Taro10-睡眠障害報道資料.PDF
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9 10% % Multiple sleep latency testmslt, % SAS 1 2 3SAS 3 Multiple sleep latency test Timothy R et al.,daytime Sleepiness and Alertness, In Principle and Practice of Sleep Medicine IVth edition
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12 Dawson D et al., Nature 388:235, a
13 Froberg JE : Twenty-four-hour patterns in human performance, subjective and physiological variables and differences between morning and evening active subjects. Biol Psychol 5: , 1977 Bolbery Daan process-s process-c Two-process process-c process-c process-c process-s process-s process-c process-s process- C process-s process-c process-c process- C 8
14 process-s GABA Two-process Daan S : Timing of human sleep: recovery process gated by a circadian pacemaker. Am J Physiol: 246:R ,
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16 SAS SAS AHI 5 SAS SAS SAS SAS SAS polysomnography:psg MSLT PSG MSLT PSG REM 11
17 Epworth sleepiness ScaleESS ESS ESS AHI30 / OSAS ESS /3 SAS MSLT maintenance of wakefulness testmwt SAS SAS
18 PLMD SAS PLMD 13
19 Epworth sleepiness ScaleESS Johns MW:A new method for measuring daytime sleepiness:the Epworth sleepiness scale.sleep 14: ,
20 Doi Y,Minowa M:Gender differences in excessive daytime sleepiness among Japanese workers.soc Sci Med :56: Roehrs T, Shore E, Papineau K,Rosenthal L,Roth T.A two week sleep extension in sleepy normals.sleep :19: Roth B.Narcolepsy and hypersomnia :review and classification of 642 personally observed cases.schweiz Arch Neurol Neurochir Psychiatr :119: Bonnet MH.:Effect of sleep disruption on sleep,performance and mood.sleep, 8:11-19,1985 Young T,Palta M,Dempsey J,et al:the occurrence of sleep-disordered breathing among middleaged adults. N Engl J Med 328: ,1993 Hamilton,G.S.et al.:obstructive sleep apnoea and cardiovascular disease.intern. Med.J.,34(7): ,2004 Phillips,B.:sleep-disordered breathing and cardiovascular disease.sleep Med.Rev., 9(2): ,2005 Gottlieb, D.J.,et al:relation of sleepiness to respiratory disturbance index; The Sleep Heart Health Study, Am J Respir Crit Care Med, 159: , Sullivan CE,Issa FG,Berthon-Jones M et al.reversal of obstructive sleep apnoea by continuos positive airway pressure applied through the nares.lancet.18;1 8225:862-5, Lowe AA,Sjoholm TT.Ryan CF et al:treatment,airway and compliance effects of a titratable oral appliance.sleep.15;23 Suppl 4:S Prinsell JR:Maxillomandibular advancement surgery in a sitespecific treatment approach for obstructive sleep apnea in 50 consecutive patients.chest.1166: ,
21 SAS SAS SAS 1987 George 1988 Findley Virginia OSAS Young Wisconsin cohort study OSAS apnea hypopnea index: AHI> Teran-Santos OSAS AHI> Sassani MEDLINE-Pubmed OSAS CI (1) Wisconsin cohort study Sleep heart health study SAS SAS SAS SAS AHI 16
22 SAS AHI 5AHI AHI AHI SAS AHI OSAS CI CI (4) 17
23 18
24 1 George(1987) OSAS27 93 Findley(1988) OSAS29 35 OSAS 41 6 Findley(1988) OSAS46 SAS Findley(1989) OSAS12 SAS CPAP Findley(1991) 3 Haraldsson (1992) Martikainen (1994) SAS 2.2 1, ,
