Language：English   Publishing type：Research paper (scientific journal)  

Children are increasingly exposed to electronic media, which can potentially influence their sleep habits. However, few studies have investigated the effects of children's life patterns on sleep habits and electronic media usage. This study investigated the differences in sleep habits and electronic media usage between 18- and 42-month-old children attending nursery schools, kindergartens, or staying at home, and respectively enrolled 183 (boys, n = 93; girls, n = 90) and 215 (boys, n = 104; girls, n = 111) 18- and 42-month-old children who underwent health check-ups. We found that 18-month-old children attending nursery school had significantly earlier wake times on weekdays and shorter sleep durations on weekends than children who stayed at home despite no differences in electronic media usage. There were no differences in sleep duration among 42-month-old children attending nursery schools, kindergartens, or staying at home; however, kindergarteners demonstrated a higher use of portable and home video games. Different life patterns affect electronic media usage in preschool children, especially those attending kindergarten. Particular attention should be paid to the higher usage of electronic media devices by kindergarteners, although they had the same sleep duration, as did other preschool children.

DOI： 10.3390/ijerph17145189

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study examined the association between sleep habits and problems and Internet addiction in adolescents. METHODS: Junior high school students from a local town in Japan (n=853; male/female, 425/428) were the subjects of this study, and were assessed for severity of Internet addiction and sleep habits and problems using the self-reported version of the Young's Internet Addiction Test (IAT) and Child and Adolescent Sleep Checklist (CASC). RESULTS: The wake time on weekdays was not significantly different among the three groups; addicted, possibly-addicted, and non-addicted. In the addicted group, the total night sleep time was significantly shorter, and the bedtime was significantly delayed on both weekdays and weekends compared with those in the possibly-addicted and non-addicted groups. The wake time of the addicted group was significantly later than that of the other groups. The total scores of sleep problems measured by the CASC were significantly higher in the addicted and possibly-addicted groups than in the non-addicted group. CONCLUSION: Internet addiction is strongly associated with sleep habits and problems in adolescents. These findings suggest that internet addiction should be considered while examining adolescent lifestyle.

DOI： 10.30773/pi.2019.03.21.2

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OBJECTIVES: Preeclampsia (PE) is the 2nd leading cause of maternal mortality in developing countries. Maternal deaths caused by PE mainly result from eclampsia. The aim of this study was to survey the current status of PE at a local hospital in Zambia and identify preventive measures against eclampsia. STUDY DESIGN: The obstetric data of normal pregnant women and patients complicated with gestational hypertension (GH), PE, and eclampsia in 2017 at Zimba Mission Hospital, Zambia were collected from admission and delivery registries and analyzed. MAIN OUTCOME MEASURES: The mode of delivery, maternal and perinatal mortality. RESULTS: Among 1704 deliveries, 42 women (2.5%) were complicated with hypertensive disorders of pregnancy (HDP) (GH: 17, PE: 25). There were 2 stillbirths and 1 neonatal death in PE. Magnesium sulfate (MgSO4) was administered to severe PE patients (11 cases) based on the Pritchard regimen for a resource poor setting. No eclampsia happened after starting MgSO4. All eclampsia (8 cases) happened out of hospital at the gestational age of 35-40 weeks. All the eclamptic patients were primigravidae aged 15-23 years old. MgSO4 injection was started on admission. Cesarean section was performed in 7 cases. All the patients of PE including eclampsia were discharged without any sequelae. CONCLUSION: The Pritchard regimen is considered to be suitable in the setting. However, the morbidity of eclampsia was high out of hospital. We have to educate pregnant women about the risks of PE and encourage the measurement of blood pressure at health facilities.

DOI： 10.1016/j.preghy.2019.05.008

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Publishing type：Research paper (scientific journal)  

© 2019 Objectives: Preeclampsia (PE)is the 2nd leading cause of maternal mortality in developing countries. Maternal deaths caused by PE mainly result from eclampsia. The aim of this study was to survey the current status of PE at a local hospital in Zambia and identify preventive measures against eclampsia. Study design: The obstetric data of normal pregnant women and patients complicated with gestational hypertension (GH), PE, and eclampsia in 2017 at Zimba Mission Hospital, Zambia were collected from admission and delivery registries and analyzed. Main outcome measures: The mode of delivery, maternal and perinatal mortality. Results: Among 1704 deliveries, 42 women (2.5%)were complicated with hypertensive disorders of pregnancy (HDP)(GH: 17, PE: 25). There were 2 stillbirths and 1 neonatal death in PE. Magnesium sulfate (MgSO4)was administered to severe PE patients (11 cases)based on the Pritchard regimen for a resource poor setting. No eclampsia happened after starting MgSO4. All eclampsia (8 cases)happened out of hospital at the gestational age of 35–40 weeks. All the eclamptic patients were primigravidae aged 15–23 years old. MgSO4 injection was started on admission. Cesarean section was performed in 7 cases. All the patients of PE including eclampsia were discharged without any sequelae. Conclusion: The Pritchard regimen is considered to be suitable in the setting. However, the morbidity of eclampsia was high out of hospital. We have to educate pregnant women about the risks of PE and encourage the measurement of blood pressure at health facilities.

DOI： 10.1016/j.preghy.2019.05.008

Scopus

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Publishing type：Research paper (scientific journal)  

© 2019 The Author(s). Background: Globally, 2.6 million stillbirths occur every year. Of these, 98% occur in developing countries. According to the United Nations Children's Fund, the neonatal mortality rate in Zambia in 2014 was 2.4%. In 2016, the World Health Organization released the International Classification of Diseases - Perinatal Mortality (ICD-PM) as a globally applicable and comparable system for the classification of the causes of perinatal deaths. However, data for developing countries are scarce. The aim of this study was to evaluate the rates and causes of stillbirths and neonatal deaths at a local hospital in Zimba, Zambia to identify opportunities for preventive interventions. Methods: All cases of stillbirths and neonatal deaths at Zimba Mission Hospital in Zambia in 2017 were included in this study. Outborn neonates who were transferred to the hospital and later died were also included in the study. Causes of stillbirths and neonatal deaths were analyzed and classified according to ICD-PM. Results: In total, 1754 babies were born via 1704 deliveries at the hospital, and 28 neonates were transferred to the hospital after birth. The total number of perinatal deaths was 75 (4.2%), with 7 deaths in the antepartum, 25 deaths in the intrapartum, and 43 deaths in the neonatal period. Most antepartum deaths (n = 5; 71.4%) were classified as fetal deaths of unspecified causes. Intrapartum deaths were due to acute intrapartum events (n = 21; 84.0%) or malformations, deformations, or chromosomal abnormalities (n = 4; 16.0%). Neonatal deaths were related primarily to complications from intrapartum events (n = 19; 44.2%); low birth weight or prematurity (n = 16; 37.2%); or infection (n = 3; 7.0%). Conclusions: Perinatal deaths were associated with acute intrapartum events and considered preventable in 40 cases (53.3%). Effective interventions to prevent perinatal deaths are needed.

DOI： 10.1186/s12884-019-2231-9

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Globally, 2.6 million stillbirths occur every year. Of these, 98% occur in developing countries. According to the United Nations Children's Fund, the neonatal mortality rate in Zambia in 2014 was 2.4%. In 2016, the World Health Organization released the International Classification of Diseases - Perinatal Mortality (ICD-PM) as a globally applicable and comparable system for the classification of the causes of perinatal deaths. However, data for developing countries are scarce. The aim of this study was to evaluate the rates and causes of stillbirths and neonatal deaths at a local hospital in Zimba, Zambia to identify opportunities for preventive interventions. METHODS: All cases of stillbirths and neonatal deaths at Zimba Mission Hospital in Zambia in 2017 were included in this study. Outborn neonates who were transferred to the hospital and later died were also included in the study. Causes of stillbirths and neonatal deaths were analyzed and classified according to ICD-PM. RESULTS: In total, 1754 babies were born via 1704 deliveries at the hospital, and 28 neonates were transferred to the hospital after birth. The total number of perinatal deaths was 75 (4.2%), with 7 deaths in the antepartum, 25 deaths in the intrapartum, and 43 deaths in the neonatal period. Most antepartum deaths (n = 5; 71.4%) were classified as fetal deaths of unspecified causes. Intrapartum deaths were due to acute intrapartum events (n = 21; 84.0%) or malformations, deformations, or chromosomal abnormalities (n = 4; 16.0%). Neonatal deaths were related primarily to complications from intrapartum events (n = 19; 44.2%); low birth weight or prematurity (n = 16; 37.2%); or infection (n = 3; 7.0%). CONCLUSIONS: Perinatal deaths were associated with acute intrapartum events and considered preventable in 40 cases (53.3%). Effective interventions to prevent perinatal deaths are needed.

DOI： 10.1186/s12884-019-2231-9

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Language：Japanese   Publisher：(株)ニュー・サイエンス社  

認知症においては、周辺症状としての睡眠障害が高頻度にみられる。睡眠覚醒調節機構の障害に加え、感覚器からの入力低下、社会的活動の減少も加わり、睡眠障害を生じやすい。概日リズムと深く関連するメラトニンは、認知症患者においては分泌ピークが偏移し、振幅も低下している。睡眠障害への対応としては、光環境を調節し、日中の活動性を高めるといった非薬物的アプローチが治療の基本となる。薬物治療も行われるが、十分なエビデンスが得られていないものも多い。認知症患者の睡眠の改善は、認知症のマネジメントの上でも重要である。(著者抄録)

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BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention and hyperactivity/impulsivity, and is often treated pharmacologically. It is necessary to use both subjective and objective assessments to diagnose and determine the efficacy of pharmacological treatment in children with ADHD, but cognitive assessment tools for ADHD are scarce. We examined a computer-administered, brief, and repeatable cognitive assessment tool: CogHealth. The aims of this study were to use the CogHealth battery, an objective assessment tool, to compare cognitive function between children with ADHD or ADHD + autism spectrum disorder (ASD) and healthy children and to assess improvements in cognitive function following pharmacological treatment. METHODS: We measured the cognitive function of nine children with ADHD or ADHD + ASD using CogHealth and compared the results with those of 33 age-matched children from the community. Cognitive function comparisons were made before and after psychostimulant treatment with methylphenidate. RESULTS: We detected significant cognitive abnormalities in the children with ADHD, compared with the control subjects. The children with pre-treatment ADHD had significantly more errors on the detection task (DT), and more anticipatory errors in the one card learning task, compared with control children. The children with ADHD significantly improved their accuracy on the one back test (OBT), and had significantly fewer errors, anticipatory errors, and shorter reaction times after osmotic-release oral system methylphenidate treatment. CONCLUSION: The DT is a useful neurocognitive function assessment for children with ADHD, and the OBT can measure pharmacological treatment effectiveness in children with ADHD.

