Maeda Tsutomu, Oniki Kentaro, Miike Teruhisa
Nonprofit Organization Rihome, Fukui, Japan.
Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Pediatr Int. 2019 Oct;61(10):1036-1042. doi: 10.1111/ped.13976.
Sleep disorders, along with extreme difficulty in awakening, are one of the main causes of school refusal. The accumulation of chronic sleep deprivation accompanied by a late-night lifestyle is considered the basic inciting factor.
From 2007, we initiated a sleep education program (Min-Iku) in Fukui, Japan, with the aim of improving pupil lifestyle and preventing future school refusal. All grade 1-6 Miyake-primary school (M-PS) pupils participated in this program and gave their informed consent. The Min-Iku included (i) implementation of a "daily life rhythm survey" by recording the sleep-wake rhythm in a table for 14 days; (ii) evaluation of the sleep table according to the classifications A-D; (iii) interviews of stage D children and their guardians; (iv) lectures on the importance of daily life rhythms for parents and teachers; and (v) 45 min classwork for all participating pupils.
In 2007, 10% of M-PS graduates developed school refusal behavior after entering Kaminaka junior high school (K-JHS). The incidence of school refusal, however, decreased each year after the implementation of the Min-Iku program and finally reached 0 by 2012. The sleep onset time of pupils improved each year, with the most common sleep time reaching 9:30 p.m. on both weekdays and holidays. With an earlier sleep time, the night-time sleep duration was significantly extended (P < 0.001 vs 2007 data).
The Min-Iku program for primary school pupils successfully achieved a more routine night-time sleep pattern and a regular life rhythm, which prevented school refusal during the subsequent JHS years.
睡眠障碍以及极难唤醒是拒学的主要原因之一。慢性睡眠剥夺的累积以及深夜的生活方式被认为是基本诱发因素。
从2007年起，我们在日本福井启动了一项睡眠教育项目（Min - Iku），旨在改善学生的生活方式并预防未来的拒学情况。宫城县立小学（M - PS）1至6年级的所有学生都参与了该项目并给予知情同意。Min - Iku项目包括：（i）通过在表格中记录14天的睡眠 - 觉醒节律来实施“日常生活节奏调查”；（ii）根据A - D分类对睡眠表格进行评估；（iii）对处于D阶段的儿童及其监护人进行访谈；（iv）为家长和教师举办关于日常生活节奏重要性的讲座；以及（v）为所有参与学生安排45分钟的课堂作业。
2007年，M - PS的10%毕业生进入上中初中（K - JHS）后出现拒学行为。然而，在实施Min - Iku项目后，拒学发生率逐年下降，到2012年最终降至0。学生的入睡时间逐年改善，工作日和节假日最常见的睡眠时间均达到晚上9:30。随着睡眠时间提前，夜间睡眠时间显著延长（与2007年数据相比，P < 0.001）。
针对小学生的Min - Iku项目成功实现了更规律的夜间睡眠模式和正常的生活节奏，从而预防了后续初中阶段的拒学情况。
