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性格それとも病気?診断が難しいナルコレプシーとは

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居眠りが病気なんて、誰も思いませんよね。空腹や寝不足の時、午後の授業やつまらない会議中など、ついついウトウトしてしまう事は誰でもあります。あまり頻繁だと、「怠け者」とか「自己管理がなっていない」と怒られるかもしれませんが、「病院へ行け」といわれる事はありませんよね。しかし、実はこれは「過眠症(ナルコレプシー)」と呼ばれるれっきとした病気なのです。

この病気の原因もあまり分かっていません。10代の若者に多いので、本人も自覚がなく周りからも冷たい目でみられがちです。今回はこの病気の症状と診断方法を調べてみました。

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ナルコレプシーの症状

眠い

この病気の症状は、よく眠っていても空腹でも関係なく眠気がおそい、また毎日くりかえして眠くなります。しかも一日に4~5回おこり、それが最低3ヶ月以上続くというものです。

Aさんの場合:「小学3年の頃より授業中の居眠りがはじまりました。当時は「寝る子は育つ」等と言われ、両親も私自身さえ、まさか睡眠障害だとは夢にも思いませんでした。いきなりたまらなく眠くなって机につっぷして眠ってしまい、注意されるとすぐ起きれるのですが、1時間しないうちにまた眠くなり、、を何度も繰り返して先生にいつも怒られました。」

ナルコレプシーの発症は10代に多く、特に14~16歳に著しいピークを示します。この時期の子供は夜更かしが始まりやすいため、病気とは本人も家族も思わない事が多いようです。

Bさんの場合:「銀行員という仕事柄、お客様と大切な打ち合わせが多いのに、途中でたびたび眠ってしまい、上司に「たるんでいる!」と叱責される事もしばしばでした。眠気が襲ったとき、眠気覚ましのガムを噛んだり、冷水で顔を洗ったり、コーヒーなどでカフェインを取ったりと様々な眠気覚まし法を試みましたが、決定的な効果があるものはありませんでした。」

ナルコレプシーの眠気の強さはどれくらいかというと、48時間眠ってない状態が続いた場合に似ているという報告もあります。2日も寝なかったら相当眠気は強そうですよね。

Cさんの場合:「いつも肝心な時に眠くなるので、自分でもおかしいとは感じていました。映画で「過眠症」の主人公がでてくる作品を観て、あまりに自分の状況と似ていたためすぐに病院を受診しましたが、先生の判断は「うつ病」でした。強い薬を投与され、体調はよくならずとても辛かったです。」

この病気は他の病気と間違われる事が非常に多いのが特徴です。睡眠障害の病名は100以上あると言われますが、まだまだ医師の知識不足の多い病気ですので、病院をたらいまわしにされる事も多いようです。

ナルコレプシーの検査

終夜睡眠ポリグラフ検査(ポリソムノグラフィー)

体のあちこちに脳波や筋電図、呼吸状態などを計るセンサーを付け、一晩眠って状態を調べる検査です。大体病院に1泊して夕方から夜にかけて検査をします。翌朝検査が終わればそのまま学校や会社へ行くこともできます。どうしても検査のための入院ができないときには、簡易型の検査装置を借りて、自宅で検査することも可能です。

料金は健康保険が使えるので、3割負担の人なら1万5000円前後となります。また、宅配便でポータブル検査装置を送ってくれるサービスは6000円くらいで受けられます。

睡眠潜時反復検査(MSLT)

この検査でナルコレプシーの診断がほぼ分かります。2008年の4月から保険適用となりました。病院に入院して2時間ごとに眠りやすさを調べます。ナルコレプシーの患者さんは眠るまでの時間が8分未満(典型的には5分以内)で、眠るとすぐにレム睡眠になることが2回以上みられるという特徴があります。

国際的な睡眠障害の診断基準に従うと、3ヶ月以上にわたってほぼ毎日強い眠気があり、情動脱力発作が見られた場合のみナルコレプシーと診断されますが、情動脱力発作がなくても、この検査によってナルコレプシーと診断されることもあります。検査は1日がかりなので入院が必要。料金は1万5000円くらいのところが多いようです。

強い眠気があるのにナルコレプシーでなかった場合、他の病気の可能性も考えられます。睡眠不足症候群や特発性過眠症、睡眠時無呼吸症候群、むずむず脚症候群、睡眠覚醒リズム障害、うつ病、統合失調症などでも同様の強い眠気が現れることがあります。安易にナルコレプシーと自己診断せず、必ず病院で診察を受けましょう。

睡眠障害の対応と治療ガイドライン
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まとめ

ナルコレプシーは「過眠症」「居眠り病」「なまけ病」と言われる、どちらかと言うと性格的なものと判断されやすい病気です。本人の自覚も少なく、この病気のために会社を首になったり、対人関係がうまくいかなくてうつ病になったりする事もあります。

この病気は周囲の温かい配慮と自覚が必要です。投薬治療で生活はかなり改善される事が分かっていますから、自分がもしかしてそうも、、?と悩まれている人は、一度病院を受診してみてはいかがでしょうか。是非本記事を参考にして、あなたの生活の役立てて下さい。

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