DOI： 10.1111/ped.13662

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Language：Japanese   Publisher：(株)東京医学社  

・ナルコレプシーは日中の過度の眠気を生じる中枢性過眠症の代表的疾患である。・青年期に発症することが多く、授業中の居眠りなどで学校生活にも支障をきたすが、早期に診断・治療されていないケースも多い。・日中の眠気は、業務や社会生活上の支障も大きく、運転中の眠気は居眠り運転事故の原因ともなる。・情動脱力発作を伴う中核群では、中枢のオレキシン欠乏が主たる病態である。・臨床的診断には終夜睡眠ポリグラフィによる睡眠の評価と、反復睡眠潜時検査による眠気とREM関連病態の評価が必要である。・日中の眠気や脱力発作は、薬物治療により改善するが、良好な治療効果を得るためには、睡眠時間の確保を含めた睡眠衛生指導も必要である。(著者抄録)

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Language：Japanese   Publisher：(一社)日本外来小児科学会  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本助産学会  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

高齢者においては、身体機能の低下や併存する疾患により、転倒・骨折を起こしやすい状態にある。睡眠と関連する転倒・骨折を予防する上では、(1)睡眠時に高まる転倒・骨折リスクの防止、(2)睡眠薬などによる転倒リスクの防止、(3)夜間の睡眠の改善による転倒の予防といった側面から考える必要がある。また、睡眠に関連する転倒・骨折を起こす場所は自宅に限らず、入院時の病棟や介護施設なども含まれる。高齢者の生活・ケアに関わるすべての人が、高齢者の睡眠管理に留意する必要がある。(著者抄録)

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Publishing type：Research paper (scientific journal)  

CiNii Research

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Other Link： https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-15K11741/

Language：Japanese   Publisher：(株)ライフ・サイエンス  

レストレスレッグス症候群(Restless Legs Syndrome:RLS)の治療においては、ドパミン作動性薬剤(レボドパおよびドパミンアゴニスト:DA)の長期投与を行った結果、治療開始前よりも症状の増悪や発現時刻の前進を生じる「オーグメンテーション」が発現することがあり、日本人においてもその頻度は稀ではないと報告されている。欧米におけるオーグメンテーションの治療アルゴリズムでは、オーグメンテーションの発現リスクが低いα2δリガンドをRLSのファーストラインに使用することが推奨されている。欧米と治療実態は異なるが、日本においてもRLSの診療にあたってはオーグメンテーションの発現を念頭におき、「DAの使用は低用量で抑える」、「症状が増悪した場合はオーグメンテーションを疑う」、「効果を維持しながらオーグメンテーションの発現を予防する薬剤選択を行う」といった治療上の認識を強化することが必要である。比較的低用量のDAで治療していたにもかかわらず症状の悪化がみられた場合に、DAの増量で対処しようとすると、さらに増悪する場合がある。長時間作用型DAへの変更、リボトリールやガバペンチンエナカルビル、オピオイドの併用などが考えられるが、その選択と用量設定は容易ではないので、このような場合にはできるだけ早く専門医へ紹介することが望ましい。(著者抄録)

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Language：Japanese   Publisher：(株)南江堂  

不眠の背景には,睡眠習慣の問題が関連している場合も多い.睡眠衛生指導は,良質な睡眠をとるうえで好ましくない睡眠習慣についての知識をもち,生活を改善するための指導方法である.快適な睡眠環境の確保や,就床前の嗜好品の摂取(カフェイン,飲酒,喫煙)を避けることを指導する.就床,起床時刻のばらつきや,睡眠時間帯のずれ(後退あるいは前進),長時間の昼寝(午睡)も不眠の原因となる.睡眠覚醒のメカニズムを理解することは,睡眠衛生指導の内容をより明快にし,患者への説得力を増すうえでも有用である.(著者抄録)

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01647&link_issn=&doc_id=20180112110003&doc_link_id=%2Fet9child%2F2017%2F005805%2F004%2F0618-0623%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fet9child%2F2017%2F005805%2F004%2F0618-0623%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01647&link_issn=&doc_id=20180112110011&doc_link_id=%2Fet9child%2F2017%2F005805%2F014%2F0663-0668%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fet9child%2F2017%2F005805%2F014%2F0663-0668%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT, INC  

Objectives: Suvorexant is the first dual orexin receptor antagonist for treating insomnia. This study aimed to evaluate the tolerability, efficacy, and safety of suvorexant on insomnia in adolescents. Methods: Thirty patients (8 male and 22 female; mean standard deviation age: 15.72.4 years; range: 10-20) with insomnia were administered suvorexant. Clinical background, persistence rate, the Clinical Global Impression (CGI), and the Athens Insomnia Scale (AIS) were compared between patients who continued and discontinued suvorexant treatment. Results: Seventeen patients (56.7%) successfully continued taking suvorexant. Among the 13 patients who did not continue treatment, 5 patients were lost to follow-up. Of the remaining eight who did not continue treatment, four decided to discontinue of their own accord, two decided to discontinue due to lack of effectiveness, and two decided to discontinue due to adverse reaction, namely abnormal dreams. Among patients who completed the study, CGI significantly decreased from 3.6 +/- 0.8 to 3.1 +/- 0.9 (p=0.014). The score of sleep quality in AIS was significantly higher among the patients who discontinued suvorexant than those who continued suvorexant (p=0.02). Conclusion: Our results indicate that suvorexant could be considered a treatment option for adolescents.

DOI： 10.1089/cap.2016.0206

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Language：Japanese   Publisher：(株)三原医学社  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

【目的】インターネットは急速に普及し,生活に必要不可欠なものとなりつつある一方,インターネット使用の制御が困難となるインターネット依存が社会的問題になっている.本研究では,中学生におけるインターネット依存の有病率を調査し,インターネット依存と精神的問題の関連および要因の特定を目的とした.【方法】12〜15歳の中学生874名を対象に,インターネット依存度テスト(IAT),日本語版精神健康調査質問紙短縮版30項目(GHQ)に加え,電子機器の使用状況に関する質問紙を行った.【結果】中学生853名(回収率97.6%,男子425名,女子428名)から回答を得た.IATの平均総得点は32.4±13.6(男子31.4±13.2,女子33.3±13.9)であった.IATの重症度分類では,addictedが2.0%(男子2.1%,女子1.9%),possibly-addictedが21.7%(男子19.8%,女子23.6%)であった.IATの得点に影響する因子は,学年(P=0.001)とGHQ総得点(P<0.001)が有意であった.GHQの平均総得点は,addictedが12.9±7.4,possibly-addictedが8.8±6.0,non-addictedが4.3±4.6であり,依存傾向があるaddictedおよびpossibly-addictedはnon-addictedより有意に得点が高く,問題を抱えた生徒の割合が多かった.また,スマートフォンを自由に使用できることがインターネット依存と関連があった.【考察】インターネット依存の有病率は,possibly-addictedを含め中学生の23.7%にみられ,精神的問題との関連が考えられた.インターネットの適切な利用に関して,保護者,教育機関,医療機関がそれぞれ注意する必要がある.(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00755&link_issn=&doc_id=20171010080001&doc_link_id=vol%3D119%26year%3D2017%26mag%3D0%26number%3D9%26start%3D613&url=https%3A%2F%2Fjournal.jspn.or.jp%2FDisp%3Fstyle%3Dabst%26vol%3D119%26year%3D2017%26mag%3D0%26number%3D9%26start%3D613&type=%90%B8%90_%90_%8Co%8Aw%8EG%8E%8F&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00022_2.gif

Language：Japanese   Publisher：(株)日本助産師会出版  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03787&link_issn=&doc_id=20170808410006&doc_link_id=1701333&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1701333&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publisher：(一社)日本助産学会  

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Language：Japanese   Publisher：(株)医薬ジャーナル社  

小児の健全な発達において睡眠は重要な役割を果たしており,睡眠障害や睡眠不足は,児のパフォーマンスにも影響する。睡眠障害には,小児期に多く見られる疾患や,成人とは異なる特徴を有する疾患があり,小児の睡眠障害を診療する施設が少ないこともあり,見過ごされている場合も多い。また情報通信機器が普及した現代においては,これらとの関わり方が児の睡眠習慣に大きく影響し得ることから,子どもの健全な睡眠を確保する上で,医療・保健従事者の果たす役割は大きい。(著者抄録)

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Language：Japanese   Publisher：エーザイ(株)  

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Language：Japanese   Publisher：(株)ファルコバイオシステムズ  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

AHI measured using type-3 PM is a useful predictor of outcome following initial PVI in patients with paroxysmal AF.

DOI： 10.1007/s10840-016-0148-z

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BackgroundAutism spectrum disorders (ASD) are characterized by persistent deficits in social communication and social interaction across contexts, and are associated with restricted patterns of behavior. The developmental quotient (DQ) is based on the developmental age and chronological age of children. This study investigated the utility of the DQ to estimate cognitive ability in young children with ASD.
MethodsThe DQ and intelligence quotient (IQ) were assessed using the Kyoto Scale of Psychological Development 2001 (KSPD) and Wechsler Intelligence Scale for Children-III (WISC-III), respectively. The correlation between the DQ and IQ was then analyzed among children with ASD.
ResultsWe enrolled 18 children with ASD (16 boys, two girls; age, 63.6 9.4 months; age range, 45-83 months). Overall, Cognitive-Adaptive and Language-Social DQ scores were significantly correlated with IQ score in the full scale, verbal, and performance domains. Full-scale IQ and overall DQ had a linear correlation (y = -22.747 + 1.177x, R-2 = 0.677, R = 0.823).
ConclusionsThe DQ scores obtained using the KSPD were a reasonable estimate of cognitive ability in children with ASD. The KSPD may be a useful alternative to the WISC-III for young children with ASD and could facilitate earlier assessment.

DOI： 10.1111/ped.12969

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Language：Japanese   Publisher：(株)三原医学社  

2014年11月に、愛媛県伊予郡松前町内の公立中学校3校に在籍する生徒874名を対象に、地域の中学生においてインターネットの利用・依存が睡眠習慣に与える影響について調査し検討した。最終的な有効回答は853名(男子425名、女子428名、平均13.6±0.9歳)であった。IATスコアによる重症度分類では依存状態が2.0%、依存傾向が21.7%であった。重症が高い即ち依存傾向が強いほど、睡眠の問題が有意に多く、平日の睡眠時間・就寝時刻、休日の起床・就寝時刻に群間差を認め、インターネット依存と睡眠習慣・睡眠衛生への関与が示唆された。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

AimInternet addiction disrupts the daily lives of adolescents. We investigated the prevalence of Internet addiction in junior high school students, elucidated the relation between Internet addiction and mental states, and determined the factors associated with Internet addiction in adolescents.
MethodsJunior high school students (aged 12-15 years) were assessed using Young's Internet Addiction Test (IAT), the Japanese version of the General Health Questionnaire (GHQ), and a questionnaire on access to electronic devices.
ResultsBased on total IAT scores, 2.0% (male, 2.1%; female, 1.9%) and 21.7% (male, 19.8%; female, 23.6%) of the total 853 participants (response rate, 97.6%) were classified as addicted and possibly addicted, respectively. Total GHQ scores were significantly higher in the addicted (12.9 7.4) and possibly addicted groups (8.8 +/- 6.0) than in the non-addicted group (4.3 +/- 4.6; P < 0.001, both groups). A comparison of the percentage of students in the pathological range of GHQ scores revealed significantly higher scores in the possibly addicted group than in the non-addicted group. Further, accessibility to smartphones was significantly associated with Internet addiction.
ConclusionStudents in the addicted and possibly addicted groups were considered problematic' Internet users. Use of smartphones warrants special attention, being among the top factors contributing to Internet addiction.

