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Thesis
介護老人保健施設・特別養護老人ホームにおける高齢者のアクチグラフによる睡眠・覚醒アセスメント

遠藤　順朗
埼玉医科大学・生理学教室

医学博士　乙第1006号　平成18年2月17日 （埼玉医科大学）

The Sleep-Wakefulness Assessments of Very Old Residents in Nursing Homes
Yoriaki Endo (Department of Physiology, Saitama Medical University, Moroyama, Iruma-gun, Saitama 350-0495, Japan)

　The aim of this study is to assess the sleep/wake activity of very old residents (over 90 years old) in nursing homes by using actigraphy. We have divided them following three groups, Group 1: non-demented and good ADL (activity of daily living) 16 people (mean age, 93.7 years old). Group 2: severely demented but good ADL 16 people (94.9 years old), and Group 3: severely demented and poor ADL (with severe health problems) 16 people (93.9 years old). Group 1 showed good circadian rhythmicity of sleep/wake activity, but frequent naps (the mean numbers of sleep episodes with over 5 minutes are 7.7, significantly higher than group 2) in their active time zone and several brief awakenings in their sleeping time zone (bed interval). Group 2 also showed good circadian rhythmicity of sleep/wake activity, less naps in active time zone than Group 1, but more frequent awakenings ( the numbers of awakening episodes are 7.7) and the fragmentation of sleep in bed interval. Group 3 showed the disruption of circadian rhythmicity, 65％ sleeping time in 24 hours and the fragmentation of sleep in 24 hours. From these results, it is suggested that it is necessary to concern the level of both dementia and ADL including individual health problems for the assessment of sleep/wake activity in nursing home residents and actigraphy is suitable as an assessment of sleep/wake activity for the nursing home residents.
Keywords: Sleep/wake activity, actigraphy, over 90 years old, circadian rhythm, nursing home, ADL