icon fsr

雑誌詳細

文献概要

特集 精神・神経疾患に併存する過眠の背景病態と治療マネジメント

気分障害に併存する過眠

著者: 大槻怜1 鈴木正泰1

所属機関: 1日本大学医学部精神医学系

ページ範囲:P.1339 - P.1346

抄録 気分障害に併存する過眠は,性別や年齢,気分障害の亜型によっても頻度が異なる。過眠は,不眠同様に前駆症状から残遺症状まで幅広くみられ,発症や再発・再燃の危険因子となりうる重要な症状の1つである。これまでの知見から,気分障害患者において過眠の訴えがきかれた場合には,1)薬剤の影響ではないか,2)夜間睡眠は十分にとれているか(不眠のほか他の睡眠障害の合併には注意が必要),3)過眠のタイプはどれか(長時間睡眠or日中の眠気),4)実際の睡眠なのか臥床なのか,を検討し,適切な対応をとる必要がある。気分障害の過眠に対する治療方法は,季節性感情障害に対する高照度光療法など一部の気分障害亜型や類縁の疾患に対して有効性が示された方法が少数あるのみで確立していない。本稿では,気分障害に併存する過眠について,これまでに得られている知見を整理した上で,その対応について筆者らの私案を含め述べる。

参考文献

1)American Psychiatric Association:Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC, 2013
2)World Health Organization:International Statistical Classification of Diseases and Related Health, 10th Revision. WHO Geneva, 1992
3)American Academy of Sleep Medicine:International Classification of Sleep Disorders. 3rd ed. American Academy of Sleep Medicine, Darien, IL, 2014
4)Kaplan KA, McGlinchey EL, Soehner A, et al:Hypersomnia subtypes, sleep and relapse in bipolar disorder. Psychol Med 45:1751-1763, 2015
5)Gold PW, Licinio J, Wong ML, et al:Corticotropin releasing hormone in the pathophysiology of melancholic and atypical depression and in the mechanism of action of antidepressant drugs. Ann N Y Acad Sci 771:716-729, 1995
6)Edinger JD, Fins AI:The distribution and clinical significance of sleep time misperceptions among insomniacs. Sleep 18:232-239, 1995
7)Nutt D, Wilson S, Paterson L:Sleep disorders as core symptoms of depression. Dialogues Clin Neurosci 10:329-336, 2008
8)Breslau N, Roth T, Rosenthal L, et al:Sleep disturbance and psychiatric disorders:a longitudinal epidemiological study of young adults. Biol Psychiatry 39:411-418, 1996
9)Chellappa SL, Araújo JF:Excessive daytime sleepiness in patients with depressive disorder. Braz J Psychiatry 28:126-129, 2006
10)Geoffroy PA, Hoertel N, Etain B, et al:Insomnia and hypersomnia in major depressive episode:prevalence, sociodemographic characteristics and psychiatric comorbidity in a population-based study. J Affect Disord 226:132-141, 2018
11)Worthington J, Fava M, Davidson K, et al:Patterns of improvement in depressive symptoms with fluoxetine treatment. Psychopharmacol Bull 31:223-226, 1995
12)Kaplan KA, Gruber J, Eidelman P, et al:Hypersomnia in inter-episode bipolar disorder:does it have prognostic significance? J Affect Disord 132:438-444, 2011
13)Benazzi F:Symptoms of depression as possible markers of bipolar II disorder. Prog Neuropsychopharmacol Biol Psychiatry 30:471-477, 2006
14)Billiard M, Dolenc L, Aldaz C, et al:Hypersomnia associated with mood disorders:a new perspective. J Psychosom Res 38 Suppl 1:41-47, 1994
15)Plante DT, Cook JD, Goldstein MR:Objective measures of sleep duration and continuity in major depressive disorder with comorbid hypersomnolence:a primary investigation with contiguous systematic review and meta-analysis. J Sleep Res 26:255-265, 2017
16)Nofzinger EA, Thase ME, Reynoldset CF, et al:Hypersomnia in bipolar depression:a comparison with narcolepsy using the multiple sleep latency test. Am J Psychiatry 148:1177-1181, 1991
17)Hein M, Lanquart JP, Loas G, et al:Prevalence and risk factors of excessive daytime sleepiness in major depression:a study with 703 individuals referred for polysomnography. J Affect Disord 243:23-32, 2019
18)鈴木正泰:【日常精神医療で遭遇する対処困難な過眠の見立てと対応】気分障害における過眠への対応.精神経誌 123:424-430, 2021
D report. CNS Spectr 15:394-404, 2010
20)Worthington J, Fava M, Davidson K, et al:Patterns of improvement in depressive symptoms with fluoxetine treatment. Psychopharmacol Bull 31:223-226, 1995
21)Baldwin DS, Papakostas GI:Symptoms of fatigue and sleepiness in major depressive disorder. J Clin Psychiatry 67 Suppl 6:9-15, 2006
22)Ravindran AV, Kennedy SH, O'Donovan MC, et al:Osmotic-release oral system methylphenidate augmentation of antidepressant monotherapy in major depressive disorder:results of a double-blind, randomized, placebo-controlled trial. J Clin Psychiatry 69:87-94, 2008
23)Omori Y, Kanbayashi T, Sagawa Y, et al:Low dose of aripiprazole advanced sleep rhythm and reduced nocturnal sleep time in the patients with delayed sleep phase syndrome:an open-labeled clinical observation. Neuropsychiatr Dis Treat 14:1281-1286, 2018
24)Peterson MJ, Benca RM:Mood disorders. in Kryger M, Roth T, Dement W(eds):Principles and Practice of Sleep Medicine, pp1488-1500, WB Saunders Company, Philadelphia, 2010

掲載雑誌情報

出版社:株式会社医学書院

電子版ISSN:1882-126X

印刷版ISSN:0488-1281

雑誌購入ページに移動
icon up
あなたは医療従事者ですか?