DOI： 10.1111/pcn.12402

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Language：Japanese   Publisher：(株)先端医学社  

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Language：Japanese   Publisher：(一社)日本児童青年精神医学会  

本研究は、自閉スペクトラム症(Autism Spectrum Disorders:ASD)児の認知特性、特に視覚性注意機能の特徴をCog Health認知機能検査を用いて明らかにすることを目的とした。愛媛大学医学部附属病院精神科に外来受診中の7〜15歳のASD児37例と、7〜15歳の健常対象児131例を対象とした。ASD群にはCog Health認知機能評価の1ヵ月以内にWechsler Intelligence Scale for Children(WISC)を用いて知的水準を評価し、両群に対しCog Health認知機能検査を用いて注意機能およびワーキングメモリーの評価を行った。知的能力とCog Health各課題の正答率の関連については、遅延再生課題の正答率のみ知能指数と有意な関連があった。遅延再生を除いた各課題の誤回答数、見込み反応数、時間切れ反応数、正答率、反応速度の結果を比較したところ、注意分散課題において対照群に比べ、ASD群の見込み反応数が有意に低く、反応速度が有意に遅く、正答率が有意に高く、注意分散課題でのASD児の優位性が明らかとなった。ASD児の中枢統合性の障害や、視覚探索能力の高さ、字義通り性などの認知機能を反映している可能性が示された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J01647&link_issn=&doc_id=20170113280022&doc_link_id=10.20615%2Fjscap.57.4_618&url=https%3A%2F%2Fdoi.org%2F10.20615%2Fjscap.57.4_618&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(株)日本医事新報社  

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Language：Japanese   Publisher：(株)北隆館  

児童青年期の睡眠覚醒の問題は、精神機能・認知・行動に影響を及ぼす。睡眠の不足や睡眠障害は学校でのパフォーマンスに影響し、近年急速に普及しているインターネットは、依存の問題に加え、睡眠習慣を悪化させることによる影響も懸念される。睡眠の問題を早期に発見する簡便で有効な手法は確立されておらず、睡眠習慣への介入も有効ではあるものの、持続的な効果をえるためには更なる取り組みが必要である。(著者抄録)

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Backgrounds: Suicide is a leading cause of death in adolescence. Effective strategies are required to prevent suicide. We aimed to assess the prevalence of suicidal ideation in early teens and the relationship between family mental health and suicidal ideation of their child.
Methods: A population-based survey in a rural town included 185 junior high school students and their caregivers. Suicidal ideation and mental states were assessed with General Health Questionnaire (GHQ) and Profile of Mood States (POMS) form.
Results: Nineteen (10.3 %) students experienced suicidal ideation in the preceding weeks and had more mental health problems than students without suicidal ideation. Caregivers of students with suicidal ideation demonstrated significantly higher suicidal depression scores in GHQ. Multivariate logistic regression analysis revealed that suicidal depression of caregivers was the most important factor for suicidal ideation of students.
Conclusions: Suicidal ideation of children is associated with suicidal depression of their caregivers. For the prevention of suicide in adolescents, not only their own mental status but also that of caregivers should be taken into consideration.

DOI： 10.1186/s12888-016-0934-2

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Language：Japanese   Publisher：日本メディス(株)  

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Language：Japanese   Publisher：(株)日本医事新報社  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

神経発達障害,主に注意欠如・多動症(ADHD)や自閉スペクトラム症(ASD)に関連する睡眠障害には,生来性の睡眠の量や質の低下,睡眠覚醒リズムの構築異常,発達障害に並存する睡眠障害,発達障害の二次障害としての睡眠障害,二次障害の一症状としての睡眠障害,さらに発達障害の薬物治療に伴う睡眠障害があり多因子である.小児ADHDとの関連が深い睡眠障害としては,閉塞性睡眠時無呼吸症候群(OSAS)やレストレスレッグス症候群(RLS)が挙げられる.小児のOSASは低身長や認知機能・行動の問題,ADHD様症状や夜尿の遷延などの症状がみられる.アデノイド・扁桃腺肥大によるものが多く,外科的処置が第一選択となる場合が多い.ADHDとRLSでは共通して鉄欠乏やドパミン系の異常の関与が指摘され,合併頻度は予想以上に高い.RLSでは一般的に睡眠薬は無効であり,的確な診断が重要となる.小児ASDと関連の深い睡眠障害としては,不眠障害,睡眠時随伴症および概日リズム睡眠-覚醒障害などが挙げられる.発達障害児の不眠やリズム障害に対しては睡眠衛生指導や行動療法的介入が一般的であるが,薬物治療も必要となる場合がある.実臨床では眠気が目立ち,低覚醒状態ではないかと思われる発達障害児に遭遇する.発達障害児は過覚醒状態・低覚醒状態・混合状態であるとの説が存在し,今後発達障害と覚醒度との関連は注目すべきポイントである.ADHD治療薬である中枢神経刺激薬は不眠の原因ともなりうるが,逆にADHD症状の改善に伴い睡眠が改善するとの報告もある.一方,非中枢神経刺激薬は不眠を改善する場合があり,併存する睡眠の問題を考慮して診療する必要があるが,さらなる検討を要する.以上のように,睡眠障害が発達障害の症状を増幅している場合があり,睡眠障害の治療により発達障害の症状が軽減しうる可能性がある.睡眠障害をも念頭において,発達障害の日常診療を行う必要がある.(著者抄録)

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：(株)日本医事新報社  

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Language：Japanese   Publisher：(株)診断と治療社  

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Language：Japanese   Publisher：(一社)日本助産学会  

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Language：Japanese   Publisher：(一社)日本助産学会  

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Language：Japanese   Publisher：(株)日本助産師会出版  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J03787&link_issn=&doc_id=20160212330005&doc_link_id=1602112&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1602112&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publishing type：Research paper (scientific journal)  

Neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), are commonly associated with sleep disturbances. The etiology of sleep disorders is multifactorial, such as congenital vulnerability of the quality and quantity of sleep, congenital abnormality of the sleep-wake pattern, comorbid sleep problems with developmental disorders, and sleep disturbances associated with pharmacological treat- ment. Obstructive sleep apnea disorder (OSAS) and restless legs syndrome (RLS) are closely associated with ADHD. OSAS in children not only presents with symptoms of sleep distur- bances, but also with associated symptoms such as growth failure, neurocognitive and behav- ioral symptoms, ADHD-like symptoms, and enuresis. The first-line treatment is adenotonsillec- tomy. ADHD and RLS show high rates of comorbidity with common etiologies like iron defi- ciency and the alternation of dopamine transporter expression. Hypnotics are not effective for RLS, and a precise diagnosis is vital to treat RLS associated with ADHD. ASD is also associated with a high frequency of sleep disorders, especially insomnia, para- somnia, and sleep-wake disorders. The first strategy against sleep disturbances is behavioral intervention ; however, pharmacological treatment is sometimes needed. In clinical practice, excessive daytime sleepiness was reported in children with ADHD or ASD, which might lead to a deficit in alertness. Alertness deficits associated with neurodevel- opmental disorders remain uncertain, and so they should be assessed. The effect of stimulants on sleep in patients with ADHD differed among individuals, which might be the cause of insomnia and also treatment for ADHD and sleep hygiene. Non-stimu- lants are often effective for insomnia. Neurodevelopmental and sleep disorders are complex and bidirectional. Sleep disturbances should be taken into consideration in daily clinical practice.

PubMed

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)医学書院  

レストレス・レッグス症候群(RLS)患者98人(男性33人:女性65人,平均年齢63.6歳)を対象に,日中の精神症状の有無とその程度について調査を行った。各尺度の平均点数は,IRLS 16.4点,SDS 39.1点,HADS-A 5.6点,Apathy Scale 12.8点,PSQI 8.5点であり,軽度の抑うつと不安・焦燥が認められた。またRLSが重症であるほど夜間の睡眠障害だけでなく,日中の抑うつと不安・焦燥も重篤であるとの結果が得られた。RLS患者では日中に抑うつ,不安・焦燥を合併していることがあるため,これらの症状に注意をしながら診療にあたる必要がある。(著者抄録)

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2015359232

Language：Japanese   Publisher：(株)三原医学社  

2014年度に愛媛県久万高原町の全中学生を対象に、夏季休暇時期に生活習慣についてのワークブックを作成し、その取り組みおよび介入効果について検討した。夏季休暇開始1週間前に学校担任からワークブックを配布してもらい、配布日の夜から記入を開始し、夏季休暇終了後1週間目までの記入を依頼した。全中学生204名のうち、171名(中学1年生49名、中学2年生60名、中学3年生62名)からワークブックを回収することができた。ワークブックへの記入を実施した後のアンケート(有効回答137名)では、「頑張って取り組めた」15.3%、「まずまず取り組めた」42.3%、「あまり取り組めなかった」19.0%、との回答であった。睡眠改善の課題についての自覚的達成感について尋ねたところ、「達成できた」「やや達成できた」と、規則正しい生活の確立で72%、光環境の調整で52%、メディア環境の調整で53%が回答した。中学生自身が記入するワークブックは、睡眠改善などに有効なことが示唆された。

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Language：Japanese   Publisher：(株)星和書店  

睡眠障害に関連するDSM-IV-TRからDSM-5における最も大きな変化は、名称が睡眠障害から睡眠-覚醒障害に変わったことに加え、DSM-IV-TRで大別されていた原発性睡眠障害、I軸・II軸の障害に関連した睡眠障害、一般身体疾患に関連した睡眠障害が、DSM-5では症候に基づいて分類された点である。DSM-5の構成は、睡眠専門医が用いる睡眠障害国際分類(ICSD-3)と基本的には同じであり、不眠障害、過眠障害、ナルコレプシー、呼吸関連睡眠障害、概日リズム睡眠-覚醒障害、睡眠時随伴症に分類されている。本稿では、DSM-5で新たに病名に採用されたレストレスレッグス症候群と、睡眠時随伴症に新たに加えられたレム睡眠行動障害を中心に、睡眠-覚醒障害の治療について解説する。(著者抄録)