25 Stoohs(1994) 90 SAS SAS 2 Stoohs(1995) 350 MESAM-4 ODI5 73 ODI Findley(1995) Haraldsson (1995) 62 SAS Steer Clear 13 SAS UPPP UPPP Wu(1996) 253 SAS Teran-Santos (1999) Shiomi OSAS Case-control study OSAS 6.3 PSG OSAS OSAS AHI Mc Nicholas OSAS ERS (2002) Sassani (2004) OSAS OSAS CL: MEDLINE- PubMed Howard (2005) 2,342 PSG161 ESS OSAS 24 EDS 59.6 SDB 15.8 Hartenbaum (2006) OSAS ACCP, ACOEM, NSF. Chest 130: 902-5,
26 1.OSA ( 1. ) ( ) 2. 2 (1) BMI 35 kg/m 2 (2) (3) ( 2 ) 3.Epworth Epworth
27 (split-night) OSA (CPAP) 2. CPAP OA(oral appliance; ) OA OA 2. 5 OA 10 ( 5 ) 10 22
28 SAS Lenne SAS Findley OSAS OSAS EEG OSAS Matthew OSAS 15 ; AI
29 OSAS OSAS Turkington SAS CPAP CPAP CPAP CPAP CPAP CPAP 24
30 OSAS SAS 25
31 1) Michael G.Lenne, Thomas J.Triggs, Jennifer R.Redman.Interactive Effects of Sleep Deprivation, Time of Day, and Driving Experience on a Driving, SLEEP, vol.21,no.1, ) Findley, L.J.,et al. Vigilance and Automobile Accidents in Patients with Sleep Apnea or Narcolepsy, Chest, 108: , ) Matthew R.Risser MS, J. Catesby Ware PhD, Frederick G. Freeman PhD. Driving Simulation with EEG Monitoring in Normal and Obstructive Sleep Apnea Patients, SLEEP, Vol.23,No3,2000 4) P M Turkington, M Saralaya, M W Elliott. Time Course of Changes in driving Simulator Performance with and without Treatment in Patients with Sleep Apnoea Hypopnoea Syndrome, Thorax, 59: 56-59, ) Pierre Philip, MD, PhD, et al. Fatigue, Sleepiness, and Performance in Simulated Versus Real Driving Conditions, SLEEP, vol.28,no.12,
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33 ,490 1, % 1,215 28
34 SAS SAS 30.3%18.1% 29
35 %13.8% 67.7%74.0%
36 32.2%27.6% 38.9%13.7% 13.7% 11.9%6.5% 31
37 63.3%55.4% 32
38 (1) Van Den Berg, J., Landstrom, Ulf. Symptoms of sleepiness while driving and their relationship to prior sleep, work and individual characteristics. Transportation Research Part F 9, :2006 (2) Flatly, D., Reyner, L.A., Horne, J.A. Sleep-related crashes on sections of different road types in the UK( ) Road Safety Research Report No.52: 2004,London: Department of Transport. (3)..., pp :1996 (4) Pack, A.I., Pack, A.M., Rodgman, E., Cucchiara, A., Dinges, DF.,Schwab, C.W. Characteristic of crashes attributed to the driver having fallen asleep. Accident Analysis Prevention, 27, :
39 SAS 5,235 3, SAS 3,235 SAS SAS SAS SAS SAS 34
40 SAS SAS SAS 30 35
41 SAS SAS SAS SAS
42 1.7 SAS 50.0% 1.2 SAS SAS SAS 37
43 SAS 1.4 SAS SAS 2.2 SAS SAS 38
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45 SAS SAS 73.0% 78.3% 69.9% 81.0% 78.5% 59.2% SAS SAS SAS SAS SAS 17.3% SAS
46 SAS % SAS 41
47 ( )
48 14 SAS SAS 15 SAS 16 SAS ( 19 ) 17 SAS 18 SAS 19 SAS SAS 20 43
49 (SAS) SAS SAS SAS 1980 SAS SAS AHI SAS SAS SAS SAS SAS SAS SAS SAS OSAS 35 SAS 44
50 SAS SAS SAS (1) SAS SAS SAS SAS SAS SAS SAS SAS SAS (2) SAS SAS SAS SAS SAS SAS 45
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81 (1) 75
82 (2)SAS 76
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84 (2) SAS 78
