臨牀透析 Vol.33 No.8(9)


特集名 予後改善を目指した透析医療
題名 睡眠障害の改善は生命予後を改善する
発刊年月 2017年 07月
著者 小池 茂文 豊橋メイツ睡眠治療クリニック
【 要旨 】 睡眠障害は血液透析患者に非常に多い合併症である.透析患者の睡眠障害は,単に不眠症だけでなく睡眠時無呼吸症候群(SAS),周期性四肢運動(PLM),むずむず脚症候群(RLS)も高頻度に合併し,重複かつ重症の比率が高いことが大きな特徴である.睡眠障害の個々が重症で重複する場合だけでなく,個々は軽症や中等度であるが3重複や4重複することで眠気や不眠の症状が重症化する場合もある.一方で睡眠障害には不眠症やRLSのように患者が自覚しやすいものと,SASやPLMのように患者が自覚しにくく積極的な検査で初めて発見診断できるものがあることを知る必要がある.SASの改善は透析患者の生命予後に影響し,RLSの治療はQOL改善に寄与するものと考えられている.
Theme Manifold preferable strategies for better prognosis of the dialysis patients
Title Treating sleep disorders to improve vital prognoses
Author Shigefumi Koike Sleep Center, Toyohashi Mates Clinic
[ Summary ] Sleep disorders are an extremely common complication in hemodialysis patients. Insomnia is not the only sleep disorder observed in dialysis patients. Sleep apnea syndrome (SAS), periodic limb movement (PLM), and restless leg syndrome (RLS) are also common complications. Those complications are primarily characterized by high ratios of overlap and severity. Symptoms of drowsiness and insomnia can become severe not only when severe individual sleep disorders overlap, but also when three or four mild or moderate sleep disorders overlap. Meanwhile, it is also necessary to know that sleep disorders are divided into categories that patients can easily recognize, such as insomnia or RLS. Those patients will find it difficult to recognize and problems may be first discovered and diagnosed through active testing, such as SAS and PLM. Improving SAS has an effect on the vital prognosis of dialysis patients. Treatment of RLS is thought to contribute to improved quality of life.
戻る