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)アークメディア  

2010年4月1日から2012年3月31日迄にA児童発達支援センターに通所した児童のうち、毎日(週5)通所しており、難聴児・肢体不自由児を除く91名(男児75名、女児16名)を対象に、児童の養育者および児童指導員双方からみた児童の精神健康状態の認識の違いを明らかにするために、強さと困難さ質問票(Strengths and Difficulties Questionnaire:SDQ)を用いた調査を行った。地域の児童と比較して児童発達支援センターに通所する児童は男女ともSDQにおける殆どの下位尺度(情緒面、多動・不注意、仲間関係、向社会性)で困難さが存在し、支援の必要性が高いと考えられた。男児のSDQ「総スコア」および下位尺度の「多動・不注意」において、児童指導員は養育者よりも支援の必要性を有意に高いと認識していることが分かった。女児に関しては養育者と児童指導員の比較で有意差を認めなかった。SDQは児童の困難さを数値化し表すことができ、養育者と教師が共通理解を得るために役立つことが示唆された。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01552&link_issn=&doc_id=20141209140015&doc_link_id=%2Fao1clphd%2F2014%2F004312%2F016%2F1811-1819%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fao1clphd%2F2014%2F004312%2F016%2F1811-1819%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本神経学会  

認知症患者では睡眠障害が高頻度にみられる。睡眠覚醒調節機構の障害に加え、感覚器からの入力低下、社会的活動の減少も加わり、概日リズム睡眠障害を生じやすい。加齢にともなって増加する睡眠障害や、中枢神経病変にともなうレム睡眠行動異常症も共にみられる。概日リズムと深く関連するメラトニンは、認知症患者においては分泌ピークが偏移し、振幅も低下しており、体内時計機構に即したアプローチが求められる。光環境を調節し、日中の活動性を高めることが治療の基本となるが、メラトニンも夜間の睡眠に改善に有効である。認知症患者の睡眠の改善は、認知症のマネジメントの上でも重要であり、対処可能な睡眠障害を的確に治療することが望ましい。(著者抄録)

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Language：Japanese   Publisher：(株)三原医学社  

児童青年期レストレスレッグス症候群(RLS)における不眠と日中症状について検討した。児童青年期RLS症例8例を対象とした。全例が夜間症状を有していたが、1日中のRLS症状も認めた。半数の症例では、夜間症状よりに日中症状のほうが日常生活上の支障となった。2例で休暇中に症状の改善がみられ、1例では小学校入学後に症状の増悪を認めた。併存障害としては、1例でADHDが併存した。経過中に使用した治療薬剤としては、全例で鉄剤が投与され、ドパミンアゴニストとして5例でプラミペキソール、6例でロチゴチン(プラミペキソールからの切換3例を含む)が投与された。1例でクロナゼパム、1例でα2δリガンド(ガバペンチンエナカルビル)がプラミペキソールとの併用で投与された。全例で治療によるRLS症状の改善を認めたが、日中症状が著明な症例では、日中の服薬やドパミンアゴニスト貼付剤への変更が必要であった。

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Language：Japanese   Publisher：愛媛医学会  

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Language：Japanese   Publisher：慶應義塾大学出版会(株)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: Children with autism spectrum disorders (ASD) often present with emotional and behavioral problems, which could change the clinical course, especially during childhood, and affect future quality of life. The aim of this study was to clarify the age- and sex-related differences of these problems in ASD.
Methods: The study subjects were 173 patients with ASD (age: 4-16 years) and 173 age-and sex-matched community children (control group). The parent version of the Strengths and Difficulties Questionnaire was used for comparison of the emotional and behavioral problems between the two groups.
Results: The Strengths and Difficulties Questionnaire scores were significantly higher in children with ASD than controls at all ages. The score of total difficulties was significantly higher in girls with ASD than in boys, while the score in male controls was significantly higher than in female controls. Age-related differences in emotional and behavioral problems were observed both in children with ASD and controls, but the characteristics were different: in children with ASD, emotional symptoms and peer problems in both sexes and conduct problems in girls increased significantly with age, while none of the problems in the controls changed with age except for a decrease in the score of hyperactivity/inattention developmentally in both sexes. Prosocial behaviors of children with ASD and controls showed small changes with age.
Conclusion: Emotional and behavioral problems are common in children with ASD and showed age-and sex-related differences. Our study emphasizes the importance of recognizing those differences among children with ASD for early intervention.

DOI： 10.1111/pcn.12164

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Language：Japanese   Publisher：中国・四国学校保健学会  

本研究は、途上国の小学生の下痢に関する認識を調査し、予防行動確立の要因を考察することを目的とした。調査は2009年に中央アフリカ共和国バンギ市A地区で、3年生以上の子ども50人とその保護者48人、教員20人を対象に実施した。子どもと保護者は現地通訳を介した半構成聞き取り調査、教員は質問紙調査で、属性、衛生行動、下痢の原因、対処行動、予防行動について質問した。回答は衛生行動に関する言葉を抽出し、カテゴリー化した。また、地域や学校に関しては聞き取り調査と観察により情報収集した。分析の結果、1.子どもが罹りやすい病気は、衛生設備の整った都市部でも「マラリア」「下痢」が多かった。2.子どもの衛生行動は、家庭で日常生活習慣として習得しているため、下痢の予防行動としては十分に認識されていないことが示唆された。3.子どもが下痢に関する認識を深め、習得している衛生行動を予防行動に発展させていくためには、学校での保健教育の充実が必要であることが示唆された。(著者抄録)

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Language：Japanese   Publisher：愛媛医学会  

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Language：Japanese   Publisher：(公社)全国国民健康保険診療施設協議会  

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Language：Japanese   Publisher：(株)メディカルレビュー社  

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Language：English   Publishing type：Research paper (scientific journal)  

Children with autism spectrum disorders (ASD), including autistic disorder, frequently suffer from comorbid sleep problems. An altered melatonin rhythm is considered to underlie the impairment in sleep onset and maintenance in ASD. We report three cases with autistic disorder in whom nocturnal symptoms improved with ramelteon, a selective melatonin receptor agonist. Insomnia and behavior, assessed using the Clinical Global Impression-Improvement Scale, improved in two cases with 2 mg ramelteon and in the third case with 8 mg ramelteon. Our findings demonstrate that ramelteon is effective not only for insomnia, but for behavioral problems as well, in patients with autistic disorder.

DOI： 10.1155/2014/561071

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Language：Japanese   Publishing type：Research paper (international conference proceedings)   Publisher：Societas Neurologica Japonica  

Sleep disturbance is common in patients with dementia. Circadian rhythm sleep disorders are caused by the disturbance of sleep-wake regulation in the central nervous system, disturbed input into the sensory organs, and decreased social activities. Diurnal change of serum melatonin level in Alzheimer's disease showed decreased amplitude and shifted peak secretion. Age related sleep disturbances and sleep disorders due to the neurodegeneration including REM sleep behavior disorder also increase in dementia. Identifying and treating underlying sleep disorders along with therapeutic approach to circadian mechanism is effective. Treatment of circadian abnormality in dementia require light therapy and increased daytime activity. Use of oral melatonin is also effective for the improvement of nocturnal sleep. Treatment of sleep problems in dementia also contribute to the better management of dementia.

DOI： 10.5692/clinicalneurol.54.994

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：KARGER  

Background: There are few reports about sleep disturbances in patients with chronic obstructive pulmonary disease (COPD) in Asian countries. Objectives: To investigate the associations between sleep-disordered breathing (SDB) with hypoxemia and sleep quality, including sleep duration, in patients with COPD, we measured SDB and sleep quality including the objective sleep duration determined by an actigraph and portable monitoring. Methods: A cross-sectional epidemiological health survey of 303 male employees (means +/- SD: age 43.9 +/- 8.2 years; BMI 24.0 +/- 3.1) was conducted. Sleep quality was measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A respiratory disturbance index (RDI) >= 5 indicated SDB. Results: Nineteen subjects (6.3%) had COPD. Among these, 11 (3.6%) had COPD with SDB (overlap syndrome). Sleep duration, ESS, and PSQI scores were not significantly different between COPD patients and normal control subjects. However, COPD patients had significantly longer sleep latency (p = 0.019), a lower sleep efficiency (p = 0.017), and a higher sleep fragmentation index (p = 0.041) and average activity (p = 0.0097) during sleep than control subjects. They also had a significantly higher RDI and more severe desaturation during sleep than control subjects (p < 0.01). The differences remained after adjustment for age and BMI but disappeared following adjustment for RDI. Conclusions: COPD patients with even mild-to-moderate airflow limitations had nocturnal desaturation and RDI-related impaired sleep quality without significant symptoms. (C) 2014 S. Karger AG, Basel

DOI： 10.1159/000366064

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Obstructive sleep apnea syndrome (OSAS) in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD-) like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized.

DOI： 10.1155/2014/520215

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Objective: We aimed to ascertain the efficacy and safety of transdermal rotigotine (2 and 3 mg/24 h) in Japanese patients with restless legs syndrome (RLS).
Methods: In our double-blind placebo-controlled study, 284 Japanese patients with idiopathic RLS were randomly assigned to receive rotigotine 2 mg/24 h or 3 mg/24 h, or placebo, for 13 weeks. The primary endpoint was the change in International Restless Legs Syndrome Study Group rating scale (IRLS) total score.
Results: The placebo-subtracted decreases in IRLS total score for rotigotine 2 mg/24 h and 3 mg/24 h were -2.8 +/- 1.3 and -3.1 +/- 1.3, respectively, which were significant (P < 0.05). The interaction between baseline Pittsburgh Sleep Quality Index (PSQI) and treatment group for the change in IRLS total score was significant, indicating greater improvements in IRLS total score in patients with severe insomnia. Overall, 80.0%, 86.2%, and 51.6% of patients in the rotigotine 2 mg/24 h, 3 mg/24 h, and placebo groups, respectively, experienced adverse events (AEs) including application site reactions in 42.1%, 50.0%, and 7.4% of patients, respectively. None of the AEs were severe.
Conclusions: Our results showed that rotigotine was effective without major safety concerns at doses of up to 3 mg/24 h in Japanese patients with RLS. (C) 2013 Elsevier B. V. All rights reserved.

