Tanigawa Takeshi
Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
JMA J. 2025 Jul 15;8(3):673-678. doi: 10.31662/jmaj.2024-0200. Epub 2025 Jul 9.
Ensuring good sleep quality and adequate sleep duration is crucial for health. Sleep apnea syndrome (SAS) impairs sleep quality and increases the risk of diabetes, cardiovascular diseases, and accidents. The author has significantly advanced the understanding of SAS in Japan through over 20 years of epidemiological studies. Findings have revealed that individuals with a 3% oxygen desaturation index (ODI) ≥15 events/h have a 1.69-fold higher risk of developing diabetes. Those with mild to severe sleep-disordered breathing (SDB) with a 3% ODI ≥5 events/h face high risks of heart disease and lacunar infarction, at 26.1% and 30.1%, respectively. Among shift workers aged ≥40, SDB was significantly associated with elevated blood pressure. Additionally, the risk of traffic accidents in SDB patients is approximately 2.5 times higher than in those without SDB. The author advocated for routine SAS screening, especially for professional drivers, to enhance public safety. In collaboration with the Ministry of Land, Infrastructure, Transport and Tourism, comprehensive guidelines for SAS screening were developed, emphasizing the necessity of objective methods due to the disconnect between subjective sleepiness and objective alertness. These methods include pulse oximetry and the 3-minute psychomotor vigilance test (PVT). Highlighting the health risks for night-shift workers with SDB, the author promoted regular screening and early intervention. Additionally, pediatric SAS was linked to attention-deficit hyperactivity disorder-like symptoms, stressing the need for early treatment. Post-disaster health initiatives showed increased insomnia among Fukushima recovery workers, with continuous positive airway pressure therapy proving beneficial. The author also developed health security measures using PVT for doctors working long hours, linking reduced wakefulness to depression and burnout. These contributions have significantly improved public health and safety in Japan, influencing health policies and promoting widespread SAS screening and sleep debt evaluation. Continued support from doctors of the Japan Medical Association is essential to maintain these advancements.
确保良好的睡眠质量和充足的睡眠时间对健康至关重要。睡眠呼吸暂停综合征（SAS）会损害睡眠质量，并增加患糖尿病、心血管疾病和发生事故的风险。作者通过20多年的流行病学研究，在日本显著推进了对SAS的认识。研究结果显示，氧饱和度下降指数（ODI）≥15次/小时且下降幅度为3%的个体患糖尿病的风险高出1.69倍。ODI≥5次/小时且下降幅度为3%的轻度至重度睡眠呼吸障碍（SDB）患者患心脏病和腔隙性脑梗死的风险很高，分别为26.1%和30.1%。在40岁及以上的轮班工人中，SDB与血压升高显著相关。此外，SDB患者发生交通事故的风险比无SDB者高出约2.5倍。作者主张进行常规的SAS筛查，尤其是对职业司机，以提高公共安全。与国土交通省合作，制定了SAS筛查的综合指南，强调由于主观困倦与客观警觉性之间的脱节，采用客观方法的必要性。这些方法包括脉搏血氧测定法和3分钟精神运动警觉性测试（PVT）。作者强调了SDB夜班工人面临的健康风险，推动定期筛查和早期干预。此外，儿童SAS与注意力缺陷多动障碍样症状有关，强调了早期治疗的必要性。灾后健康倡议显示，福岛恢复工作的工人失眠情况增加，持续气道正压通气治疗被证明有益。作者还为长时间工作的医生制定了使用PVT的健康安全措施，将清醒时间减少与抑郁和职业倦怠联系起来。这些贡献显著改善了日本的公众健康和安全，影响了健康政策，并促进了广泛的SAS筛查和睡眠债评估。日本医学协会医生的持续支持对于维持这些进展至关重要。
