睡眠障害の社会生活に及ぼす影響(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] The Influence of Sleep Disorders on Social Life(Symposium : Psychosomatic Function and Sleep Disorders)  [in Japanese]

多くの疫学研究により,睡眠障害が非常に頻度の高い疾患であることが明らかにされている.近年,睡眠障害の診断にあたって,睡眠の量や質だけでなく日中の生活機能障害が重視されており,その社会生活への悪影響を数量化した研究が散見される.本稿では,睡眠障害の中で頻度の高い不眠症および日常生活で経験することの多い睡眠不足が社会生活に及ぼす影響について概説した.不眠は,耐糖能障害や免疫機能低下など,系統的に身体機能に影響を及ぼすことがわかっている.また精神生理機能への影響も大きく,慢性不眠症者では一般人に比べて産業事故リスクが7倍と報告されている.不眠によって集中力・記憶・日常の仕事をやり遂げる能力・他人との関わりを楽しむ能力が低下し,QOL (quality of life)水準は悪化する.さらに,不眠はうつ病の前駆症状として考えられてきたが,近年うつ病発症リスクの有意な要因としても重要視されている.睡眠不足症候群は先進諸国ではかなり多く,無視できない睡眠障害の一つである.睡眠不足症候群での眠気水準は他の一般的な過眠性疾患と同水準であるが,運転事故既往者では眠気重症度が有意に高い.睡眠不足は,身体的,精神生理的機能に影響を及ぼし,睡眠の充足感が低いほど抑うつ得点が高くなることが示されている.睡眠障害に対しては,十分な治療を行うことにより症状が改善し,社会生活への悪影響も抑制される.国民のQOLを向上し健康な社会生活を送るために,睡眠障害の早期発見・早期治療と睡眠健康に関する啓発活動が今後必要である.

Several epidemiological studies have shown that sleep problems are common in Japanese general population. When treating sleep disorders, it is important to aim both at improving the disorder as well as often related dysfunctional daily life patterns. Recent studies have been designed specifically to evaluate the impact of sleep disorders on QOL (quality of life). The objective of this paper is to review the influence on social life of insomnia and insufficient sleep, which are the most common sleep disorders. Insomnia is statistically linked to a worsening of health condition. Persistent insomnia increases the risk of several somatic diseases such as hypertension and diabetes mellitus. In addition, the disorder has also a negative impact on waking functions related to quality of life, e.g. impaired concentration, impaired memory, decreased ability to accomplish daily tasks, and decreased enjoyment of interpersonal relationships. The risk of both work-related accidents and motor-vehicle accidents are usually found to be higher in insomniacs than in controls. Moreover, several studies have provided data suggesting that insomnia is one of the risk factors for the development of depression. Although chronic insufficient sleep and sleep loss are highly frequent in Japanese population, the number of insufficient sleepers who consult medical facilities is thought to be relatively low. From our study, 22% of the patients with insufficient sleep syndrome reported having had accidents or near misses. Moreover, the group of patients reporting these mishaps showed higher sleepiness scores than the other patients. This finding leads us to emphasize that insufficient sleep should not be overlooked and should be treated by prolonging nocturnal sleep and/or taking an appropriate daytime nap. Substantial treatment for sleep disorders usually improves not only sleep itself but also QOL. The importance of early recognition and treatment of sleep disorders as well as campaigns for sleep health awareness must be emphasized.