Sleep health, lifestyle and mental health in the Japanese elderly: ensuring sleep to promote a healthy brain and mind.

The Ministry of Health, Labor and Welfare in Japan proposed a plan called "Health Japan 21," which adopted sleep as one of the specific living habits needing improvement. This has led to increased interest in mental health needs at community public health sites. In addition, it was reported from a recent 2000 survey that one in five Japanese, and one in three elderly Japanese, suffer from insomnia. Insomnia is becoming a serious social problem; so much so that alarm bells are ringing with insomnia listed as one of the refractory diseases of the 21st century. Against this background, in January 2001, Japan began a national project called "Establishing a Science of Sleep." This article is an overview of sleep and health in the elderly, sleep mechanisms and the characteristics of insomnia among the elderly. At the same time, it introduces the scientific basis for lifestyle guidance that is effective for ensuring comfortable sleep, an essential condition for a healthy, energetic old age, with actual examples from community public health sites. The present authors reported that a short nap (30 min between 1300 and 1500 h) and moderate exercise such as walking in the evening are important in the maintenance and improvement of sleep quality. The study was to examine the effects of short nap and exercise on the sleep quality and mental health of elderly people. "Interventions" by short nap after lunch and exercise with moderate intensity in the evening were carried out for 4 weeks. After the "intervention," wake time after sleep onset significantly decreased and sleep efficiency significantly increased, showing that sleep quality was improved. The frequency of nodding in the evening significantly decreased. As a result, the frequency of nodding before going to sleep decreased, and the quality of nocturnal sleep was improved. Present results demonstrated that the proper awakening maintenance during evening was effective in improving sleep quality. After the "intervention," mental health also improved with improving sleep quality. Furthermore, physical health also improved with improving sleep quality. These results suggest that this "intervention" technique is effective for the quality of life (QOL) and the activity of daily living (ADL) of elderly people.