icon fsr

雑誌詳細

文献概要

特集 高齢者のメンタルヘルス

高齢者における睡眠の問題とメンタルヘルス

著者: 金野倫子1

所属機関: 1埼玉県立大学保健医療福祉学部共通教育科

ページ範囲:P.11 - P.21

はじめに
 睡眠の問題は加齢に伴って増加することはよく知られている。わが国における2000年代の調査では,基本的には健康だが睡眠の量や質に何らかの問題を抱える人の割合は,60歳以上では約30%(29.5%)で,他の年代,たとえば40〜50歳台の18.9%と比べても約1.5倍となっている22)。このような傾向は諸外国の報告においても認められる23)
 一方,睡眠の問題は年代を通じて本人の生活の質(quality of life:QOL)を大きく低下させることが示されてきたが,近年ではさまざまな身体疾患,精神疾患のリスクを高めることが相次いで報告されている。さらに最近では,身体疾患,精神疾患の病理と不眠の間には双方向性の関係がみられるという報告も増加している。
 本稿では,高齢者の不眠についてその特徴を整理し,他の疾患リスク,特に精神疾患のリスクとの関係について,これまでの報告を展望する。次に高齢者の不眠に対して治療的介入をする場合に留意しておきたい点について解説する。また,本稿では「睡眠の問題」,「不眠」を睡眠に関する自覚的訴え全般として,実際に診断される「不眠症」やその他の「睡眠障害」と区別して用いる。

