School of Nursing and Social Services, Health Sciences University of Hokkaido
Abstract
本研究の目的は,認知症高齢者の睡眠・覚醒状態の測定方法を検討することである.対象は,施設療養する中等症から重症の認知症高齢者10人のうち,アクチグラフ装着が継続困難な対象を除いた6人である.方法は,睡眠・覚醒観察法(30分と60分間隔)とアクチグラフによる連続3日間の同時測定を実施し,「一日の総睡眠時間」「夜間睡眠時間」「夜間睡眠率」「夜間中途覚醒回数」について比較分析した.結果,睡眠・覚醒観察法は,観察間隔よりも短い間隔で中途覚醒が起こる時や,臥床開眼状態で身体の動きや寝息がない時に睡眠・覚醒の判別を誤る可能性が示された.アクチグラムは不随意な動きや掻く,寝具をまさぐる動きを「覚醒」,身体活動性が著しく低いと「睡眠」と判別しやすい傾向にあった.以上より,認知症高齢者の睡眠・覚醒状態の把握にあたっては,身体活動性や不随意運動,睡眠の断片化の程度を考慮し測定用具を選択していく必要性が示された.This study investigated the assessment method of sleep-awake patterns of elderly with dementia. Ten elderly people in the level of moderate to severe dementia residing at a long-term care unit were recruited for subjects, and six of them were selected based on their capability of wearing actigraphs. The total sleep time, nighttime sleep time, nighttime sleeping ratio, and frequency of nighttime awakening were investigated for three days in a row, and comparative analyses were carried out. The result suggested possibility of observational method for making wrong assessment when subjects were staying in bed quietly with their eyes close, or when subjects\u27 awakening patterns were shorter than observational intervals. It was also found that actigraphs tend to detect involuntary movement such as scratching or fumbling blankets as awakening, and static activity as sleeping. It was suggested that subjects\u27 physical activity, involuntary movement, and sleeping fragmentation were needed to be concerned for selecting a method of assessing sleep-awake patterns among elderly with dementia
