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命に関わる怖い病気かも!?睡眠中にむせる病気

咳

 
寝ている間にむせる、なんて嫌な症状ですよね。睡眠は人の心身の健康にとって重要なもの。夜中に何度も起きたりしていると、健康が阻害されてしまいます。たまだといいものの、しょっちゅう起きるなら少し心配です。早めに病院にかかった方が良いでしょう。

こちらでは、睡眠中にむせる病気についてご紹介します。

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睡眠中にむせるのはなぜ

むせる病気

医者

睡眠中にむせる病気にはいくつか考えられます。最近知られてきた睡眠時無呼吸症候群(SAS)や、あまり知られていない鼻の疾患「後鼻漏」、高齢の方ならば摂食・嚥下障害などがあります。それぞれに他の特徴があるのでどれがあてはまるかチェックしてみましょう。

睡眠時無呼吸症候群(SAS)

睡眠時無呼吸症候群(Sleep Apnea Syndrome:SAS)とは睡眠中に10秒以上の呼吸が停止、つまり無呼吸が5回以上繰り返される病気です。主に、いびきや昼間の眠気、熟睡感がない、起床時の頭痛などの症状があります。日中の眠気などのために仕事に支障をきたしたり、居眠りによる事故の発生率を高めたりするなど、社会生活に重大な影響を引き起こします。

症状

  • イビキをかく
  • 睡眠時に呼吸が止まる
  • 睡眠時むせる
  • 日中しばしば居眠りする
  • 記憶力、集中力が低下する
  • 起床時激しい頭痛がする

原因
睡眠時無呼吸は、多くの場合、空気の通り道である気道が、部分的あるいは完全に閉塞してしまうことにより起こります。肥満の人に多く見られ、あごや首に脂肪がついていることが主な原因と考えられます。しかし太っていなくてもあごが小さいとなることも。また、扁桃腺の肥大や鼻づまりなども原因となります。

後鼻漏とは

後鼻漏(こうびろう)は、鼻水がのどの方へ流れ落ちてくる疾患です。通常、鼻水の多くは鼻の穴から出ていきます。しかし、後鼻漏の場合は絶えまなくのどに鼻水が流れ込んできます。その為、口から吐き出し続けるか、飲み込み続けるしかありません。主に以下の症状が挙げられます。

症状

  • 鼻水がのどに下る
  • 痰がからむ
  • 口の中がネバネバする
  • 口臭
  • 咳ばらいがある

原因
後鼻漏はのどではなく鼻に問題があると考えられます。何らかの異常で大量に発生した鼻水が、鼻腔の構造や鼻水の発生位置などの理由によってのどの方へ流れ込んでいます。原因となる疾患としてはアレルギー性鼻炎などの鼻炎が考えられますが、特にのどへ流れてくる鼻水が臭うようであれば、副鼻腔炎の可能性が高いでしょう。他にも萎縮性鼻炎、鼻の内部の腫瘍、ソーンワルト病などが少ないですが原因としてあります。

摂食・嚥下障害

食べ物を口に運んで飲み込むという動作を嚥下と言います。嚥下運動をつかさどる神経系に異常が生じたり、口・舌・歯に炎症などの異常が生じると摂食・嚥下障害が起こります。また、誤嚥によって肺炎などの呼吸器障害が起こると体に大きな負担をかけることになるので、早めの対処が重要と考えられます。

症状

  • 食事中に、よくせき込んだりよくむせる
  • 飲み込んだ後、声が変わる
  • よくタンがからむ
  • のどに何かがつかえているような感じがする
  • 食品や唾液でのどが詰まる

原因
嚥下運動をつかさどる神経や筋肉に異常が生じたり、口・舌・歯に炎症などの異常が生じると起こります。入れ歯の不具合などでなることも。また、精神的・心理的な原因で起こることもあります。ただしもっとも多い原因は脳血管障害と言われています。

睡眠中にむせる病気の対処法

睡眠時無呼吸症候群(SAS)

睡眠時無呼吸症候群の治療は「内科的治療」「外科的治療」「歯科装具」などがあります。睡眠障害の専門医にかかり、適切な治療を受けましょう。中程度以上の人にはCPAP療法が効果的です。

生活習慣改善
もし太っているなら、肥満の解消を目指しましょう。やせることは治療の一環になります。また、アルコールは控えるようにし、寝酒はやめましょう。アルコールによって筋肉が弛緩し、上気道を狭めてしまいます。ただでさえ寝るときは筋肉が緩んでいますので、アルコールが加わればさらに無呼吸に陥るリスクを高めることになります。

後鼻漏

耳鼻咽喉科において、鼻水を発生させている原因を治療することが第一です。アレルギー性鼻炎や副鼻腔炎(蓄膿症)などを根治しないとなくなりません。後鼻漏自体には効果的な治療方法がこれまでありませんでしたが、最近は有効な治療法も出てきているようです。専門外来を訪ねてみるのも良いでしょう。

摂食・嚥下障害

症状に合った対処方法がありますので、専門医に指示を仰ぎましょう。摂食・嚥下障害があると、唾液の分泌低下などが原因で口腔内細菌が増殖し口腔内が不衛生になることがあります。これは誤嚥性肺炎につながる可能性を高めるので毎食後の口腔ケアが大事です。また、家庭で出来る事として、嚥下体操も効果的です。

睡眠時無呼吸症候群診療ハンドブック
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まとめ:睡眠中にむせる原因を知ろう

睡眠中にむせる場合、原因は3つ考えられます。それぞれ症状に特徴があります。おさらいしておきましょう。

  • 睡眠時無呼吸症候群(SAS):いびきをかく
  • 後鼻漏:咳ばらいがある
  • 摂食・嚥下障害:食事中にむせる

睡眠障害は日中の集中力低下を誘引し、思わぬ事故をもたらします。自覚のある方は早めに病院にかかってくださいね。

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