2023 年 19 巻 1 号 p. 22-29
Background: Patients in rehabilitation facility have enormously long free time and often fall asleep during daytime. Excessive daytime sleep (DS) was reported to decrease rehabilitation efficiency resulting in poor functional recovery. In general population, insomnia, obesity, depression, dementia and the use of sleeping pills are known to be important risk factors of excessive DS. However, the causes of excessive daytime sleep in patients undergoing inpatient rehabilitation have not been clearly identified. Therefore, the current preliminary study aimed to explore factors underlying excessive DS in elderly patients undergoing inpatient rehabilitation following acute stroke.
Methods: Subjects were 17 patients without dementia with more than 65 years of age who were admitted to our rehabilitation wards following acute stroke. In all the patients, daytime and nighttime sleep states were monitored with wrist actigraphy consecutively for five days. Relationships of DS duration with insomnia, obesity, depression, apathy, hypnotic administration, motor functional ability, recreational activities and self-exercise were investigated.
Results: All the patients had more or less DS, the duration of which widely ranged from 43 to 550 min/day with mean value 210 ± 122 min/day. This DS duration was 3 - 4 times longer than that in general elderly population. The majority of patients had sufficiently long nighttime sleep (NS). There was no correlation between DS duration and NS duration. DS duration had no relationship with obesity, depression, apathy, hypnotic administrations, or motor functional ability. DS duration was, however, significantly shorter in patients performing self-exercise (n = 10, 157 ± 82 min) than in those without self-exercise (n = 7, 285 ± 135 min) (p = 0.03). Recreational activities did not shorten DS duration.
Conclusion: Patients in rehabilitation facility tend to have long DS because of enormously long free time and consequent idleness. Taking up the free time with self-exercise appears to be useful for preventing excessive DS.