DOI： 10.1016/j.sleep.2013.07.007

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Language：Japanese   Publisher：(株)日本臨床社  

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Language：Japanese   Publisher：(株)日本臨床社  

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Aim This study was conducted to verify the reliability, validity, and responsiveness of the Japanese version of the International Restless Legs Syndrome Study Group Rating Scale for restless legs syndrome (J-IRLS) as a sub-study of a clinical trial of pramipexole against restless legs syndrome. Methods After evaluating the test-retest reliability, concurrent validity and construct validity were analyzed. The responsiveness of J-IRLS was confirmed by evaluating the correlations between the changes in J-IRLS total score after treatment, Clinical Global Impression Improvement Scale (CGI-I), and Patient Global Impression. Results Test-retest reliability of J-IRLS was good (intra-class correlation coefficient, 0.877
95% confidence interval, 0.802-0.925). The correlation coefficient of J-IRLS total score and CGI-S score for the first and second visit was 0.804 and 0.796, respectively (both P &lt
0.0001). Factor analysis of J-IRLS itemsalone identified a two-factor structure. Exploratory analysis on 10 items of J-IRLS together with the Japanese version of the Pittsburgh Sleep Quality Index revealed that several items on the Japanese version of the Pittsburgh Sleep Quality Index appeared as the third factor. The correlations of CGI-I and Patient Global Impression with change in J-IRLS total score after treatment were highly significant. Conclusions Reliability, validity, and responsiveness of J-IRLS were considered adequate. The scale is highly applicable both for evaluating the severity of restless legs syndrome and for assessing drug efficacy. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

DOI： 10.1111/pcn.12074

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Language：Japanese   Publisher：(株)三原医学社  

思春期における睡眠習慣・睡眠不足と行動・感情面の問題との関連を明らかにすることを目的として検討を行った。愛媛県東温市全ての中学校・高等学校の生徒を対象に、学校を通じて保護者に問診票を配布して記入を依頼した。有効な回答は1379名であった。問診項目としては、睡眠習慣の指標として児童青年睡眠チェックリスト(CASC)を使用し、行動、感情の指標として強さと困難さ質問票(SDQ)を用いた。分析の結果、睡眠時間については、週末-平日睡眠差2時間以上群では平日睡眠時間が有意に短く、週末睡眠時間と平均総睡眠時間は有意に長いなどの有意差がみられた。SDQスコアによる行動・感情面との関連性との検討で、短睡眠時間群と長睡眠時間群ではSDQスコアに有意差は見られなかった。しかし、週末の睡眠時間のみが長い群ではSDQの総スコアおよび感情スコアが有意に高く、行動、感情面の問題が多いことが示された。

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER COLL CHEST PHYSICIANS  

Background: Dyslipidemia is often comorbid with obstructive sleep apnea (OSA), but few population-based studies have investigated their relationship. Short sleep duration is associated with hypertension and diabetes; however, its association with dyslipidemia is not well known. We investigated relationships among OSA, sleep duration, and the lipid profile in a community-based study.
Methods: We measured the respiratory disturbance index (RDI) and sleep duration by a type 3 portable device and actigraph in 275 men in a Japanese company. Fasting blood parameters were obtained from periodic inspection data.
Results: According to Japanese criteria, 143 subjects had dyslipidemia. Percent sleep time of oxygen saturation as measured by pulse oximetry (Spo(2)) < 90% and prevalence of severe OSA were greater and sleep duration and mean Spo(2) during sleep were lower in subjects with dyslipidemia than in those without. Univariate analysis showed that the RDI was positively correlated with serum triglyceride (TG) levels (rho = 0.20, P < .01), and sleep duration was negatively correlated with serum total cholesterol (TC) levels (gamma = 0.13, P = .03) and serum low-density lipoprotein cholesterol levels (gamma = -0.12, P = .04). Stepwise multiple regression analysis revealed that TG was correlated with RDI (beta = 0.14, P = .02), BMI (beta = 0.20, P < .01), and alcohol intake (13 = 0.20, P < .01), and that TC was correlated with sleep duration (beta = 0.13, P = .03), age (beta = 0.15, P = .02), and waist/hip ratio (beta = 0.15, P = .02).
Conclusions: Short sleep duration was associated with TC levels and RDI was positively associated with TG levels among working-aged men in an urban Japanese company. Correcting the status of OSA and/or short sleep duration might improve the lipid profile and cardiovascular consequences.. CHEST 2013; 143(3):720-728

DOI： 10.1378/chest.12-0338

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Language：Japanese   Publisher：(株)南江堂  

睡眠関連運動障害とは,単純で(多くは)常同的な運動により睡眠が障害されるものをいう.レストレスレッグス症候群や周期性四肢運動は内科疾患による二次性のものも多い.こむらがえりや歯ぎしり,律動性運動障害は,睡眠の障害につながる場合に治療の対象となる.病歴から臨床的に診断できる疾患がある一方,確定診断に睡眠ポリグラフ検査が必要な疾患もあり,専門医との連携が必要である.(著者抄録)

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Other Link： http://search.jamas.or.jp/link/ui/2013091493

Language：Japanese   Publisher：エーザイ(株)  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

睡眠医療の対象疾患は、睡眠時無呼吸症候群(sleep apnea syndrome:SAS)、不眠症、ナルコレプシー、まずまず脚症候群など多岐にわたる。また認知症を有する高齢者や小児の睡眠障害患者も増加しつつある。さらに、睡眠衛生全般に対する生活指導やSAS治療の自己管理指導、生活習慣改善のアドバイスを行うなどチーム医療による包括的なケアシステムが必要となる。以上から、睡眠医療においては、看護師の睡眠医学の知識と技術の向上、ならびに睡眠医療看護を専門とする看護師の育成が特に重要と考えられる。諸外国では看護師がプラクティショナーとして多職種間の連携役、患者管理、他施設との調整役、新人スタッフへの指導、教育など重要な役割を担い、また専門看護師が医師の指導のもと持続陽圧呼吸(continuous positive airway pressure:CPAP)療法のフォローアップを行っている。これら諸外国における睡眠医療に携わる看護師の役割と筆者らの睡眠医療センターでの経験を加えて、本邦での睡眠医療における看護職の担うべき役割について提言する。(著者抄録)

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Other Link： http://search.jamas.or.jp/link/ui/2013104833

Language：Japanese   Publisher：(株)三原医学社  

子どもの睡眠の問題をスクリーニング・追跡するためには、年齢とともに変化する睡眠の量・質や睡眠環境の影響を考慮しなければならないが、従来の小児睡眠質問票は適用年齢層が限られているものが多く、学齢ごとの比較や長期の追跡が困難であった。そこで著者等は、乳幼児から高校生まで共通して使用できる睡眠チェックリストCASCを作成した。その概要は、36の設問で構成され、前半の12設問(就床・起床時刻や睡眠時間、睡眠習慣)については数字記入・選択肢の回答方式とし、後半の24設問(就床時の問題、睡眠中の問題、日中の問題)については頻度スケールによる回答方式とした。今回、幼稚園児から高校生までの計53名を対象に信頼性と妥当性の検討を行った。その結果、2週間隔で2回実施したCASC評価のスコアは1回目と2回目で良好な相関を示し、従来の評価法(CSHQ・PSQI)との相関も良好であった。

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Other Link： http://search.jamas.or.jp/link/ui/2013056925

Language：Japanese   Publisher：(株)三原医学社  

愛媛県東温市の幼稚園5園、小学校7校、中学校2校、高等学校1校に通う児の保護者に質問紙調査を行った。3676名から有効回答が得られた。授業中に眠くなることが週2回以上ある児の割合は、幼稚園児で1%、小学生8%、中学生21%、高校生32%であり、学齢が高いほど高率であった。授業中に居眠りしてしまうことが週2回以上ある割合は、幼稚園児1%、小学生1%、中学生6%、高校生14%であった。睡眠時間は幼稚園児が平均9時間57分、小学生が8時間28分、中学生7時間5分、高校生6時間24分であった。睡眠時間が平均より1時間以上短い群と1時間以上長い群および平均±1時間群の3群に分け、「授業中の眠気・居眠り」を群間比較したところ、小・中・高校生では睡眠時間が短いほど「授業中の眠気」が強い傾向にあったが、幼稚園児ではこの傾向は認められなかった。「授業中の居眠り」は、小・中学生では睡眠時間が短い群で有意に高頻度であったが、幼稚園児と高校生では有意な群間差は認められなかった。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Obstructive sleep apnoea is common in patients with diabetes. Recently, it was reported that short sleep duration and sleepiness had deleterious effects on glucose metabolism. Thereafter, several reports showed relationships between glucose metabolism and obstructive sleep apnoea, sleep duration or sleepiness. But the interrelationships among those factors based on recent epidemiological data have not been examined. We analysed data on 275 male employees (age, 44 +/- 8 years; body mass index, 23.9 +/- 3.1 kg m-2) who underwent a cross-sectional health examination in Japan. We measured fasting plasma glucose, sleep duration using a sleep diary and an actigraph for 7 days, and respiratory disturbance index with a type 3 portable monitor for two nights. Fifty-four subjects (19.6%) had impaired glucose metabolism, with 21 having diabetes. Of those 21 (body mass index, 25.9 +/- 3.8 kg m-2), 17 (81.0%) had obstructive sleep apnoea (respiratory disturbance index = 5). Regarding the severity of obstructive sleep apnoea, 10, four and three had mild, moderate and severe obstructive sleep apnoea, respectively. The prevalence of obstructive sleep apnoea was greater in those with than without diabetes (P = 0.037). Multiple regression analyses showed that the respiratory disturbance index independently related to fasting plasma glucose only in the diabetic subjects. In patients with diabetes, after adjustment for age, waist circumference, etc. sleep fragmentation had a greater correlation with fasting plasma glucose than sleep duration, but without significance (P = 0.10). Because the prevalence of obstructive sleep apnoea is extremely high in patients with diabetes, sufficient sleep duration with treatment for obstructive sleep apnoea, which ameliorates sleep fragmentation, might improve fasting plasma glucose.

