尿意を表出できる施設入所高齢者の中途覚醒と夜間おむつ交換の関係

Association between Wake After Sleep Onset and Changing Diapers at Night in Long-term Care Insurance Facilities' Residents

抄録

　本研究は，尿意を表出できる施設入所高齢者の中途覚醒時間等と夜間おむつ交換との関係を明らかにすることを目的に，女性高齢者5人を対象に排泄状況や睡眠変数等のデータを2週間収集した．対象者は90〜97歳，NMスケール37〜27点，N-ADL 29〜15点，日中はトイレとおむつを併用し，夜間は尿意の訴えはなく，定時のおむつ交換を1晩に2回受けていた．対象者別の中途覚醒時間の中央値は33.0〜114.5分で，中途覚醒時間の年代別基準値80分未満は3人であった．この3人では1時間あたりの中途覚醒時間は22時ごろまでに減少，5時ごろから増加する傾向を確認したが，残る2人にこの傾向はなかった．おむつ交換前後の睡眠状態に関するデータは2週間で28回／人得られ，交換前に覚醒状態で交換後に睡眠状態は4人に2〜4回／人，交換前に睡眠状態で交換後に覚醒状態は1人に8回確認された．高齢者によって中途覚醒の傾向は異なり，夜間のおむつ交換は入眠，中途覚醒いずれの要因にもなると考えられた．

　In this study, for the purpose of clarifying the relationship between wake after sleep onset and the number of diapers changed at night for elderly people who can express urine intentions, data collection of excretion status, sleep variables, etc. was carried out for 2 weeks for 5 elderly women in long-term care insurance facilities. The subjects were 90 to 97 years old, with NM scale 37-27, N-ADL 29-15, combined toilet and diaper use during the day, no complaints of urges to urinate at night, and diaper changes performed punctually twice a night. The subjects were awake at night for the median time ranged from 33.0 to 114.5 minutes, with three of the subjects being awake for less than 80 minutes on an average, which is the standard value for this age group. These three subjects were confirmed to experience a decrease in nocturnal time spent awake per hour until 10 PM and an increase after 5 AM, but this tendency was not witnessed in the remaining two subjects. Data on sleep state before and after diaper changes was obtained 28 times per subject over the two weeks, with wakefulness before replacement and sleep state after replacement attained two to four times for four of the subjects and eight times for the remaining one. The tendency to awaken varied with the subject, and it was found that nightly diaper changes affected both falling asleep and waking up during the night.