環境と睡眠障害(シンポジウム : 心身機能と睡眠障害,2006年,第47回日本心身医学会総会(東京))  [in Japanese] Environment and Sleep Disturbance(Symposium : Psychosomatic Function and Sleep Disorders)  [in Japanese]

睡眠に関する問題は医療界にとどまらず,社会問題としても大きく取り上げられてきている.不眠の原因は多岐にわたるが,環境の問題によって不眠が生じることも少なくない.今回は,入院環境と労働環境という側面から検討した.身体疾患で入院した患者の61%に何らかの不眠が認められていた.しかし,不眠患者の約50%のケースでは,主治医や患者が不眠を主な問題として取り上げていなかった.また,不眠患者の背景要因の中で「治療関係」の占める割合が高く,支持的対応を必要とする患者が多かった.労働環境と精神衛生についてみると,不安感は日勤者のほうが高く,QOLの阻害も日勤者のほうが高かった.しかし,睡眠に関してみると,交代勤務者に睡眠障害を多く認めた.睡眠障害の評価にあたっては環境要因を重視し,適切な対応を行うことが重要と考えられた.

Sleep disturbance has been a growing problem in the medical"care and society. Many reasons were known for insomnia, we experience some patients with sleep disorders caused by environmental problems. In this study, we investigated whether or not the hospital and work environment had any effect on sleep or not. We surveyed 57 inpatients with physical diseases about the existence of insomnia, background, reason of referral from other departments and the approaches to patients. Of all inpatients, 61% had sleep problems. However, about a half of the patients with insomnia did not recognize their sleep disturbances as a main problem and a half of the doctors in charge considered the sleep disturbance a as not main problem, either. Many patients had problems in doctorpatient relationships and needed supportive psychotherapy. From the viewpoint of work environment, daytime workers showed higher anxiety and lower quality of life than shift workers. Many shift workers however had sleep disturbance. We had to put greater importance on the environmental factors in the management of sleep disturbance.