臨牀透析 Vol.31 No.12(2-6)


特集名 透析患者の疲労感
題名 透析患者と疲労 (6) 睡眠障害と疲労感
発刊年月 2015年 11月
著者 小池 茂文 豊橋メイツ睡眠治療クリニック
【 要旨 】 疲労回復には質の良い十分な睡眠時間が必要である.透析患者は,睡眠時無呼吸症候群,不眠症,レストレスレッグス症候群,周期性四肢運動障害などの睡眠障害の合併が多く,そのうえ重症例も重複例も多い.不眠症状に安易な睡眠導入薬の投与をしているだけでは背景に隠れた睡眠時無呼吸症候群のような疾患を見落とすだけでなく悪化させる懸念さえある.睡眠時無呼吸症候群や周期性四肢運動障害は患者の自覚が少ないため終夜睡眠ポリグラフ検査を行う以外に見つける方法はない.それらの適正な診断・治療が透析患者の疲労回復に寄与し,予後と透析生活をより良いものにできる.
Theme Fatigue in dialysis patients
Title Sleep disorders and fatigue
Author Shigefumi Koike Sleep-disorders Center, Toyohashi Mates Clinic
[ Summary ] Sufficient good-quality sleep is necessary for recovery from fatigue. Dialysis patients often have sleep disorder comorbidities such as insomnia, sleep apnea syndrome, restless legs syndrome, and periodic limb movement disorder, which are often severe and overlapping. Hasty administration of sleep-inducing drugs for insomnia symptoms could not only lead to overlooking the underlying sleep apnea syndrome but could also potentially worsen it.
Patients with sleep apnea syndrome or periodic limb movement disorder have few subjective symptoms ; therefore, diagnosis is only possible by performing a polysomnographic examination.
The appropriate diagnosis and treatment for dialysis patients may contribute to their recovery from fatigue and greatly improve their mortality and quality of life.
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