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CPAP療法による閉塞性睡眠時無呼吸症候群の治療方法と効果

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OSAS(Obstructive Sleep Apnea Syndrome:閉塞性睡眠時無呼吸症候群)の症状が重症化した場合、CPAP療法(Continuous Positive Airway Pressure:経鼻的持続陽圧呼吸療法)による治療が効果を奏します。

CPAP療法は、CPAP装置から空気を気道に送り、睡眠時に気道が閉塞してしまうことを防ぐものです。

CPAP療法は即効性があり重篤な副作用も少ないため、OSASの治療法として多く用いられています。

本記事では、CPAP療法の概要、効果をご紹介します。OSASのつらい症状でお悩みの方は、ぜひご覧ください。

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CPAP療法とは

夜景

CPAP療法は、1981年にC.E. SullivianらによってOSASの治療に導入、劇的な改善効果が報告され、現在、重症のOSASの主な治療法となっています。

OSASは、空気の通り道である気道が睡眠時に部分的、あるいは完全に閉鎖してしまうことによって起こります。

CPAP療法は、CPAP装置から予め設定した圧力(陽圧)を気道へ送り、気道を常に陽圧に保つことにより気道の閉塞を防ぎ、睡眠中の無呼吸の状態を防ぐものです。

CPAP療法は根治療法ではないため、他の方法による治療で完治するまでは毎日就寝時には装置をつけて眠ることになります。
しかし、CPAP療法には即効性があり、いびきなどは治療の初日から解消されることが多く、睡眠の質の向上を望むことができます。

このように、CPAP療法は重症のOSASに大きな効果のある重要な治療法であるといえるでしょう。

それでは次に、CPAP療法を続ける際に注意すべき点をご紹介します。

CPAP療法の注意点

CPAP療法は、重篤な副作用の少ない療法とされています。

しかし、CPAP療法はCPAPという医療機器を自宅で使用することから、注意しなければならない点もいくつかあります。
以下にその注意点をあげます。

適切な圧で利用する

定期的に通院し、適切な圧を処方してもらうようにします。

また、睡眠姿勢、鼻腔・口腔ケア、口があいてしまう場合はチンストラップを利用するなど、CPAP療法の効果があがるように、医師の指示を仰ぎましょう。

停電、回路故障

CPAPは停電、回路故障などで送風がとまると、呼気を再呼吸してしまうことから、二酸化炭素が貯留し、呼吸困難が出現するリスクがあります。

患者本人はもちろん、家族などにもこの点を知ってもらい、停電時には注意するようにする必要があります。

また、CPAP内部にはたくさんのIC制御基盤が入っているため、乱雑に取り扱わない、水分がかからないようにする、など使用にあたっては注意が必要となります。

フィルターを清潔に保つ

吸入口のフィルターが詰まると、適切な圧や機能が維持できなくなる可能性があるため、フィルターのチェックも重要となります。

また、CPAP療法では室内空気を圧縮して上気道に送風しているため、適切な温度と湿度管理、ほこりやアレルギー源の除去といった、室内空気の管理が必要です。

消耗品の管理

マスクやチューブ、フィルターは清潔に保つとともに、消耗品であるためチェックを怠らずに、不具合が生じる前に交換する必要があります。

CPAP療法の効果

CPAP療法はOSASを根治できるものではありませんが、症状の改善には大きな効果があります。

CPAP療法で改善できる症状は次のようなものです。

  • 無呼吸・低呼吸・いびきの消失
  • 睡眠の質の向上
  • 日中の眠気などの改善
  • 高血圧や狭心症など、合併症の改善
  • 良眠により活動的になり、仕事や趣味、社会生活に意欲が湧き、生活の質(QOL)が向上する
  • 意欲の向上により、減量や禁煙に成功することもある

CPAP療法では、OSASの症状が重い人ほど自覚症状の改善が期待できます。
反対に症状が軽い人のなかには、あまり改善されない、と感じる人もいるようですが、これはCPAP療法が効かないということではなく、元の症状とCPAP療法後の状態の差が大きくないため、といえるでしょう。

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療法で生活の質の向上を目指しましょう

CPAP療法は、OSASの症状によって、社会的な生活の維持が難しくなってしまっている方にとって、即効性のある重要な療法であるといえます。

睡眠時にはマスクをつけたまま眠らなくてはならないため、慣れないとかえって寝られない、と感じたりするかもしれません。

しかし、ここまでに述べたように、CPAP療法は特に重症のOSASの患者さんにとって、大きな改善が期待できる療法です。

医師の指示を仰ぎながらCPAP療法を続けることにより、つらいOSASの症状の緩和、そして減量や生活習慣の改善などで完治を目指してください。

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