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薬による様々なナルコレプシーの治療

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昼間、食事中や移動中に突然眠ってしまう方を見たら驚いてしまうでしょう。このような症状はナルコレプシーとよばれ、一種の睡眠障害にあたります。このナルコレプシーについては、突然眠ってしまうことから社会生活に問題が生じてしまうことがありえます。
ナルコレプシーに対する治療は薬を用いた薬物療法が中心となりますが、具体的にはどのような薬が用いられるのでしょうか。

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ナルコレプシーという睡眠障害

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ナルコレプシーという言葉をご存知でしょうか。ナルコレプシーは睡眠に問題が生じ、日々の生活にも悪影響を及ぼしてしまうという睡眠障害の一種です。

ナルコレプシーは、過眠症という言葉で表現したほうがよりわかりやすくなるかもしれません。つまり、眠りすぎてしまうというタイプの睡眠障害をナルコレプシーといいます。

眠りすぎるといっても、朝いつまでも目を覚ますことができないというようなタイプの過眠症ではありません。ナルコレプシーは、通常、眠ることが考えられないような場面・シーンで眠ってしまうことに大きな特徴があります。

例えば、ナルコレプシーにかかってしまわれた場合には、会議中や試験中などの他、食事中や電話中、移動中などにも眠りに入ってしまいます。会議中や試験中に眠ってしまっては大きな問題が生じてしまうのは目に見えると言えるでしょう。また、移動中などに眠ってしまうということになれば、倒れ込んで怪我をしてしまうおそれがあるなど不都合は非常に大きいということができます。

このように到底眠るべき場面でない場面で眠ってしまうのがナルコレプシーというタイプの睡眠障害になります。

ナルコレプシーには薬物療法が必要

このナルコレプシーに罹患・発症してしまう原因ははっきりとは判明していません。そのため、治療法としては、根治的ナルコレプシーを治すという方法ではなく、経験からわかっている生活療法を実践するほか、薬による治療、つまり薬物療法が治療の中心となります。薬の中にはナルコレプシーに対して高い効果があることがわかっているタイプの薬が数多くあります。

ナルコレプシーに対して用いられる薬としては、具体的には以下のような薬があります。

日中の眠気を解消するための精神賦活剤

ナルコレプシーの主要症状とも言え、社会生活上も大きな困難を生じさせる二中の極度の眠気に対しては精神賦活剤(せいしんふかつざい)と呼ばれるタイプの薬が処方されます。精神賦活剤とは、精神の抑制状態を改善させる薬であり、イメージとしては目を覚まさせる活性剤といったイメージの薬です。

ナルコレプシーの際に用いられる精神賦活剤としてはペモリンとメチルフェニデートという名前の薬が中心的です。このような薬を処方して昼間の眠気を解消することを目指します。

夜間の睡眠や幻覚症状に用いる睡眠導入剤・抗精神薬剤

次に、ナルコレプシーの場合には夜の寝付きを良くするということも効果があります。夜しっかりと眠り、生活リズムを可能な限り正すことがナルコレプシーによる日中の眠気の解消につながるためです。

また、ナルコレプシーの場合には、夜間に幻覚症状や軽い麻痺の症状を伴うことがあります。このような症状が現れている場合には抗精神病薬剤もあわせて少量利用します。具体的にはクロルブロマジンという薬やクロミブラミンといった薬が用いられます。208

このようにナルコレプシーの中心的な症状は日中の過剰な眠気といった症状が中心とはなりますが、夜間の寝つきや幻覚・麻痺などの症状に対して対応することも必要となるケースがあります。これらのケースの場合には薬物療法を欠かすことができませんので、医師への相談の際にはご自身の症状を詳しく伝えることで効果的な薬を適切に処方してもらうことができます。

ナルコレプシーの症状が出てしまっている時にはご自身は意識がなくなってしまっているので、周囲の人からの意見なども参考にして医師に症状を可能な限り正確に伝えることが重要ということができます。

なお、異常な眠さが続き起きることが困難な場合にはナルコレプシーではなく、うつ病などによる睡眠障害の可能性もありえます。ナルコレプシーであるかどうかの診断自体も重要となりますので、薬物療法・生活療法を始める前提として睡眠障害に詳しい専門医を探すということもとても重要になると言えるでしょう。

ナルコレプシーの研究―知られざる睡眠障害の謎 (Hot‐nonfiction)
本多 裕
悠飛社
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まとめ:ナルコレプシーと薬物療法

以上、本文で述べましたナルコレプシーと薬物療法についてのポイントをまとめますと以下のようになります。

  • ナルコレプシーは日中などに極端な眠気が襲ってきてしまい、突然眠ってしまうという睡眠障害をいいます。ナルコレプシーの場合、社会生活に支障が出てしまう可能性があるので治療が必要です
  • ナルコレプシーに対する治療としては生活を改善する生活療法に加えて、薬の投薬を用いた薬物療法がとても重要となります
  • ナルコレプシーに対して効果的な薬を処方してもらうためには、ご自身の症状をしっかりと医師に伝えることが重要です。周囲の方の意見なども聞いて自分自身の状態をしっかりと把握して専門医にしっかりと症状を伝えるようにしましょう

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