縦断調査による妊娠初期，中期，後期の睡眠障害と自律神経活動との関連

Association of Autonomic Activity With Sleep Disturbances in Early, Middle, and Late Pregnancy by Longitudinal Study

要旨

　目的：妊婦の主観的・客観的睡眠指標を経時的に測定し妊娠経過に伴う睡眠障害と自律神経活動の関係を明らかにする．

　方法：初期，中期，後期に主観的睡眠指標（PSQI-J，JESS），Silmee Bar type Liteを用い客観的睡眠指標と自律神経活動を測定した．

　結果：37名を分析対象とした．PSQI-J得点（高いほど自覚的睡眠の質が悪い）は初期より中期で有意に低かった．自律神経活動では，初期にHF平均（高いほど副交感神経活動優位）は有意に高く，LF平均/HF平均（高いほど交感神経活動優位）は有意に低かった．相関分析の結果，後期にPSQI-J得点とHF平均との間に負の相関，LF平均/HF平均との間に正の相関，JESS得点（高いほど日中の過度な眠気が強い）とHF平均との間に負の相関，LF平均/HF平均との間に正の相関を認めた．

　結論：妊婦の睡眠障害の一因に自律神経活動が関係している可能性がある．

　Objective: To conduct serial measurement of subjective and objective sleep indices in pregnant women to determine the relationship between autonomic nervous system activity and sleep disturbances over the course of pregnancy.

　Method: Subjective sleep indices (Pittsburgh Sleep Quality Index [PSQI-J], Epworth Sleepiness Scale [JESS]), objective sleep indices, and autonomic nervous activity were measured in pregnant women using a Silmee Bar type Lite biosensor in each of early, middle, and late pregnancy. Overnight mean values of high-frequency (HF) as a measure of parasympathetic activity and overnight mean values of low-frequency (LF)/HF ratio as a measure of sympathetic activity were used in the analysis.

　Results: Thirty-seven patients were included in the analysis. PSQI-J scores were significantly lower in the middle period than in the early periods. Regarding autonomic activity, mean HF was significantly higher in the early period and mean LF/mean HF was significantly lower in the early period. In the late period, positive correlations were found between PSQI-J score and mean LF/ mean HF, as well as between JESS score and mean LF/mean HF, and negative correlations were found between PSQI-J score and mean HF, as well as between JESS score and mean HF.

　Conclusion: The present findings suggest that autonomic nervous system activity may be a contributing factor to sleep disturbances in pregnant women.