85 REM OSAS 7.3 OSAS 7.3 (PolysomnographyPSG) (Sleep Apnea SyndromeSAS) (Multiple sleep latency test MSLT) 79
86 NREM NREM Rapid EyeMovement; REM REM CPAP (apnea hypopnea index;ahi) 80
87 (Periodic Leg Movement Disorder; PLMD) ACCP ACOEM AHI CPAP (nasa1 Continuous Positive American College of Chest Physicians American College of Occupational and Environmental Medicine Airway Pressure; ) EDS (Excessive daytime sleepiness) Epworth (Epworth sleeping scale; ESS) ESS FMCSA GABA Maintenance of wakefulness test, MWT MSLT Multiple sleep latency test NSF OA Epworth - MSLT National Sleep Foundation mm (oral appliance; ) ODI 81
88 OSA Obstructive Sleep Apnea; OSAS (Obstructive Sleep Apnea Syndrome) REM SAS SDB (Sleep Disordered Breathing) UPPP (uvulopalatopharyngoplasty) OSA (Rapid EyeMovement) 82
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30% 20% 24 (quality of life;qol) QOL '79 '89 '02 (Sleep apnea syndrome;sas) 1 SAS 2 5 P 5 P ( 1) (Physical) (Physiological) (Psychological) (Psychiatric) (Pharmacological) SAS 3 ( ) 5 ( ) 4 ( ) ( ) ( )
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Sleep and sleep-related disorders in the elderly 20051027 REM Rapid Eye Movement REM Zzz Non-REM 90 180 270 360 90 How old is the elderly in sleep? 40 In: Primer of Polysomnography Circadian rhythm 24
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Respiratory 4000 Medicine, -Apr. 000, 2005 1 135 2 14 Key Words : sleep apnea syndrome, management, CPAP, surgical treatment, children sleep disordered breathing SDB SDB sleep apnea-hypopnea syndromesassahs
Microsoft Word - 「閉塞性睡眠時無呼吸症候群に対する口腔内装置に関する診療ガイドライン」
日本睡眠学会と日本睡眠歯科学会は共同で 閉塞性睡眠時無呼吸症候群に対する口腔内装置に関する診療ガイドライン を作成いたしております このガイドライン ( 案 ) について 広く皆様からのご意見をお聞きするため 平成 25 年 4 月 8 日 ( 月 ) から平成年 4 月 26 日 ( 金 ) まで意見の募集 ( パブリックコメント ) を行います ご意見は電子メールにて oa_guideline@nemuri.mobi
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Journal of Oral Health and Biosciences 臨 床 指 導 講 演 キーワード:Obstructive sleep apnea syndrome, Oral appliance, Bite-jumping appliance Oral Appliance for Treatment of Obstructive Sleep Apnea Syndrome Keisuke
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または Type 3 PM を用いる 脳波記録の誘導数が睡眠ポリグラフ検査と同等であっても 検査室外で非監視下 ( アテンドなし ) に行う場合は Type 2 PM 検査とし アテンドによる睡眠ポリグラフ検査 (Type 1) とは区別する Type 3 PM では気流 呼吸努力 酸素飽和度の連続
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章 a 図 b 口蓋垂軟口蓋咽頭形成術 uvulopalatopharyngoplasty UPPP a 術前 b 術後 睡眠障害 睡眠呼吸障害クリニックの つではないかと思われる 当初多かった不眠症にかわって 睡眠呼吸障害が漸増し 耳鼻咽喉科などと連携し 病因の解明や治療法に向けた研究がスタートし
章 診療のポイント 2 CPAP 閉塞性睡眠時無呼吸症候群 (obstructive sleep apnea syndrome: OSAS) は, 睡眠中に上気道の抵抗が増大し, 無呼吸 低呼吸 いびきをきたし, 睡眠が障害され, 種々の合併症をきたす病態である. 本邦では池松 (96) ), 林 (96) 2) がいびきに対して軟口蓋形成術を報告している. しかし 960 年代当時は OSAS の概念はまだなかった.
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070 行動医学研究 Vol.23, No.2 [ 総説 ] 行動医学研究 Vol.23, No.2, 70-75, 2018 小児の睡眠時無呼吸 Sleep Disordered Breathing in Children 木村真奈美, 和田裕雄, 谷川武 Manami KIMURA, Hiroo WADA, Takeshi TANIGAWA 順天堂大学大学院医学研究科公衆衛生学講座 Department
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