DOI： 10.1111/j.1365-2869.2012.00997.x

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Language：Japanese   Publisher：(株)世論時報社  

2010年に本邦で上市されたramelteonは、メラトニン受容体MT1、MT2に選択的なアゴニストであり、入眠作用や生体リズム位相変位作用を有する。現在の睡眠薬の主流はベンゾジアゼピン系睡眠薬や非ベンゾジアゼピン系睡眠薬であるが、精神疾患が基盤にある睡眠障害に対しては、抗うつ剤や抗精神病薬も治療に使用されている。このような精神疾患を伴う不眠に対し、ramelteonを使用し、30症例(男性19例、女性11例)の治療を行った。平均年齢は56.2±19.0歳(16〜89歳)であり、症例の内訳は統合失調症14例、認知症圏6例、気分障害圏4例、神経症性障害圏3例、発達障害圏3例であった。Ramelteon継続症例は22例(73.3%)であり、切り替え前後で有意に併用睡眠薬が減少した。精神疾患を伴う不眠に対するramelteonの使用は、既存の睡眠薬を減薬することができ、忍容性が高いことが示唆された。今後、精神疾患を伴う不眠へのramelteonの有効性に関して、臨床知見の蓄積が必要である。(著者抄録)

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：日本神経治療学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN SOC INTERNAL MEDICINE  

Objective Decreased lung function as assessed by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) is shown to be associated with cardiovascular morbidity and mortality. Although the underlying mechanisms for this association remain unknown, metabolic syndrome and obstructive sleep apnea (OSA) may have a role. We analyzed the relationships between metabolic syndrome and OSA in a cross-sectional health survey of middle-aged male employees.
Methods In this secondary analysis, we re-analyzed the relationships of lung function determined by spirometry with metabolic syndrome and OSA based on the respiratory disturbance index (RDI) with a type 3 portable monitor.
Results We analyzed 273 subjects. Independent of age, body mass index (BMI) and smoking, quartiles for lower FVC and FEV1 were associated with a higher risk of metabolic syndrome compared with quartiles for the highest FVC and FEV1, respectively. A similar trend was observed regarding the risk associated with waist circumference, and in FVC cases, dyslipidemia. The risk of hyperglycemia was significantly higher in quartiles for the second lowest FVC and FEV1 than in quartiles for the highest FVC and FEV1, respectively. A significant trend for an increase in RDI was observed in accordance with quartiles for lower FVC, but not FEV1.
Conclusion There was a significant relationship between lung function impairment and metabolic syndrome through mainly abdominal obesity, partially through hyperglycemia, and also through dyslipidemia, but only with respect to restrictive lung function. Restrictive lung function was also related to OSA. This epidemiologic evidence may indicate underlying mechanisms between decreased lung function and cardiovascular risk.

DOI： 10.2169/internalmedicine.51.7427

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Obstructive sleep apnoea (OSA) plays a significant role in increasing blood pressure. Significant decreases were reported in blood pressure of hypertensive OSA patients with sleepiness who underwent continuous positive airway pressure (CPAP) treatment, but not in non-sleepy hypertensive OSA patients. More recently, however, significant decreases in blood pressure in non-sleepy hypertensive OSA patients following CPAP were shown. Effects of sleepiness on hypertension in OSA patients have been investigated, but not the effects of hypertension on sleepiness in OSA patients. We investigated the relationships between hypertension and sleepiness in patients with OSA. We analysed data on 275 middle-aged male subjects from a cross-sectional epidemiological health survey. We measured blood pressure and sleep duration objectively using an actigraph for 7 days and the respiratory disturbance index (RDI) with a type 3 portable device for 2 nights, and assessed sleepiness using the Epworth Sleepiness Scale (ESS). The RDI correlated significantly with ESS scores in the 88 hypertensive subjects (r = 0.33, P = 0.0024), but not in the 187 non-hypertensive subjects (r =-0.01, P = 0.91). Short sleep duration correlated significantly with ESS scores in both groups. Both the RDI and short sleep duration were related independently to sleepiness in only hypertensive subjects. Furthermore, the RDI was related negatively significantly to sleep duration in hypertensive subjects. Although short sleep duration was related significantly to sleepiness in both groups, hypertension may be important for the sleepiness in OSA patients. Detailed mechanisms of the difference in the relationship between sleepiness and the severity of OSA with or without hypertension should be studied further.

DOI： 10.1111/j.1365-2869.2011.00912.x

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Language：Japanese   Publisher：(株)メディカルレビュー社  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J05233&link_issn=&doc_id=20110818190003&doc_link_id=%2Fai1parkd%2F2011%2F000403%2F003%2F0133-0136%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai1parkd%2F2011%2F000403%2F003%2F0133-0136%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本小児神経学会  

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)日本医事新報社  

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Language：Japanese   Publisher：(株)南山堂  

＜プライマリ・ケアにおけるポイント＞・睡眠の重要性は以前より指摘されているが、小児の睡眠をめぐる現状は良好とはいえない。・わが国の小児の就床時刻は欧米の小児より遅く、睡眠時間も短い。・発達の過程で、睡眠の状態は大きく変化する。昼夜のリズムが少しずつ形成されていくことに加えて、脳波上の睡眠の特徴も変化し、発達の指標となり得る。・年齢とともに睡眠時間は減少していくが、思春期では平日に睡眠不足となり、休日に長時間の睡眠をとる傾向が顕著となる。・睡眠時無呼吸症候群、レストレスレッグス症候群、概日リズム睡眠障害、過眠症などの睡眠障害は小児期からみられるが、その多くが見過ごされている。・睡眠障害に伴う眠気や起床困難は、意欲の欠如・怠惰といった評価につながりやすいが、背景に睡眠の問題がないかどうかに注意を払うことが重要である。(著者抄録)

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Language：Japanese   Publisher：(公社)日本薬学会  

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Language：Japanese   Publisher：(株)三原医学社  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

OBJECTIVE
To determine the differences and associations between nocturnal voiding (NV)/nocturia and sleep disorders.
SUBJECTS AND METHODS
Using an epidemiological survey, we compared residents with non-bothersome NV (NNV) and bothersome NV (BNV) to those with sleep disorders, including insomnia, obstructive sleep apnoea syndrome (OSAS), restless leg syndrome (RLS), and periodic limb movement disorder (PLMD), for patient background, lower urinary tract symptoms (LUTS), sleep status, and general health-related quality of life (HRQL). Furthermore, we investigated associations between BNV and sleep disorders using multivariate analyses. In all 2271 (38%) answers were available, of which 729 (32%), 966 (43%) and 546 (24%) subjects had no NV, NNV and BNV, respectively, and 348 (15%), 52 (2%), 172 (8%) and 62 (3%) were determined as having insomnia, OSAS, RLS and PLMD, respectively.
RESULTS
For LUTS, subjects with BNV were significantly worse than those with OSAS, but better than those with RLS and PLMD. Total sleep status in the BNV group was better than that in the insomnia group, but worse than that in the OSAS and RLS groups. General HRQL in the BNV group was worse than that in the OSAS group, and better than that in the RLS and PLMD groups for physical aspects. In mental aspects, subjects with BNV were better than those with insomnia. Insomnia and OSAS had a close correlation with NNV/BNV (P < 0.001-0.022), and PLMD had a significant correlation with BNV (P = 0.031). However, RLS was not associated with NV (P = 0.42) nor with BNV (P = 0.09).
CONCLUSION
NV/nocturia is closely related to sleep disorders, but obviously different from them in several aspects.

DOI： 10.1111/j.1464-410X.2009.09045.x

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

α-シヌクレインが異常蓄積する神経変性疾患であるα-synucleinopathyには、パーキンソン病、レビー小体型認知症、多系統萎縮症などがあり、変性疾患の病態や治療薬に起因する睡眠障害がしばしば認められる。日中の眠気、REM睡眠行動障害、睡眠呼吸障害、レストレスレッグス症候群などが様々な程度でみられ、予後やQOLと関連する場合もある。病態との関連のみならず、疾患マネジメントの一側面として睡眠の問題をとらえる視点も重要となる。(著者抄録)

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)医学書院  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J00749&link_issn=&doc_id=20100527180009&doc_link_id=10.11477%2Fmf.1405101629&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1405101629&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(株)星和書店  

児童青年期双極性障害における睡眠障害は、躁病エピソード・うつ病エピソードいずれにも関連する臨床症状として重要な所見である。睡眠の質・量の低下や睡眠覚醒リズムの問題は、日中の活動性・認知面・学習面への影響が大きく、特に児童期において発達に及ぼす影響を考慮すると、早期発見・早期介入が必要である。児童青年期における睡眠障害の薬物療法については、十分なコンセンサスが得られておらず、心理学的介入や認知行動療法が主として用いられる。認知行動療法的アプローチをする上で、夜間の睡眠状態に加えて日中の活動性も把握できる睡眠日誌は有用である。(著者抄録)

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Language：English   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

Background: Dopamine agonists are accepted as the first-line medications for restless legs syndrome (RLS). In some Asian countries, clonazepam is one of the prevalent medications for RLS because of its effect on sleep disturbances. To date, there have not been any studies that examined equivalent doses of pramipexole and clonazepam. To evaluate equivalent doses of pramipexole and clonazepam in RLS, we investigated the efficacy and tolerability after conversion from clonazepam to pramipexole, and examined dose equivalence between the two prescriptions.
Methods: In a prospective, open-label, multicenter study, 26 RLS patients treated with clonazepam (mean age: 69.2 +/- 11.0 years old) were enrolled and then rapidly switched to pramipexole using a conversion calculation of 4:1 for daily doses. Then the daily dose of pramipexole was up titrated or tapered by 0.125 mg/day at each subsequent examination. RLS symptoms and daytime somnolence were evaluated using the International RLS Study Group rating scale (IRIS), Clinical Global Impressions Severity of illness (CGI-S) and the Epworth Sleepiness Scale (ESS), respectively.
Results: Conversion from clonazepam to pramipexole resulted in significant reductions of IRLS (16.3 +/- 8.7 to 9.1 +/- 6.3) and ESS (6.5 +/- 4.2 to 4.4 +/- 3.2). CGI scores demonstrated improvement after conversion. In 4 patients (15%), adverse events such as somnolence, sensation of oppression in the lower limbs, diarrhea, or nausea were present. Correlation analysis demonstrated a significant relationship between these daily doses. Spearman's correlation coefficient was 0.662. Our study, however, has some limitations since it is an open-label trial and includes only 26 patients. Further studies using a double-blind design or a crossover design are recommended.
Conclusions: Statistical analysis demonstrated a 4:1 conversion for clonazepam to pramipexole. When switchover from clonazepam to pramipexole is done, this conversion ratio may be helpful to determine the initial dose of pramipexole for treating RLS. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.pnpbp.2010.02.011

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Language：Japanese   Publisher：(公社)日本発達障害連盟  

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Other Link： http://search.jamas.or.jp/link/ui/2010135872

Language：Japanese   Publisher：日本医師会  

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Language：Japanese   Publisher：(株)メディカルレビュー社  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD SLEEP MEDICINE  

Background: Severe obstructive sleep apnea (OSA), metabolic syndrome (Mets) and short sleep duration are all risk factors for cardiovascular events. There has been no report which has investigated this relationship in an age- and BMI-matched population-based study. The prevalence of OSA in Mets subjects has not been established, although the converse (i.e., the prevalence of Mets in OSA subjects) has been investigated several times.
Methods: This home cardiorespiratory (type 3) sleep study, using an actigraph, was conducted in 275 males working for an urban company. Retrospective measurements of fasting blood parameters were obtained from the company's periodical inspection data. The mean duration between the sleep study and the measurement of blood parameters was 213 days.
Results: Although there was a significant relationship between OSA severity and the prevalence of Mets (P < 0.001), the association between severity and Mets was not significant after adjustments were made for age and BMI. Severe OSA was 7.8 times as likely to be present in subjects with Mets (16.2% of all 68 Mets subjects) as those without (2.4% of 207 non-Mets) (P < 0.001). Subject with severe OSA had a significantly short sleep duration (P < 0.05). Sleep duration in Mets subjects was also significantly shorter than in those without (P < 0.05).
Conclusions: Although increased BMI and age both had a significant effect on the prevalence of OSA in patients with Mets, one of 6 subjects with Mets, but only one of 40 without Mets had severe OSA in an urban male population in Japan. Physicians should take into account this high prevalence of severe OSA in patients with Mets. Sleep duration should be taken into consideration as an important factor in studies investigating the prevalence of severe OSA and Mets.

