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不眠症の診断・治療アルゴリズム

CBTI: Cognitive behavior Therapy for Insomnia(不眠症に対する認知行動療療法)
出典
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1: 三島和夫編:睡眠薬の適正使用・休薬ガイドライン.じほう,東京,p37, 図9,2014をもとに改変

エプワース眠気尺度

睡眠障害の患者自身の自覚的体験を患者自身が評価する主観的評価方法のひとつ。日常生活における活動のなかで経験する眠気について、具体的状況設定において眠気の評価を行う8項目から構成される自記述尺度である。
出典
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1: A new method for measuring daytime sleepiness: the Epworth sleepiness scale.
著者: M W Johns
雑誌名: Sleep. 1991 Dec;14(6):540-5.
Abstract/Text: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
Sleep. 1991 Dec;14(6):540-5.

JESSTM(Japanese version of the Epworth Sleepiness Scale) ESS日本語版

エプワース眠気尺度の項目のうち車に関するものが2項目あり、そのうちの1項目を変更したもの。
出典
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1: 福原俊一, 竹上未紗, 鈴鴨よしみ, 陳和夫, 井上雄一, 角谷寛, 岡靖哲, 野口裕之, 脇田貴文, 並川努, 中村敬哉, 三嶋理晃, Murray W. Johns. 日本語版the Epworth Sleepiness Scale(JESS) ~これまで使用されていた多くの「日本語版」との主な差異と改訂~. 日本呼吸器学会雑誌 2006; 44: 896-8. 表1

わが国で使用されている睡眠薬

*非ベンゾジアゼピン系睡眠薬
出典
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1: 著者提供

不眠症のタイプによる睡眠薬・抗不安薬の選び方(表)

出典
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1: 内山真(睡眠障害の診断・治療ガイドライン研究会)編:睡眠障害の対応と治療ガイドライン第3版. じほう,2019; p111 表3

不眠症のタイプによる睡眠薬・抗不安薬の選び方

出典
img
1: 内山真(睡眠障害の診断・治療ガイドライン研究会)編:睡眠障害の対応と治療ガイドライン第3版. じほう,2019; p67 図1

不眠症の診断・治療アルゴリズム

CBTI: Cognitive behavior Therapy for Insomnia(不眠症に対する認知行動療療法)
出典
img
1: 三島和夫編:睡眠薬の適正使用・休薬ガイドライン.じほう,東京,p37, 図9,2014をもとに改変

エプワース眠気尺度

睡眠障害の患者自身の自覚的体験を患者自身が評価する主観的評価方法のひとつ。日常生活における活動のなかで経験する眠気について、具体的状況設定において眠気の評価を行う8項目から構成される自記述尺度である。
出典
imgimg
1: A new method for measuring daytime sleepiness: the Epworth sleepiness scale.
著者: M W Johns
雑誌名: Sleep. 1991 Dec;14(6):540-5.
Abstract/Text: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
Sleep. 1991 Dec;14(6):540-5.