『保健医療科学』 2022 第71巻 第5号 p.432-439（2022年12月）
＜原著＞
就学前幼児の母親の抑うつと母子の睡眠との関連
佐藤直子 1)，稲田尚子 2)，中島俊 2,3)，大井瞳 3)，井上真里 3)， 宮崎友里 3)，足達淑子 4)
1)お茶の水女子大学大学院 2)帝京大学文学部 3)国立精神・神経医療研究センター認知行動療法センター 4)あだち健康行動学研究所
Association between mother’s depressive symptoms and sleep of mothers and preschool children
SATO Naoko 1), INADA Naoko 2), NAKAJIMA Shun 2,3), OI Hitomi 3), INOUE Mari 3), MIYAZAKI Yuri 3), ADACHI Yoshiko 4)
1) Graduate School of Humanities and Sciences, Ochanomizu University
2) Teikyo University Department of Psychology, Faculty of Liberal Arts
3) National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry
4) Institute of Behavioral Health
抄録
目的 : 母親の抑うつに関して，母親自身および幼児の睡眠問題との関連がこれまでの研究で多く示されている. さらに近年では，母親の抑うつには幼児の夜間の睡眠問題だけでなく，それに関連する日中の問題の影響が示されている. しかし，これまで，母親の抑うつと母親の睡眠問題，幼児の夜間の睡眠問題または睡眠関連の日中の問題は別個に検討されてきた. そこで本研究では，幼児の夜間の睡眠問題と睡眠関連の日中の問題を同時に測定できる質問紙を用いて，母親の抑うつと母子の睡眠との関連について検討することを目的とした.
方法 : 保育園・幼稚園に通う幼児とその養育者205組を対象として，質問紙調査を実施した. 得られた回答159件(回収率77.6%)から，主たる回答者が母親である132組の母子データ(有効回答83.0%)を分析対象とした. 質問紙は，幼児の睡眠問題の評価に，日本版幼児睡眠質問票(Japanese Sleep Questionnaire for Preschoolers : JSQ-P) 10因子のうち，本研究の目的に合致したパラソムニア， 不眠・リズム障害，朝の症状，日中の過度の眠気，日中の行動，睡眠不足の6因子25項目，母親の睡眠問題の評価にAthens Insomnia Scale (AIS) ，母親の抑うつ症状の評価にOverall Depression Severity and Impairment Scale (ODSIS) を用いた. 分析は，各質問紙によって得られた得点に基づき，相関分析および重回帰分析を行った.
結果 : 相関分析の結果，ODSISはJSQ-P下位6因子のうち，幼児の夜間の睡眠問題である「不眠・リズム障害」と睡眠関連の日中の問題である「日中の行動」，AIS下位2因子と有意な相関を示した. しかし，ODSISを従属変数，ODSISと相関が示された「不眠・リズム障害」と「日中の行動」，AIS下位2因子を独立変数とした重回帰分析では，幼児の睡眠関連の日中の問題である「日中の行動」と母親の夜間の睡眠問題のみが母親の抑うつと有意な関連を示した(日中の行動: β=0.20, p=0.03, 母親の夜間の睡眠問題: β=0.32, p=0.001).
結論 : 幼児の睡眠関連の日中の問題(日中の行動)と母親の夜間の睡眠問題が，母親の抑うつ症状と関連するものと考えられる. 今後，母親のメンタルヘルスの問題を考える際には，母親の睡眠の問題だけでなく，幼児の日中の問題も含めた睡眠の問題を評価することの必要性が示唆された.
キーワード : 母親の抑うつ，幼児，睡眠問題
Abstract
Objectives : Mothersʼ depressive symptoms are known to be associated with sleep problems in mothers and preschool children. More recently, it has been shown that mothersʼ depressive symptoms are associated with not only childrenʼs nighttime sleep problems but also daytime problems associated with sleep. However, until now, mothersʼ depressive symptoms and mothersʼ sleep problems, as well as childrenʼs nighttime sleep problems or daytime problems associated with sleep, have been examined separately. This study investigated the associations with mothersʼ depressive symptoms and mothersʼ and preschool childrenʼs sleep using a questionnaire that can simultaneously evaluate nighttime sleep problems and daytime problems associated with sleep.
Methods : A questionnaire survey was administered to 205 caregivers who have children attending nursery schools and kindergartens. From the 159 responses obtained (response rate of 77.6), 132 pairs of mothers and children (valid response rate of 83.0) were selected for analysis. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) was used to evaluate sleep problems of the children. The questionnaire was designed 10 factors, in this study, 6 factors of parasomnia, insomnia/rhythm disorders, morning symptoms, excessive daytime sleepiness, daytime behavior, and sleep deprivation, which were consistent with the purpose of this study were used. Athens Insomnia Scale (AIS) was used to evaluate mothersʼ sleep problems, and the Overall Depression Severity and Impairment Scale (ODSIS) was used to evaluate mothersʼ depressive symptoms. The analysis was based on the scores obtained by each questionnaire, and correlation analysis and multiple regression analysis were conducted.
Results : The results of the correlation analysis showed that the ODSIS positively correlated with “insomnia/rhythm disorder,” a nighttime sleep problem, and “daytime behavior,” daytime problems associated with sleep among the 6 factors of JSQ-P, and the 2 factors of the AIS. However, only the childrenʼs scores of “daytime behavior,” daytime problems associated with sleep, and maternal nighttime sleep problems were associated with the scores of ODSIS on multiple regression analysis (daytime behavior: β=0.20, p=0.03, maternal nighttime sleep problems: β=0.32, p=0.001).
Conclusion : Preschool childrenʼs daytime problems associated with sleep (daytime behavior) and the mothersʼ nighttime sleep problems were considered to be related to the mothersʼ depressive symptoms. The results suggest the necessity of assessing not only the mothersʼ sleep problems but also the childrenʼs nighttime and daytime sleep problems when considering the mothersʼ mental health problems in the future.
keywords : Mothersʼ depressive symptoms, preschool children, sleep problems