DOI： 10.1093/sleep/33.1.89

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Language：Japanese   Publisher：(株)三原医学社  

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Other Link： http://search.jamas.or.jp/link/ui/2012331956

Language：Japanese   Publisher：(株)三原医学社  

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子どもの睡眠の問題を調査・スクリーニングする手法としては、問診票を用いた調査が最も簡便であるが、特に子どもの調査においては、年齢とともに睡眠の量的・質的変化がみられることに加え、睡眠環境の影響も受けることから、問診項目や設問の内容に工夫が必要である。われわれは幼児〜高校生までの幅広い年齢層に対応し、医療・教育・公衆衛生の分野で睡眠の問題をスクリーニングすることを目的として、「児童青年期睡眠チェックリスト(CASC)」を作成し、これを用いた睡眠調査・問診システムを構築した。CASCの特徴は、同一の設問セットで横断的なスクリーニングと、経時的追跡を行えることに加え、年齢に応じて保護者記入版、本人記入版を併用することで、より幅広く正確な情報を得ることができる点である。今後、各年代の標準化を行い、疫学調査や小児睡眠臨床において活用することで、小児の睡眠問題のマネジメントに貢献する有力なツールとなることが期待される。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J04991&link_issn=&doc_id=20090812050014&doc_link_id=%2Fai5slepd%2F2009%2F000303%2F015%2F0404-0408%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai5slepd%2F2009%2F000303%2F015%2F0404-0408%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本小児神経学会  

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Restless legs syndrome (RLS) is known to occur secondary to various medical conditions such as iron deficiency, pregnancy, end-stage renal disease, and neuropathy. Secondary RLS usually occurs later in the life and in the absence of a family history of RLS. Diagnosis of secondary RLS may be difficult, particularly in patients with neurological comorbidities. Sensory disturbance due to neurological disorder may mimic the symptoms of RLS symptom. In distinguishing between RLS and RLS mimics, neurophysiological findings, in addition to a detailed neurological examination, are helpful. Treatment of secondary RLS often requires management of the background medical condition. Iron supplementation is useful in patients with iron deficiency. Dopamine agonists are usually effective for both primary and secondary RLS
however, an increased dose of dopamine agonist may be necessary in some secondary RLS cases, particularly in uremic RLS. In patients with end-stage renal disease on hemodialysis, management of daytime symptoms, particularly during the hemodialysis sessions, may be necessary. Secondary RLS is still an unrecognized and underdiagnosed disorder. Medical practitioners should be aware of comorbid RLS in patients with neurological conditions that could be the cause of RLS.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Background: Various Japanese versions of the Epworth Sleepiness Scale (ESS) have been used, but none was developed via standard procedures. Here we report on the construction and testing of the developer-authorized Japanese version of the ESS (JESS).
Methods: Developing the JESS involved translations, back translations, a pilot study, and psychometric testing. We identified questions in the ESS that were difficult to answer or were inappropriate in Japan, proposed possible replacements for those questions, and tested them with analyses based on item response theory (IRT) and classical test theory. The subjects were healthy people and patients with narcolepsy, idiopathic hypersomnia, or obstructive sleep apnea syndrome.
Results: We identified two of our proposed questions as appropriate replacements for two problematic questions in the ESS. The JESS had very few missing data. Internal consistency reliability and test-retest reliability were high. The patients had significantly higher JESS scores than did the healthy people, and higher JESS scores were associated with worse daytime function, as measured with the Pittsburgh Sleep Quality Index.
Conclusions.-In Japan, the JESS provides reliable and valid information on daytime sleepiness. Researchers who use the ESS with other populations should combine their knowledge of local conditions with the results of psychometric tests. (C) 2008 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.sleep.2008.04.015

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Language：Japanese   Publisher：(株)医学書院  

Restless legs syndrome (RLS) is known to occur secondary to various medical conditions such as iron deficiency, pregnancy, end-stage renal disease, and neuropathy. Secondary RLS usually occurs later in the life and in the absence of a family history of RLS. Diagnosis of secondary RLS may be difficult, particularly in patients with neurological comorbidities. Sensory disturbance due to neurological disorder may mimic the symptoms of RLS symptom. In distinguishing between RLS and RLS mimics, neurophysiological findings, in addition to a detailed neurological examination, are helpful. Treatment of secondary RLS often requires management of the background medical condition. Iron supplementation is useful in patients with iron deficiency. Dopamine agonists are usually effective for both primary and secondary RLS
however, an increased dose of dopamine agonist may be necessary in some secondary RLS cases, particularly in uremic RLS. In patients with end-stage renal disease on hemodialysis, management of daytime symptoms, particularly during the hemodialysis sessions, may be necessary. Secondary RLS is still an unrecognized and underdiagnosed disorder. Medical practitioners should be aware of comorbid RLS in patients with neurological conditions that could be the cause of RLS.

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Language：Japanese   Publisher：(株)診断と治療社  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

We conducted a community-based study to determine the relationship among night-time frequency, sleep disturbance and general health-related quality of life (GHQL).
A total of 2271 participants, men and women, aged 41-70 and randomly selected in three Japanese towns completed a postal questionnaire survey. This questionnaire included: the International Prostate Symptom Score, the overall incontinence score of the International Consultation of Incontinence Questionnaire Short Form for lower urinary tract symptoms, the Pittsburg Sleep Quality Index for sleep problems, the Medical Outcome Study Short Form-8 for GHQL, and medical history of disease, cigarette smoking, and alcohol consumption. A multiple regression model was used for statistical analysis, and P < 0.05 was considered significant.
Although night-time frequency by itself was closely associated with most aspects of GHQL, this association disappeared in four domains (general health perception, vitality, mental health and emotional role) and in the two summary scores of the Medical Outcome Study Short Form-8 after inclusion of the influence of sleep problems represented by the total score on the Pittsburg Sleep Quality Index. However, three domains (physical function, physical role, and social function) remained significantly associated with night-time frequency. Sleep problems were by far the worst risk factor for the deterioration of GHQL.
Night-time frequency appeared to be associated with GHQL mainly by affecting sleep conditions, a symptom that independently influenced some aspects of GHQL.

DOI： 10.1111/j.1442-2042.2008.02185.x

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Language：Japanese   Publisher：(株)先端医学社  

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Other Link： http://search.jamas.or.jp/link/ui/2008227181

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACAD SLEEP MEDICINE  

Study Objectives: To examine (1) the prevalence of home-monitored sleep-disordered breathing (SDB) and obstructive sleep apnea syndrome in a Japanese working population and (2) whether home monitoring with a type 3 portable monitor and actigraphy can produce reliable data to analyze SDB in usual lifestyles.
Methods: A cross-sectional survey using a self-administered questionnaire was conducted on a group of employees at a wholesale company in Osaka, Japan. Examinations by physicians and by sleep monitoring were also performed. Unattended home cardiorespiratory (type 3) sleep studies with actigraphy were conducted for 2 nights to diagnose SDB in 322 subjects. From the baseline questionnaires and sleep diaries, participants were assessed to follow their usual lifestyles during the study (e.g., time in bed, alcohol intake). Results: Of 466 Japanese male employees, 396 responded to the questionnaire survey (85.0%).
Results from 322 male employees aged 23 to 59 (43.8 +/- 8.4 years) were analyzed. Respiratory disturbance index (RDI), calculated from the type 3 portable monitors and actigraphy, was highly reliable with an intraclass correlation of 0.98 for interscorer reliability and with an intraclass correlation of 0.95 for night-to-night reliability. Prevalence of mild (5 < RDI < 15), moderate (15 <= RDI < 30) and severe (RDI >= 30) SDB in this population were 37.4%, 15.7%, and 6.6%, respectively. The prevalence of obstructive sleep apnea syndrome (RDI >= 5 and Epworth Sleepiness Scale score > 10) was 17.6%.
Conclusions: The prevalence of moderate to severe SDB (RDI >= 15) was 22.3% in this Japanese male working population aged 23 to 59, measured in participant's usual life settings. Unattended home monitoring with type 3 portable monitors and actigraphy was highly reliable and may be suitable for analyzing SDB in the usual lifestyle setting.

DOI： 10.1093/sleep/31.3.419

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

成人の睡眠障害を主として診療を行っている睡眠専門クリニックにおける小児の受診状況を明らかにするため、受診者の年齢分布や、主訴、診断、治療など臨床的特徴、さらに受診に至った経緯について検討した。中学生以下で初診した91例(1.1%)を対象とした。日中の眠気を訴えて受診した者が最も多く、小学生では41.2%、中学生では47.3%を占めた。診断名では、過眠症が小学生の35.3%、中学生の47.3%で最も多かった。治療内容の内訳は、薬物療法が小学生の58.8%、中学生の64.8%で行われていた。受診前に睡眠の問題について他の医療機関を受診していた患児は、小学生では58.8%、中学生では25.3%で、小学生ではその半数、中学生ではほぼ全例が前医からの紹介受診であった。治療を継続している患者は、小学生で22.5%、中学生で34.1%であった。

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

Bedtime activities, sleep environment, and their impact on sleep/wake patterns were assessed in 509 elementary school children (6-12 years of age; 252 males and 257 females). Television viewing, playing video games, and surfing the Internet had negative impact on sleep/wake parameters. Moreover, presence of a television set or video game in the child's bedroom increased their activity before bedtime. Time to return home later than 8 p.m. from after-school activity also had a negative impact on sleep/wake patterns. Health care practitioners should be aware of the potential negative impact of television, video games, and the Internet before bedtime, and also the possibility that late after-school activity can disturb sleep/wake patterns.

