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居眠りする男
居眠りする男

睡眠時無呼吸症候群のCPAP療法に伴う7つの副作用と対処方法

居眠りする男

CPAP(Continuous Positive Airway Pressure:経鼻的持続陽圧呼吸療法)は、睡眠時無呼吸症候群の重要な治療法のひとつとして、多くの患者さんの治療に取り入れられています。

CPAPは重篤な副作用の少ない治療法といわれていますが、睡眠時にマスクを装着し空気を送る、という方法から副作用が生じる場合もあります。

本記事では、CPAP治療で生じる可能性のある副作用とその対処方法をご紹介します。

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CPAPの仕組み

夜明けの画像

睡眠時無呼吸症候群は、睡眠時に気道が部分的、あるいは完全に閉塞してしまうことから起こる症状です。

CPAPは睡眠時に装置を装着して気道に空気を送り、気道を常に陽圧に保つことにより気道の閉塞を防ぐという療法です。
具体的には、鼻にマスクを固定し、CPAPの機材から空気を送り込むということになり、睡眠時にはいつもマスクをつけることになります。

CPAPは対症療法であり、睡眠時無呼吸症候群を完治させるものではないため、他の方法により完治するまでは、長期間CPAP治療を続けることとなります。

このため、CPAP療法を行っていると、これに伴う副作用が生じる場合もあります。

それでは次に、CPAPの治療に伴って現れる可能性のある副作用をご紹介します。

CPAPの副作用

CPAPは重篤な副作用の少ない療法として多く使用されていますが、全く問題がないというわけでもありません。

以下にCPAPを使用したときにおこる可能性のある副作用をあげます。

副作用その1:心血管系への負担

オートタイプのCPAPの場合、過度な圧設定を行うとマスクからの漏れに応じて必要以上に圧がかかり、心血管系に負担がかかります。
過度の圧負荷により心不全を発生させ、中枢性無呼吸につながる場合もあります。

このように、CPAPを使用する際には圧の設定には細心の注意が必要となるため、副作用を防ぐためには定期的な受診による医師との連携が不可欠となります。

副作用その2:鼻の乾燥、うっ血、鼻血

CPAP装置は部屋の空気を取り込んでいるため、室内が乾燥していると喉、鼻が乾燥しやすくなります。

加湿器を使用したり濡らしたタオルを干したりして、室内の乾燥を防ぐようにしてください。それでも改善しない場合は、医師に相談してCPAP専用の加湿器を使うこともできます。

副作用その3:口腔乾燥

睡眠時に口を開けて寝ている可能性があり、顎を抑えるバンドなどでの対応が可能です。

鼻の乾燥と同様に、室内の温度や湿度を調節したり、CPAP専用の加湿器を使用したりすることで改善できることもあります。

副作用その4:入眠困難

マスクを装着して寝なければならないため、なかなか寝付けないという方もおられるようです。

このとき個人の判断で睡眠薬を飲むことは控えてください。
なぜなら、睡眠薬は一部のものを除いて気道の筋力が低下するため、無呼吸の状態が悪化してしまうからです。

ただし、新しいタイプの睡眠薬には無呼吸に対する影響が少ないものもあります。
このような薬を用いた場合は、症状の悪化は伴わずに入眠困難が改善したという研究結果も出ていますので、医師と相談の上服用されるとよいかもしれません。
この研究結果については、詳しくは「福岡病院CPAPニュース No.61」をご覧ください。

副作用その5:腰痛

CPAP導入の初期によくある副作用といえます。これは、CPAPを装着して寝ることに慣れていないため寝返りをしていないことが原因となります。

使用に慣れるに従って、自然と寝返りも打つようになり副作用は改善に向かうことが多いようです。
改善傾向が見られない場合は、寝具の硬さを調節するなどの工夫をしてみるとよいでしょう。

副作用その6:皮膚のかぶれ

マスクを長時間装着して睡眠をとるため、マスクをあてている箇所の皮膚がかぶれる場合があります。

この場合、マスクを皮膚への接触が少ない鼻孔タイプ(鼻腔に直接差し込むタイプ)に変更する、といった対処が考えられます。

副作用その7:腹部膨満感

CPAPから送られる空気を飲み込んでしまうことで、腹部に膨満感を覚えることがあります。

このような副作用が現れたときは、医師と相談して治療効果を見ながら処方圧を下げるなどの対処で改善することができます。

ネルネル 21回用 (口閉じテープ)
三晴社 (2006-06-05)
売り上げランキング: 109

まとめ:CPAP治療は副作用を上手に抑えて続けましょう

CPAP治療は重篤な副作用の少ない療法として、睡眠時無呼吸症候群の重要な治療法となっています。

しかし、毎晩機材を装着して寝なければならないため、これに伴う副作用が現れる場合があります。
【CPAP治療に伴う副作用】

  • 心血管系への負担
  • 鼻の乾燥、うっ血、鼻血
  • 口腔乾燥
  • 入眠困難
  • 腰痛
  • 皮膚のかぶれ
  • 腹部膨満感

CPAP療法を行っている方のなかには「良眠を得るために治療しているのに、かえって寝られない」という悩みを持っておられる方もいらっしゃると思います。

そのような場合にもCPAP療法をあきらめるのではなく、医師と相談しながら治療を続け、睡眠時無呼吸症候群の症状を緩和し、最終的には完治を目指していただきたいと思います。

そのときには、本記事でご紹介したCPAP療法に伴う副作用への対処方法が少しでもお役にたてば幸いです。

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