CPAP療法
CPAP療法による日常生活の変化
CPAP療法は、安全な睡眠時無呼吸症候群の治療法です。 使用するにつれて効果を実感する場合もあります。よく眠れるようになり、日常生活に対する気分が改善されます。 （1）
医師の処方に遵守した治療を行うことにより、朝の頭痛（2,3）、大きないびき、頻繁にみる悪夢、夜間の窒息感などといった睡眠時無呼吸症候群の症状に対して非常に効果的であると考えられています。
さらに、良い睡眠を得ることで運転中の居眠りリスクの抑制（4）、日中の眠気の改善、職場での生産性が向上します。（5）また、CPAP療法はうつ病やイライラなどの感情を緩和し（6,7）性的能力を改善させることができます。
睡眠時無呼吸症候群を治療することによって、次のような長期的な健康問題のリスク軽減に役立ちます。
- 高血圧 (8.9)
- 脳卒中と心臓病(6-9)
- Ⅱ型糖尿病(10-12)
- 肥満症 (13)
CPAP療法による睡眠時無呼吸症候群の治療は、患者様の生活が改善されるだけでなく、周囲の人にも良い影響をもたらします。
CPAP療法のメリット
CPAP療法は患者様のみならず、周囲の人にも影響を及ぼします。 したがって、患者様だけではなく、患者様のパートナーやご家族も安らいだ睡眠を得ることができます。
日常生活への影響
- いびきや、夜間頻回に起こる覚醒はパートナーの睡眠を妨げることをご存知ですか？ CPAPは患者様とパートナーの両者が良い睡眠を得ることを可能にするかもしれません。（14）
- 研究によると、CPAPを定期的に使用することで、性的パフォーマンスを改善し、睡眠時無呼吸症候群に関連する性問題（勃起不全、性的衝動の喪失など）を軽減させます（15）
- マスクの装着によりパートナーとの関係性に悩む場合は、パートナーや医師に相談しましょう。
- 科学的研究により、CPAP療法は使用している患者様の外見を改善することが明らかになりました。インタビューを受けた人たちによると、CPAP治療を行っている患者様はより敏捷的、若々しく、魅力的であると示されました。（16）
- 日中の慢性的な倦怠感が軽減され、活動的な状態を保ち、家族と過ごす貴重な時間を最大限に活用できます（17〜20）
- 子供や孫とより多くの時間を過ごすことができます。食事中や、家族との団らん中、外出時などの眠気が減少する可能性があります（17-20）
- 一日を通してより活動的になります。職場の会議や友人との集まりにも影響します。（17-20）
- 運転時の変化に気づくかもしれません。より移動が楽になります。（21）
- 物忘れや、集中力・注意力の問題も睡眠時無呼吸症候群の一般的な症状であり、患者様の私生活や社会生活に影響を及ぼします。これらの症状は、CPAPを定期的に使用することで軽減できます。（20）
Reference
1 .National Sleep Foundation, Sleep and CPAP adherence. Consulted 12/10/2020 @ www.sleepfoundation.org/articles/sleep-and-cpap-adherence
2. Campos-Rodriguez F, et al. Effect of Continuous Positive Airway Pressure on Blood Pressure and Metabolic Profile in Women with Sleep Apnoea. Eur Respir J. 2017;50(2);1700257.
3. Cass E, et al. Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women. J Clin Sleep Med. 2015;11(9);1029-38
4. Mahssa K, et al. Sleep apnea-related risk of motor vehicle accidents is reduced by continuous positive airway pressure: Swedish Traffic Accident Registry data. Sleep 2015;38(3);341-9
5.Siccoli M, et al. Effects of Continuous Positive Airway Pressure on Quality of Life in Patients With Moderate to Severe Obstructive Sleep Apnea: Data from a Randomized Control-led Trial. Sleep. 2008;31(11);1551-8
6 .Young T, et al, Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9);1217-39
7 Young T, et al, Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up pf the Wisconsin Sleep Cohort. Sleep. 2008;31(8);1071-8.
8. Campos-Rodriguez F, et al. Effect of Continuous Positive Airway Pressure on Blood Pressure and Metabolic Profile in Women with Sleep Apnoea. Eur Respir J. 2017;50(2):1700257.
9.Gottlieb D, et al. CPAP versus Oxygen in Obstructive Sleep Apnea. N Engl J Med. 2014;370(24):2276-85.
10. Mokhlesi B, et al. Effect of One Week of 8-Hour Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea on Glycemic Control in Type 2 Diabetes: A Proof-of-Concept Study. Am J Respir Crit Care Med. 2016;194(4):516-9.
11 . Martínez-Cerón E, et al. Effect of Continuous Positive Airway Pressure on Glycemic Control in Patients with Obstructive Sleep Apnea and Type 2 Diabetes. The Randomized Clinical Trial. Am J Respir Crit Care Med. 2016;194(4):476-85.
12 . Aronsohn R, et al. Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes. Am J Respir Crit Care Med. 2010;181(5):507-1
13. Sharma S, et al. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med. 2011;365(24):2277-86.
14 . Doherty LS. et al. Impact of nasal continuous positive airway pressure therapy on the quality of life of bed partners of patients with obstructive sleep apnea syndrome. Chest. 2003 Dec;124(6):2209-14.
