冠動脈疾患患者の不眠に関する文献検討

Literature Review on Insomnia in Patients with Coronary Artery Disease

要旨

　目的：冠動脈疾患患者の不眠に関する研究動向を把握する．

　方法：医学中央雑誌，PubMed，CINAHLを用いて2020年7月までに登録されている文献を検索した．

　結果：文献は29件が抽出され，量的研究は27件，質的研究は2件であった．そのうち介入研究は6件，看護師による研究は14件．主観的な尺度を用いた有病率と関連要因の検討，客観的な方法を用いて睡眠パターン分析が行われていた．不眠は21〜69％に見られ，女性・うつ等が関連し，患者は胸痛により眠気を消失する等の経験から安心感を得る等の工夫をしていた．看護支援は入院中の患者を対象とした研究が多く，リラクゼーションを活用した支援や教育が検討されていた．

　結論：不眠に関連する要因，疾患特有の影響を考慮した支援を明らかにする必要がある．そのため，冠動脈疾患患者の不眠の定義を明確にし，退院後に必要な支援内容を検討することが必要である．

　Objective: This study aimed to understand the trend of research on insomnia in patients with coronary artery disease.

　Methods: We searched the literature registered in July 2020 using the web version of the Ichushi, PubMed, and CINAHL databases.

　Results: A total of 31 documents were extracted; 29 and 2 were quantitative and qualitative studies, respectively. Of these, 6 were intervention studies; 14, nurse studies. Prevalence and related factors were examined using a subjective scale and sleep pattern analysis was performed using an objective method. Insomnia was seen in 21%-69% of patients and it was related to women and depression. The patients were devised to practice a sense of security from the experience of losing sleep because of chest pain. Nursing support has been mostly studied for hospitalized patients and support and education utilizing relaxation have been considered.

　Conclusion: There is a need to explore specific support that considers factors related to insomnia and disease-specific effects. Therefore, it is necessary to clarify the definition of insomnia in patients with coronary artery disease and consider the steps to provide the necessary support after their discharge.