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昼寝している男性
昼寝している男性

過眠症を引き起こす病気と治療方法

昼寝中の男

日中の耐えがたい眠気と居眠りが生じる病気を過眠症といいます。これは、単なる疲れが原因ではなく、病気によって引き起こされている場合が多くあります。

過眠症を引き起こす病気とはどのようなものがあるか、また、その病気の治療方法を紹介します。思い当たる症状があるかどうか、確認してみてください。

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ナルコレプシー

昼寝中の男

日中の過度な眠気だけでなく、睡眠発作や情動性脱力発作がある場合には、ナルコレプシーと診断されます。ナルコレプシーになると、夜間睡眠が浅く、中途覚醒が多くなります。

ナルコレプシーの治療方法としては、規則正しい日常生活を送ることと、睡眠不足を避けることが挙げられます。不眠を自覚している場合には、超短時間作用型、短時間作用型の睡眠薬を投与することで夜間睡眠が改善でき、昼間の眠気がいくらか減る場合があります。
また、昼間の眠気と睡眠発作については、中枢神経刺激薬であるリタリンやぺタナミンが処方されます。情動性脱力発作や睡眠麻疹、入眠時幻覚の症状に対しては、クロミプラミンやイミプラミンなど、レム睡眠を抑制する作用のある三環形抗うつ薬が有効です。

突発性過眠症

突発性過眠症は昼間の眠気と居眠りが主な症状ですが、眠気の程度はナルコレプシーより弱く、睡眠発作が起こることが少ないです。ただし、一旦眠り込むと目覚めるまでに1時間以上かかり、長時間を要する場合が多いです。目覚めのときには爽快感を欠きます。目覚めること自体が難しく、無理に目覚めさせると見当識障害を起こすこともあります。また、睡眠麻痺や入眠時幻覚が見られることもあります。夜間睡眠は長い場合が多いです。

突発性過眠症の治療方法は、リタリンやベタナミンなどの中核神経刺激薬が眠気にある程度効果があります。しかし、ナルコレプシー患者に比べて効果は劣ります。

反復性過眠症

反復性過眠症は比較的まれな疾患であり、ほとんどの例は10歳代です。症状は、強い傾眠が3日から3週間続き、自然に回復して全く症状がなくなりますが、その後不定の感覚で傾眠期が繰り返し現れます。傾眠期が突然起こることもありますが、感染やストレス、不眠、飲酒などが原因となって起こることが多いです。

反復性過眠症の治療方法については、傾眠期を予防する手段としてこれといって確立したものはまだありません。規則正しい生活を送って、睡眠不足や飲酒を避けるように指導されます。炭酸リチウムが予防に有効という報告がありますが、すべての患者に効果があるわけではありません。加齢によって、だんだん傾眠期が起こる回数が減っていくのが一般的です。傾眠症状に対しての有効な治療法はありません。

睡眠相後退症候群

睡眠相後退症候群は、早く寝ようとしてベッドに入っても、何時間も寝付けず、ある一定の時間にならないと入眠できないという病気です。生体リズムの遅れにより睡眠時間帯が極端に遅くなっていることが特徴です。無理に起きても、午前中は過剰な眠気や集中力の低下、倦怠感などがあって仕事や勉強が不可能ですが、午後や夕方になるとこれらの症状がなくなります。そのため、学業や社会生活に大きな支障をきたいします。

睡眠相後退症候群の治療には、多くの場合、睡眠薬による治療は無効です。毎日約3時間ずつ入眠時間を遅らせて社会生活にちょうどいい時間帯に眠れるようになったらそれを固定させる時間療法が今まで用いられてきましたが、その効果は1か月程度しか持ちません。そのため、最近では朝の高照度光照射やメラトニンなどの薬物を単独、または組み合わせて治療に取り入れられています。
また、睡眠日記をつけて、規則正しい生活習慣の構築のために生活指導も治療に大切です。睡眠相後退症候群
による社会的不適応について理解した上で、就寝前のテレビゲームやビデオ鑑賞、カフェインやアルコール摂取を避けます。必要に応じて入院することもあり、積極的に環境や睡眠週刊の改善を行います。一旦睡眠のリズムが正常化しても再発することが多いので、治療後も精神療法を含めたサポートが必要です。

9割の不眠は「夕方」の習慣で治る (SB新書)
白濱 龍太郎
SBクリエイティブ
売り上げランキング: 149,175

まとめ:過眠症に潜む病気を見極めて、適切な治療を受けよう

過眠症は、日中の耐えがたい眠気と居眠りが生じる病気です。過眠症はストレスや睡眠環境などが原因の場合もありますが、病気によって起こっているという可能性もあります。
例えば、ナルコレプシーや突発性過眠症、反復性過眠症などが挙げられます。それぞれの病気に対して薬物療法で対処するものもありますが、病気について解明されていないものもあります。また、治療として生活習慣の改善も必要とする病気もあります。

過眠症は自分の努力だけではどうにもならないことがありますので、専門医に受診して病気に合った適切な治療を受けましょう。

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