精神医学64巻10号

2022年10月発行

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

不安症・ストレス因関連障害・解離症に併存する過眠

著者： 内海智博¹ 栗山健一¹

所属機関： ¹国立精神・神経医療研究センター精神保健研究所睡眠・覚醒障害研究部

ページ範囲：P.1353 - P.1363

抄録　不安症・ストレス因関連障害・解離症に併存する過眠の病態に関する系統的なエビデンスは乏しいが，本稿では主たる病態機序に即し①夜間の睡眠不良による二次的な過眠症状と，②不安症・ストレス因関連障害に伴う睡眠発作様症状に分け，その病態特徴と治療アプローチを検討する。前者は併存不眠や中途覚醒の結果として生じる睡眠効率低下による二次症状としての過眠であり，原疾患の治療と並行し，併存する夜間睡眠不良に対する治療を実施することが有効と考えられる。他方で，後者は不安や心的負荷により生じる「葛藤」や感情の調節障害が過眠の背景病態と考えられ，適切な精神医学的評価を行うとともに，主に非薬物的心理介入が治療上有効であると考えられる。

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