF, 2006) 20 0 32.2 *** p<.001; McNemar NSF t χ 2 n =118 n =111 6.47 (49.2) 6.23 (45.0) 14.15 (3.13) 14.17 (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. 0.06 n.s. 0.08 n.s. 0.73 n.s. 0.64 n.s. 0.10 n.s. 1.30 n.s. 0.03 n.s. 0.02 n.s. 0.13 n.s. 1.10 n.s. Mean (SD)
1. 63.6 27.1 9.3 17.3** 2 83.1 11.9 5.1 2. 39.0 50.0 11.0 8.5* 2 53.1 38.1 8.5 3. 80.7 15.1 4.2 6.3 2 87.4 9.2 3.4 4. 52.1 37.0 10.9 13.4** 2 68.9 27.7 3.4 5. 44.9 33.9 21.2 6.4 2 56.8 28.0 15.3 6. 61.0 33.9 5.1 6.5 2 72.9 23.7 3.4 7. 37.3 40.7 22.0 1.5 2 39.8 41.5 18.6 8. 0 70.3 24.6 5.1 13.8** 2 84.7 13.6 1.7 9. 42.4 53.4 4.2 14.5** 2 62.7 33.1 4.2 10. 35.6 44.1 20.3 29.6*** 2 2 68.6 23.7 7.6
Up
() 24 6 12 18 24 6 12 18 24 () 10 10
1 2 1 2 3 0.405 0.346 0.522 4 5 6 6 7 80 8 9 4 5 7 9 0.510 0.387 0.475 0.362 0.793 0.390 0.421 10 10 2 d
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 1 3 21 2 20 明らかな変化がみられた項目 3 2 19 18 4 5 1 17 6 0 16 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 15 8 14 悩み事しない 9 13 10 12 11 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
25 24 1 47 48
2014828 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: 131-136.
HDL Kaneita, Y., Uchiyama, M., Yoshiike, N., and Ohida, T. Associations of Usual Sleep Duration with Serum Lipid and Lipoprotein Levels. Sleep, 31, 5, 645-652. 7 (Fukuda & Hozumi, 1987) 8 8
y = -45.082x + 64.236 r = -0.589 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, 683-689. Fukuda, K. and Hozumi, N. A case of school refusal: rest-activity cycle and filial violence. Psychological Reports, 1987, 60, 683-689. 24 24
absence period since the onset of school refusal 300 250 200 150 100 50 0 142 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, 207-208. 100% 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
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, 478-485.
724 1 6 (Fukuda & Ishihara, 1997) Pattern A, Full Term Infant Pattern A, Preterm Infant Autocorrelation Autocorrelation 1.00 0.00-1.00-1.00 0 6 12 18 30 36 42 48 0 6 12 18 30 36 42 48 Lag in Hours Lag in Hours A24 1.00 0.00 Pattern B, Full Term Infant Autocorrelation 1.00 0.00 Pattern B, Preterm Infant -1.00-1.00 0 6 12 18 24 30 36 42 48 0 6 12 18 24 30 36 42 48 Lag in Hours Lag in Hours B 24 Pattern C, Preterm Infant Pattern C, Full Term Infant Autocorrelation 1.00 0.00 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, 59-65. 1.00 1.00 Autocorrelation 0.00 Autocorrelation 0.00-1.00-1.00 0 6 12 18 24 30 36 42 48 0 6 12 18 24 30 36 42 48 Lag in Hours Lag in Hours C
National Sleep Foundation Final report of 2004 sleep in America poll. http://www.sleepfoundation.org/site/c.huixkjm0ixf/b.2419041/k.1302/2004_sleep_in_america_poll.htm
36 1995 ActiWatch 16