DOI： 10.1080/15402000802371338

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Language：Japanese   Publisher：(株)医学書院  

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筆者らは、米国で開発され標準化された子供の睡眠に関する質問票Children's Sleep Habits Questionnaire(CSHQ)の日本語版(CSHQ-J)を作成した。翻訳作業および評価作業については、BrislinやMorganらの提唱する方法を参考にして逆翻訳、個別面接を用いたプレテストなどの複数の手法を組み合わせて行った。その結果、CSHQ-Jは、日米の言語の違いを除き、CSHQと同等の質問票である可能性が示唆された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J04991&link_issn=&doc_id=20071113200012&doc_link_id=%2Fai5slepd%2F2007%2F000201%2F013%2F0083-0088%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai5slepd%2F2007%2F000201%2F013%2F0083-0088%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：Japanese   Publisher：(株)医学書院  

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Language：Japanese   Publisher：金原出版(株)  

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Language：Japanese   Publisher：(株)ライフメディコム  

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Language：Japanese   Publisher：(株)南山堂  

過眠症状を呈する疾患はナルコレプシーを中心とする一次性過眠症と睡眠中の異常現象が引き起こす睡眠の浅化・分断に基づく二次性過眠症とに大きく分けられる。また、慢性的な睡眠不足や薬剤の副作用、概日リズム睡眠障害、うつ状態なども過眠症状の原因として注意すべきである。過眠症状は日常生活に支障をきたし、時には重大な事故を引き起こすこともある。原因により対処法も異なるため、的確な診断と治療が必要である。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-LISS  

Aims: To determine the distributions of bothersome and non-bothersome nocturnal voiding and the differences between them using a community-based study. Subjects and Methods: A total of 2,205 men and women aged 41-70 years from three Japanese towns responded to our postal questionnaire survey. The questionnaire included the International Prostate Symptom Score, Pittsburgh Sleep Quality Index (PSQI), Medical Outcome Study Short Form-8, medical history of several diseases, and history of cigarette smoking and alcohol consumption. We chose subjects who had one or two episodes of nocturnal voiding per night and divided them into two subgroups based on the answer to a question on trouble sleeping due to nocturnal voiding in the PSQI We compared data regarding lower urinary tract symptoms (LUTS), sleep, and general health-related quality of life (GHOL) among these subgroups. Results: Of the subjects: 314 (14.2%), 693 (31.4%), 149 (6.8%), and 168 (7.6%) had once-bothersome, once-non-bothersome, twice-bothersome, and twice-non-bothersome nocturnal voiding per night, respectively. Regarding LUTS, the twice-bothersome nocturnal voiding group had the worst and the once-non-bothersome group had the best scores while the once-bothersome and twice-non-bothersome nocturnal voiding groups had equivalent scores. Regarding sleep and GHOL, trouble sleeping but not the frequency of nocturnal voiding per se affected the scores. The twice-non-bothersome nocturnal voiding group generally had better scores than the once-bothersome group, while the former had more frequent nocturnal voiding. Conclusions: Sleep and GHOL of subjects with mild (once or twice) night-time frequency are considerably impacted by sleeping troubles.

DOI： 10.1002/nau.20451

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Language：Japanese   Publisher：(一社)日本呼吸器学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ACADEMY SLEEP MEDICINE  

Study Objectives: Cerebrospinal fluid (CSF) hypocretin-1 levels and their relationship with the clinical characteristics of narcolepsy without cataplexy have not been well elucidated. Our aim was to examine whether clinical characteristics vary with CSF hypocretin-1 levels among narcoleptic patients without cataplexy.
Design: Clinical features, variables on the multiple sleep latency test, and results of HLA typing were correlated with CSF hypocretin-1 levels.
Setting: University-based sleep laboratories and a sleep disorders center.
Patients: Seventeen patients (5 male, 12 female) who fulfilled the diagnostic criteria of narcolepsy without cataplexy according to the International Classification of Sleep Disorders. Inerventions: Patients underwent lumbar puncture for CSF sampling.
Measurements and Results: Five patients showed a markedly decreased CSF hypocretin-1 level, whereas the remaining 12 patients showed almost normal levels. The mean rapid eye movement (REM) latency was significantly shorter and the age at onset was significantly earlier in the low CSF hypocretin-1 group compared with the normal CSF hypocretin-1 group. HLA-DR2 was positive in all of the patients with low CSF hypocretin-1, whereas only 33.3% of patients with normal CSF hypocretin-1 were DR2 positive.
Conclusions: Some narcoleptic patients without cataplexy have low CSF hypocretin-1 levels. In patients who have narcolepsy without cataplexy, short mean REM latency, younger age at onset, and HLA-DR2 are associated with CSF hypocretin-1 deficiency. Markedly decreased CSF hypocretin-1 levels could be a significant marker for identifying subgroups of narcolepsy patients without. cataplexy.

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Language：Japanese   Publisher：(株)星和書店  

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経鼻持続陽圧呼吸療法(CPAP)は,睡眠時無呼吸症候群(SAS)に対して最も効果的な治療であるが,適切な治療圧の設定,マスクのタイプやサイズの選定とともに,導入前の十分な指導がCPAPをうまく使用できるかどうかのカギとなる.CPAPは長期にわたって使用を継続する必要があるため,使用開始後の不快感,口渇,マスク内の結露,エアリークなどの諸問題に対しては,速やかに適切な対応を行うことが求められる(著者抄録)

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Language：Japanese   Publisher：(株)永井書店  

過眠を呈する代表的な疾患としては,ナルコレプシー,特発性過眠症などがあるが,臨床症状のみでは診断が困難な場合も少なくない.過眠症の診断には,終夜睡眠ポリグラフィ(PSG)や睡眠潜時反復検査(MSLT)などの脳波を用いた睡眠検査による評価が有用である.特に日中の眠気を客観的に評価する手法としては,脳波を用いた手法以外に十分に確立された検査方法は見い出されていない.しかし,睡眠検査所見は必ずしも特異的なものではないことから,これらの疾患の診断に際しては,脳脊髄液オレキシン測定や組織適合抗原(HLA)などの所見も,適宜活用することが望ましい(著者抄録)

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Language：Japanese   Publisher：(株)へるす出版  

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Language：Japanese   Publisher：千代田開発(株)  

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Language：Japanese   Publisher：(一社)日本臨床神経生理学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN SOC INTERNAL MEDICINE  

A 42-year-old woman presented gradual development of hypersomnia and memory disturbance. T2-weighted and FLAIR MRI scans revealed a high intensity abnormality in the hypothalamus. Stereotactic brain biopsy specimen revealed prominent infiltration of the lymphocytes in the vessel walls. Since there was no evidence of systemic angiitis, the diagnosis of isolated angiitis of the CNS (IAC) was made. Polysomnographic study showed decreased REM sleep and increased stage I sleep. Orexin A in the CSF was decreased. Hypersomnia and a decrease of the CNS orexin A improved after corticosteroid therapy. Hypersomnia can be an initial symptom of IAC if it involves the hypothalamus.

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Language：Japanese   Publisher：(株)星和書店  

概日リズム睡眠障害の中でも睡眠相後退症候群や非24時間睡眠覚醒症候群は,夏休みや受験勉強を契機に青年期にみられることが多いが,今回,睡眠相後退パターンから非24時間睡眠覚醒パターンへの移行がみられた症例(15歳男性)を経験した.本症例では「塾通い」が重要な社会同調因子として働き,その同調因子の消失を契機に非24時間型睡眠覚醒症候群の存在が明らかになった.塾は児童・生徒たちの社会的同調因子の一つとなることがあり,日本社会的に特徴な現象である

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Language：English   Publisher：DR DIETRICH STEINKOPFF VERLAG  

DOI： 10.1007/s00415-004-0442-z

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PubMed

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Language：Japanese   Publisher：(株)ライフ・サイエンス  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

A 60-year-old patient with multiple system atrophy (MSA) who presented with rapid eye movement (REM) sleep behavior disorder was investigated longitudinally by all-night polysomnography. REM sleep components, i.e. rapid eye movements and chin muscle activity, were analyzed together with the frequency of behaviors/movements on the videorecording. Decreased frequency of elaborate motor activity during REM sleep with time in this patient was compatible with the observation by his wife, and this change seemed to correlate with predominant tonic chin electromyogram with relatively suppressed phasic chin muscle activity, but the reduction of the REM sleep behavior disorder (RBD) episodes could be interpreted as being due to the increased rigidity along with MSA progression. The chronological change in REM sleep components in RBD with neurological disorders is worth studying in large follow-up series to enlarge our knowledge about the mechanism of behavioral manifestation of RBD in humans. (C) 2004 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.sleep.2003.09.007

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PubMed

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Language：Japanese   Publisher：(株)永井書店  

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Language：Japanese   Publisher：(株)永井書店  

REM睡眠行動障害は,REM睡眠中の激しい寝言や異常行動を特徴とする.治療が可能な疾患であるにも拘わらず,日常診療においては誤診されたり,見過ごされていることも多い.本疾患の発症様式を検討すると共に,診断に不可欠な睡眠ポリグラフ検査所見の特徴を提示し,その有用性を検討した.夜間の異常行動を主訴とする61歳の男性症例を呈示した

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

The demographic features of 296 patients who consulted a sleep disorders centre in the United Kingdom were reviewed. Diagnosis after a sleep study was mainly that of sleep-related breathing disorders; however, various other sleep disorders were also diagnosed. Considering that most sleep disorders are diagnosed only after sleep investigations, it should be emphasized that such a facility should be well prepared in undertaking not only polysomnography but also various sleep investigations, including multiple sleep latency testing and actigraphy. In addition, several treatment options, including sleep hygiene, light therapy, and behavioural therapy, should be available. Therefore, a sleep disorders centre needs to be operated by sleep specialists.

DOI： 10.1046/j.1440-1819.2002.01010.x

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PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL SCIENCE ASIA  

We opened a mini-sleep disorders clinic in a local general hospital in rural Japan, and have been operating it for more than 3 years, We encountered many difficulties during this period when we tried to provide proper clinical service. Problems ranged from lack of sleep specialists and polysomnography technicians, shortage of funding, non-existence of an educational system to obtain comprehensive knowledge about sleep medicine, and also lack of cooperation among different departments necessary for maintaining clinical service. Through our experience, we analyzed various factors that prevent Japan from establishing a clinical service of sleep medicine.

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Language：Japanese   Publisher：(公財)明治安田厚生事業団  

1)ある中山間部に住む健康高齢者26名を自覚的良眠群と不眠群とに分類し,両群において生活上の行動の規則正しさをSocial Rhythm Metric(SRM)を用いて検討した結果,差は認められなかった. 2)差が認められなかった原因として,内科疾患や整形外科的疾患,睡眠時呼吸障害,痴呆やうつ状態といった不眠の原因となる疾患を合併している者が除外されていたことが考えられた

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Language：Japanese   Publisher：公立豊岡病院  

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Language：Japanese   Publisher：公立豊岡病院  

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Language：Japanese   Publisher：公立豊岡病院  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese  

J-GLOBAL

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Language：English   Publishing type：Research paper, summary (international conference)  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Meeting report  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2008207645

Language：Japanese   Publisher：三原医学社  

CiNii Books

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Language：Japanese   Publisher：三原医学社  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publisher：三原医学社  

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Language：Japanese   Publisher：三原医学社  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：OXFORD UNIV PRESS INC  

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Language：Japanese   Publishing type：Meeting report  

J-GLOBAL

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ACADEMY SLEEP MEDICINE  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ACADEMY SLEEP MEDICINE  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ACADEMY SLEEP MEDICINE  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER ACAD SLEEP MEDICINE  

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