15 . Melehan KL. et al. Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men With Obstructive Sleep Apnea and Erectile Dysfunction. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1601-1611.
16 . Chervin RD. et al. The face of sleepiness: improvement in appearance after treatment of sleep apnea. J Clin Sleep Med. 2013 Sep 15;9(9):845-52.
17.No DD et al. Can continuous positive airway pressure therapy improve the general health status of patients with obstructive sleep apnea?: a clinical effectiveness study. Chest. 2002 Nov;122(5):1679-85.
18 . Sforza E. et al. Daytime sleepiness and nasal continuous positive airway pressure therapy in obstructive sleep apnea syndrome patients: effects of chronic treatment and 1-night therapy withdrawal. Sleep. 1995 Apr;18(3):195-201.
19. Bolitschek J. et al. Impact of nasal continuous positive airway pressure treatment on quality of life in patients with obstructive sleep apnoea. Eur Respir J. 1998 Apr;11(4):890-4.
20. Antique NA. et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011 Jan 1;34(1):111-9.
21 . Mazza S. et al. Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform. Eur Respir J. 2006 Nov;28(5):1020-8.
22 . Deering S. et al. CPAP Adherence is Associated With Attentional Improvements in a Group of Primarily Male Patients With Moderate to Severe OSA. J Clin Sleep Med. 2017 Dec 15;13(12):1423-1428.
23 . American Academy of Sleep Medicine (AASM). CPAP - Benefits Health Risk Prevention. Aug 2015. http://sleepeducation.org/essentials-in-sleep/cpap/benefits .
2. Campos-Rodriguez F, et al. Effect of Continuous Positive Airway Pressure on Blood Pressure and Metabolic Profile in Women with Sleep Apnoea. Eur Respir J. 2017;50(2);1700257.
3. Cass E, et al. Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women. J Clin Sleep Med. 2015;11(9);1029-38
4. Mahssa K, et al. Sleep apnea-related risk of motor vehicle accidents is reduced by continuous positive airway pressure: Swedish Traffic Accident Registry data. Sleep 2015;38(3);341-9
5.Siccoli M, et al. Effects of Continuous Positive Airway Pressure on Quality of Life in Patients With Moderate to Severe Obstructive Sleep Apnea: Data from a Randomized Control-led Trial. Sleep. 2008;31(11);1551-8
6 .Young T, et al, Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9);1217-39
7 Young T, et al, Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up pf the Wisconsin Sleep Cohort. Sleep. 2008;31(8);1071-8.
8. Campos-Rodriguez F, et al. Effect of Continuous Positive Airway Pressure on Blood Pressure and Metabolic Profile in Women with Sleep Apnoea. Eur Respir J. 2017;50(2):1700257.
9.Gottlieb D, et al. CPAP versus Oxygen in Obstructive Sleep Apnea. N Engl J Med. 2014;370(24):2276-85.
10. Mokhlesi B, et al. Effect of One Week of 8-Hour Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea on Glycemic Control in Type 2 Diabetes: A Proof-of-Concept Study. Am J Respir Crit Care Med. 2016;194(4):516-9.
11 . Martínez-Cerón E, et al. Effect of Continuous Positive Airway Pressure on Glycemic Control in Patients with Obstructive Sleep Apnea and Type 2 Diabetes. The Randomized Clinical Trial. Am J Respir Crit Care Med. 2016;194(4):476-85.
12 . Aronsohn R, et al. Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes. Am J Respir Crit Care Med. 2010;181(5):507-1
13. Sharma S, et al. CPAP for the metabolic syndrome in patients with obstructive sleep apnea. N Engl J Med. 2011;365(24):2277-86.
14 . Doherty LS. et al. Impact of nasal continuous positive airway pressure therapy on the quality of life of bed partners of patients with obstructive sleep apnea syndrome. Chest. 2003 Dec;124(6):2209-14.
15 . Melehan KL. et al. Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men With Obstructive Sleep Apnea and Erectile Dysfunction. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1601-1611.
16 . Chervin RD. et al. The face of sleepiness: improvement in appearance after treatment of sleep apnea. J Clin Sleep Med. 2013 Sep 15;9(9):845-52.
17.No DD et al. Can continuous positive airway pressure therapy improve the general health status of patients with obstructive sleep apnea?: a clinical effectiveness study. Chest. 2002 Nov;122(5):1679-85.
18 . Sforza E. et al. Daytime sleepiness and nasal continuous positive airway pressure therapy in obstructive sleep apnea syndrome patients: effects of chronic treatment and 1-night therapy withdrawal. Sleep. 1995 Apr;18(3):195-201.
19. Bolitschek J. et al. Impact of nasal continuous positive airway pressure treatment on quality of life in patients with obstructive sleep apnoea. Eur Respir J. 1998 Apr;11(4):890-4.
20. Antique NA. et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011 Jan 1;34(1):111-9.
21 . Mazza S. et al. Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform. Eur Respir J. 2006 Nov;28(5):1020-8.
22 . Deering S. et al. CPAP Adherence is Associated With Attentional Improvements in a Group of Primarily Male Patients With Moderate to Severe OSA. J Clin Sleep Med. 2017 Dec 15;13(12):1423-1428.
23 . American Academy of Sleep Medicine (AASM). CPAP - Benefits Health Risk Prevention. Aug 2015. http://sleepeducation.org/essentials-in-sleep/cpap/benefits .