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日本人になぜか多い「ナルコレプシー」と病院治療

病院

ランチの後はついつい眠くなりませんか?午後の授業を受けた記憶がない、、。という強者もいるかも知れません。しかし、あなたが学生で、どんなに睡眠をとっても日中に毎日4~5回は耐えきれず眠ってしまうという人は、ナルコレプシーかも知れません。

この病気は15歳前後の時期に多くみられ、40歳以上で発症する事はまれです。世界の有病率の平均は2000人に1人程度(0.05%)と決して珍しい病気ではありませんが、日本では600人に1人程度(0.16%)となぜか非常に多い病気です。眠くなるだけ、の病気ですが、病院治療が必要との報告もあります。今回はナルコレプシーの問題点と病院でどの様な治療をするのかを調べてみました。

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ナルコレプシーの特徴

寝る

ナルコレプシー特徴は、日中に何度も繰り返す居眠りが、ほとんど毎日何年間にもわたって継続することです。正常の人でも、ランチの後や退屈な会議で眠くなりますよね。ナルコレプシーの場合通常10分~20分ほど居眠りが続きます。この居眠りが一時間を越えることはまれです。しかし、一度目が覚めても2~3時間程度経過すると、再び眠気に襲われます。居眠りの回数は、一日に1~4回程度です。この居眠りは、前日に充分な睡眠時間をとっていても起きます。

ナルコレプシーの危険性

睡眠発作

この病気の特徴は、健常人なら緊張していて眠ることなどないような場面でも、突然眠気に襲われて数分程度眠り込んでしまうことです。自動車の運転中や、スポーツの試合をしているとき、大事な試験を受けている時や店先で顧客との商談中でも突然睡魔に襲われるのです。

これは「睡眠発作」と呼ばれ、普通の居眠り傾向とは質の違うものと考えられており、その一部には日中起こるレム睡眠を主体とする場合があると考えられています。

情動脱力発作

笑ったり喜んだりと喜怒哀楽の感情が昂ぶった際、突然体中の力が脱力するという発作です。全身にわたって倒れてしまう発作のほか、膝の力が抜けてしまう、呂律がまわらなくなる、などの部分発作もあります。通常は数秒ほどで収まります。

ナルコレプシーと区別してカタプレキシーと呼ばれる発作です。

幻覚

睡眠発作が起こった時に、入眠直後にレム睡眠状態になるために非常に現実感を伴った夢をみる場合があります。寝入り際に幽霊を見たといった類の心霊現象を訴える事が多く、夢というより幻覚をみる事が多くなります。

金縛り

意識はあるのに、身体が動かず、幻覚をみる場合もあります。

病院の選び方

やはり、眠くなるだけとはいえないようですね。病院で治療する必要がありそうです。病院は以前は心療内科や、精神科を受診する事が多かった病気ですが、最近では「睡眠治療専門」の病院もあります。東京で評判の良い病院をいくつかご紹介しましょう。

睡眠総合ケアクリニック代々木
*03-3374-9112 *東京都渋谷区代々木1-24-10 TSビル1F 代々木駅[A1]から徒歩約2分 完全予約制です。口コミで人気の高い病院ですので、診察に時間がかかる場合もあるます。

渋谷睡眠メディカルクリニック
*03-5464-0659 *東京都渋谷区渋谷1-8-7第27SYビル10階B室 渋谷駅[宮益坂口]から徒歩約5分

いびき、睡眠時無呼吸症候群の治療に定評のある病院です。

財団法人健康医学協会附属 霞が関ビル診療所
*03-3581-6031 *東京都千代田区霞が関3-2-5 霞が関ビル3F
アクセスが良く、他の病気の治療も行っています。不眠治療にも定評があります。

晴和病院睡眠障害外来
* 03-3260-9171  *東京都新宿区弁天町 91
ナルコレプシーなどの中枢性過眠症、睡眠相後退症候群などの概日リズム睡眠障害に定評があります。

睡眠呼吸障害クリニック
*03-3556-9181 *東京都千代田区三崎町2-18-11 堀内三崎町ビル2F 
睡眠時無呼吸症候群を主として、ナルコレプシーなどの慢性過眠症、レム睡眠行動障害、周期性四肢運動障害などの睡眠障害も対象に治療を行っています。

治療方法

中枢神経刺激薬を使用することで日中の眠気を抑制する投薬療法が基本です。メチルフェニデート(リタリン)・モダフィニル(モディオダール)・ペモリン(ベタナミン)等、うつ病に使われる薬と同じものが多いのが特徴です。

2012年以降はモダフィニルがナルコレプシー専用の治療薬として日本国内で承認され、最大30日分まで処方が可能となっています。血中濃度の半減期が12時間と比較的長くので、朝食後に一回飲むだけで約8時間効果が持続し、副作用も少ない薬です。

睡眠障害の対応と治療ガイドライン
じほう
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まとめ

いかがですか。ナルコレプシーはなぜなるのか原因はとく分かっていません。15歳前後の若者に特有の病気で、日本人に比較的多くみられますが、若者でなくても、様々な病気の併発によって、この病気が引き起こされる場合があります。有名人では、阿佐田哲也氏や中島 らも氏が、アルコールや薬物の乱用に加えてこの病気になったそうです。

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