参考文献

1)Ancoli-Israel S, Kripke DF, Klauber MR, et al:Sleep-disordered breathing in community-dwelling elderly. Sleep 14:486-495, 1991
2)Asada T, Motonaga T, Yamagata Z, et al:Associations between retrospectively recalled napping behavior and later development of Alzheimer's disease:association with APOE genotypes. Sleep 23:629-634, 2000
3)Billioti de Gage S, Bégaud B, Bazin F, et al:Benzodiazepine use and risk of dementia:prospective population based study. BMJ 345:e6231, 2012
4)Billioti de Gage S, Moride Y, Ducruet T, et al:Benzodiazepine use and risk of Alzheimer's disease:case-control study. BMJ 349:g5205, 2014
5)Blackwell T, Yaffe K, Ancoli-Israel S, et al:Poor sleep is associated with impaired cognitive function in older women:the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 61:405-410, 2006
6)Boot BP, Boeve BF, Roberts RO, et al:Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease:a population-based study. Ann Neurol 71:49-56, 2012
7)Brenes GA, Miller ME, Stanley MA, et al:Insomnia in older adults with generalized anxiety disorder. Am J Geriatr Psychiatry 17:465-472, 2009
8)Chang PP, Ford DE, Mead LA, et al:Insomnia in young men and subsequent depression:The Johns Hopkins precursors study. Am J Epidemiology 146:105-114, 1997
9)Cole MG, Dendukuri N:Risk factors for depression among elderly community subjects:a systematic review and meta-analysis. Am J Psychiatry 160:1147-1156, 2003
10)Ettensohn M, Soto Y, Bassi B, et al:Sleep problems and disorders in patients with depression. Psychiatric Annals 46:390-395, 2016
11)Fortier-Brochu E, Beaulieu-Bonneau S, Ivers H, et al:Insomnia and daytime cognitive performance:a meta-analysis. Sleep Med Rev 16:83-94, 2012
12)Foster RG, Roenneberg T:Human responses to the geophysical daily, annual and lunar cycles. Curr Biol 18:R784-R794, 2008
13)Franzen PL, Buysse DJ:Sleep disturbances and depression:risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci 10:473-481, 2008
14)Gray SL, Dublin S, Yu O, et al:Benzodiazepine use and risk of incident dementia or cognitive decline:prospective population based study. BMJ 352:i90, 2016
15)Hatta K, Kishi Y, Wada K, et al:Preventive effects of ramelteon on delirium:a randomized placebo-controlled trial. JAMA Psychiatry 71:397-403, 2014
16)HitaYañez E, Atienza M, Cantero JL:Polysomnographic and subjective sleep markers of mild cognitive impairment. Sleep 36:1327-1334, 2013
17)Hood S, Amir S:The aging clock:circadian rhythms and later life. J Clin Invest 127:437-446 2017
18)Huang Y, Potter R, Sigurdson W, et al:Effects of age and amyloid deposition on Aß dynamics in the human central nervous system. Arch Neurol 69:51-58, 2012
19)Imfeld P, Bodmer M, Jick SS, et al:Benzodiazepine use and risk of developing Alzheimer's disease or vascular dementia:A case-control analysis. Drug Saf 38:909-919, 2015
20)Jaussent I, Bouyer J, Ancelin ML, et al:Insomnia and daytime sleepiness are risk factors for depressive symptoms in the elderly. Sleep 34:1103-1110, 2011
21)Kang JE, Lim MM, Bateman RJ, et al:Amyloid-ßdynamics are regulated by orexin and the sleep-wake cycle. Science 326:1005-1007, 2009
22)Kim K, Uchiyama M, Okawa M, et al:An epidemiological study of insomnia among the Japanese general population. Sleep 23:41-47, 2000
23)Kim KW, Kang SH, Yoon I et al:Prevalence and clinical characteristics of insomnia and its subtypes in the Korean elderly. Arch Gerontol Geriatr 68:68-75, 2017
24)Laborde-Lahoz P, El-Gabalawy R, Kinley J, et al:Subsyndromal depression among older adults in the USA:prevalence, comorbidity, and risk for new-onset psychiatric disorders in late life. Int J Geriatr Psychiatry 30:677-685, 2015
25)Lim AS, Kowgier M, Yu L, et al:Sleep fragmentation and the risk of incident Alzheimer's disease and cognitive decline in older persons. Sleep 36:1027-1032, 2013
26)Manber R, Edinger JD, Gress JL, et al:Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid MDD and insomnia. Sleep 31:489-495, 2008
27)Mishima K, Okawa M, Shimizu T, et al:Diminished melatonin secretion in the elderly caused by insufficient environmental illumination. J Clin Endocrinol Metab 86:129-134, 2001
28)Neerland BE, Krogseth M, Juliebø V, et al:Perioperative hemodynamics and risk for delirium and new onset dementia in hip fracture patients:A prospective follow-up study. PLoS One 12:e0180641, 2017
29)Ohayon MM, Carskadon MA, Guilleminault C, et al:Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals:developing normative sleep values across the human lifespan. Sleep 27:1255-1273, 2004
30)岡村毅,井藤佳恵,金野倫子,他:地域在住高齢者の日中の眠気.日本公衆衛生雑誌 59:675-683, 2012
31)Picchietti DL, Van Den Eeden SK, Inoue Y, et al:Achievements, challenges, and future perspectives of epidemiologic research in restless legs syndrome(RLS). Sleep Med 31:3-9, 2017
32)Reeve S, Sheaves B, Freeman D:The role of sleep dysfunction in the occurrence of delusions and hallucinations:a systematic review. Clin Psychol Rev 42:96-115, 2014
33)Rodriguez-Vazquez J, Camacho-Arroyo I, Velazquez-Moctezuma J:Differential impact of REM sleep deprivation on cytoskeletal proteins of brain regions involved in sleep regulation. Neuro psychobiology 65:161-167, 2012
34)Sánchez AI, Buela-Casal G, Berm\u000000fadez MP, et al:The effects of continuous positive air pressure treatment on anxiety and depression levels in apnea patients. Psychiatry Clin Neurosci 55:641-646, 2001
35)Sindi S, Kaåreholt I, Johansson L, et al:Sleep disturbances and dementia risk:A multicenter study. Alzheimers Dement 14:1235-1242, 2018
36)Thase ME:Depression, sleep, and antidepressants. J Clin Psychiatry 59(suppl 4):55-65, 1998
37)Tsapanou A, Gu Y, Manly J, et al:Daytime sleepiness and sleep inadequacy as risk factors for dementia. Dement Geriatr Cogn Dis Extra 5:286-295, 2015
38)Yaffe K, Laffan AM, Harrison SL, et al:Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 306:613-619, 2011
39)Zhai L, Zhang H, Zhang D:Sleep duration and depression among adults:a meta-analysis of prospective studies. Depress Anxiety 32:664-670, 2015

掲載雑誌情報

出版社:株式会社医学書院

電子版ISSN:1882-126X

印刷版ISSN:0488-1281

雑誌購入ページに移動
icon up
あなたは医療従事者ですか?