Research on diagnostic and treatment approach of intractable insomnia through elucidation of the pathophysiology of sleep state misperception

2021 Fiscal Year Final Research Report

• Project/Area Number: 19H03578
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 52030:Psychiatry-related
• Research Institution: Akita University
• Principal Investigator: Mishima Kazuo 秋田大学, 医学系研究科, 教授 (40239223)
• Co-Investigator(Kenkyū-buntansha): 榎本 みのり 東京工科大学, 医療保健学部, 講師 (60415578) ; 竹島 正浩 秋田大学, 医学部附属病院, 講師 (60778736)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 不眠症 / 睡眠状態誤認 / 認知行動療法

Outline of Final Research Achievements

A risk factor analysis of sleep state misperception in chronic insomnia was conducted. Thirty-one patients with treatment-resistant chronic insomnia (mean age 63.2 years) and 42 healthy controls (59.6 years) were simultaneously recorded in a sleep diary and actigraph MTN and evaluated for daytime functional impairment. The insomnia group reported 62 minutes less subjective total sleep time, 39 minutes longer wake time after sleep onset, and 28 minutes longer sleep latency than the control group. The insomnia group had a significantly longer total bedtime (45 minutes). The insomnia group had significantly poorer daytime dysfunction. In the insomnia group, the longer the time-in-bed and the earlier the bedtime, the greater the sleep state misperception. These results indicate that the presence of sleep state misperception in the insomnia group is associated with bedtime behavior.

Free Research Field

精神医学

Academic Significance and Societal Importance of the Research Achievements

慢性不眠症の治療抵抗要因の中で最も対応に困窮するのが睡眠状態誤認（Sleep state misperception; SSM）である。SSMは客観的睡眠が改善しているにも関わらず主観的な睡眠評価が低く留まる病態像で、薬物療法が奏功せず難治性である。睡眠薬の多剤併用・長期投与に陥る主な原因一つであり、その抑止の観点からもSSMのリスク要因分析、臨床診断および治療法の開発が求められている。本研究の成果は不眠症に対する認知行動療法の主要コンポーネントである睡眠制限法の理論的根拠とも合致した所見であり、睡眠薬の適正使用の推進にも寄与する。