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The potential usefulness of orexin antagonists for sleep disorders and delirium in patients in the intensive care unit.

Research Project

Project/Area Number 16K11418
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Emergency medicine
Research InstitutionJichi Medical University

Principal Investigator

Sanui Masamitsu  自治医科大学, 医学部, 教授 (30424039)

Project Period (FY) 2016-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥5,200,000 (Direct Cost: ¥4,000,000、Indirect Cost: ¥1,200,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2016: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Keywordsせん妄 / 睡眠 / 重症患者 / 集中治療 / オレキシン / スボレキサント / 重症 / ポリソムノグラフィー / スポレキサント / 集中治療医学
Outline of Final Research Achievements

As a first step to investigate preventive effects of orexin antagonists for delirium in critically ill patients, we measured the orexin levels in the cerebrospinal fluid and obtained results suggesting the possibility of a disappearance of diurnal variation in orexin secretion in delirious patients. We utilized existing simple sleep monitors to investigate the feasibility of simple sleep monitoring in critically ill patients and showed its characteristics and limitations. We found methodological problems in observational studies regarding potential preventive effects on delirium with orexin antagonists, and suggested the possibility of no preventive effect. We conducted a multicenter prospective pre-post intervention study to verify the usefulness of a sleep promotion and delirium prevention protocol in the ICU including orexin antagonists, but no significant results were obtained.

Academic Significance and Societal Importance of the Research Achievements

重症患者におけるオレキシン拮抗薬のせん妄予防効果が、観察研究や一部のランダム化比較試験で示されているが、その生理学的論拠や研究方法論には検討の余地が大きい。本研究は、生理学的に拮抗薬使用の論拠となる、“重症患者におけるオレキシンの動態”に迫る初の研究であり、今後も研究を継続する意義が大きい。また研究方法論として、重症患者の睡眠に対する有用・簡便なモニタリング法が確立されていない現状から、各種のモニタリングを検討し、その限界を示した。また、既存の観察研究の重大な問題点を指摘した。総じて、重症患者におけるせん妄の減少という重大な課題を解決する道程の中で、一定の足跡を残したと考える。

Report

(8 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (14 results)

All 2023 2022 2021 2020 2019 2018 2017 2016

All Journal Article (6 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 6 results,  Open Access: 4 results) Presentation (8 results) (of which Invited: 5 results)

  • [Journal Article] A preliminary study on the utility of Root TM; with SedLine TM; for sleep evaluation in critically ill patients: Comparison with polysomnography and the Richards-Campbell Sleep Questionnaire.2023

    • Author(s)
      Nagatomo K, Sanui M, Masuyama T, Iizuka Y, Shiotsuka J
    • Journal Title

      J Intensive Crit Care

      Volume: 9 Pages: 012-012

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Reducing the effect of immortal time bias affects the analysis of prevention of delirium by suvorexant in critically ill patients: A retrospective cohort study.2022

    • Author(s)
      Shiotsuka J, Uchino S, Sasabuchi Y, Masuyama T, Lefor AK, Sanui M
    • Journal Title

      PLoS One

      Volume: 17 Issue: 12 Pages: e0277916-e0277916

    • DOI

      10.1371/journal.pone.0277916

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Validity of an under-mattress sensor for objective sleep measurement in critically ill patients: a prospective observational study2020

    • Author(s)
      Nagatomo Kanae、Masuyama Tomoyuki、Iizuka Yusuke、Makino Jun、Shiotsuka Junji、Sanui Masamitsu
    • Journal Title

      Journal of Intensive Care

      Volume: 8 Issue: 1 Pages: 16-16

    • DOI

      10.1186/s40560-020-0433-x

    • Related Report
      2020 Research-status Report 2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Suvorexant is associated with a low incidence of delirium in critically ill patients: a retrospective cohort study.2018

    • Author(s)
      Masuyama T, Sanui M, Yoshida N, Iizuka Y, Ogi K, Yagihashi S, Nagatomo K, Sasabuchi Y, Lefor AK.
    • Journal Title

      Psychogeriatrics

      Volume: - Issue: 3 Pages: 209-215

    • DOI

      10.1111/psyg.12314

    • Related Report
      2018 Research-status Report 2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] 重症患者の不眠とせん妄治療戦略の現況2017

    • Author(s)
      長友 香苗、讃井 將満
    • Journal Title

      臨床麻酔

      Volume: 41 Pages: 309-318

    • Related Report
      2016 Research-status Report
    • Peer Reviewed
  • [Journal Article] 術後せん妄の評価と対応2016

    • Author(s)
      塩塚潤二、讃井將満
    • Journal Title

      呼吸器ケア

      Volume: 14 Pages: 542-543

    • Related Report
      2016 Research-status Report
    • Peer Reviewed
  • [Presentation] ICU入室中の重症患者における簡易睡眠脳波計による睡眠評価2021

    • Author(s)
      増山智之、西山聖也、讃井將満
    • Organizer
      日本集中治療医学会第5回関東甲信越支部学術集会
    • Related Report
      2021 Research-status Report
  • [Presentation] The patient with delirium at the ER: Do's and don'ts2019

    • Author(s)
      Sanui M
    • Organizer
      EuroAsia
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] Sleep deprivation, social media, burn out2019

    • Author(s)
      Sanui M
    • Organizer
      EuroAsia
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] 適切な鎮痛・鎮静2019

    • Author(s)
      讃井 將満
    • Organizer
      日本急性血液浄化学会
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] 重症患者の睡眠:良い介入のための基礎知識2019

    • Author(s)
      讃井將満
    • Organizer
      第46回日本集中治療医学会学術集会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] なぜICUにおける睡眠の改善は難しいのか2019

    • Author(s)
      讃井將満
    • Organizer
      第69回日本救急医学会関東地方会学術集会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] 重症患者におけるポータブル脳波計SedLineを用いた睡眠モニタリングの有用性2018

    • Author(s)
      増山 智之、長友 香苗、吉田 直人、加藤 剛、岩崎 夢大、関根 彰子、簗瀬 史貴、川岸 利臣、八木橋 智子、讃井 將満
    • Organizer
      第45回日本集中治療医学会学術集会
    • Related Report
      2017 Research-status Report
  • [Presentation] ICU患者に対する看護師による睡眠評価の妥当性の検討2018

    • Author(s)
      吉田 直人、長友 香苗、増山 智之、牧野 淳、八木橋 智子、讃井 將満
    • Organizer
      第45回日本集中治療医学会学術集会
    • Related Report
      2017 Research-status Report

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Published: 2016-04-21   Modified: 2024-01-30  

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