ç¡ç ãšèšæ¶ã®è€éãªé¢ä¿ãæ¢ããèªç¥æ©èœãšèšæ¶å®çãæ¹åããããã«ç¡ç ãæé©åããæ¹æ³ãåŠã³ãŸãããã
ç§å¯ãè§£ãæããïŒèšæ¶ãšç¡ç ã®æ·±é ãªé¢ä¿
ç¡ç ãšèšæ¶ã¯å¯æ¥ã«çµã³ã€ããŠãããç¡ç ã¯èšæ¶ãå®çãããèªç¥æ©èœãé«ããäžã§éèŠãªåœ¹å²ãæãããŠããŸãããã®å æ¬çãªã¬ã€ãã§ã¯ãç¡ç ãšèšæ¶ã®é åçãªé¢é£æ§ãæ¢ãããã®èåŸã«ããç§åŠãæãäžããèªç¥èœåãåäžãããããã«ç¡ç ãæé©åããããã®å®è·µçãªæŠç¥ãæäŸããŸãã
ç¡ç ãšèšæ¶ã®é¢é£æ§ã®èåŸã«ããç§åŠ
人éã®è³ã¯ãåžžã«äºãã«éä¿¡ãåããã¥ãŒãã³ã®è€éãªãããã¯ãŒã¯ã§ããèŠéäžããããã®ãã¥ãŒãã³ã¯éåžžã«æŽ»çºã§ãæ å ±ãåŠçããæ°ããèšæ¶ã圢æããŠããŸããããããç¡ç ã¯åãªãéæŽ»åæéã§ã¯ãªããè³ããããã®èšæ¶ãåç·šæããå®çãããæŽ»çºãªããã»ã¹ãªã®ã§ãã
èšæ¶ã®å®çïŒç¡ç ã®åœ¹å²
èšæ¶ã®å®çãšã¯ãäžå®å®ãªçæèšæ¶ãå®å®ããé·æèšæ¶ã«å€æãããããã»ã¹ã§ããç¡ç ã¯ãç¹ã«ç¹å®ã®ç¡ç 段éã«ãããŠããã®ããã»ã¹ã§éèŠãªåœ¹å²ãæãããŸããç¡ç ã«ã¯ããã€ãã®æ®µéããããããããã«ç¬èªã®ç¹åŸŽãšæ©èœããããŸãã
- ãã³ã¬ã ïŒNREMïŒç¡ç ïŒãã³ã¬ã ç¡ç ã¯N1ãN2ãN3ã®3ã€ã®æ®µéã«åãããŠããŸããN3段éã¯ãåŸæ³¢ç¡ç ãŸãã¯æ·±ãç¡ç ãšããŠãç¥ãããèšæ¶ã®å®çã«ç¹ã«éèŠã§ããæ·±ãç¡ç äžãè³ã¯èŠéäžã«èµ·ãã£ãç¥çµæŽ»åãã¿ãŒã³ãåçãããã¥ãŒãã³éã®çµåã匷åããèšæ¶ãåºããŸãã
- ã¬ã ïŒREMïŒç¡ç ïŒã¬ã ç¡ç ã¯ãæ¥éãªçŒçéåãè³æŽ»åã®å¢å ãçèã®åŒç·©ãç¹åŸŽã§ããã¬ã ç¡ç ã¯ãæç¶ãèšæ¶ïŒäŸïŒæ°ããã¹ãã«ã®åŠç¿ïŒãææ èšæ¶ã®å®çã«äžå¯æ¬ ã§ãããšèããããŠããŸãããŸãã倢ãèŠãããšãšãé¢é£ããŠããŸãã
ç ç©¶ã«ãããšãç¡ç äžè¶³ã¯èšæ¶ã®å®çãèããæãªãããšã瀺ãããŠããŸããç¡ç äžè¶³ã®äººã¯ãååãªç¡ç ããšã£ãäººã«æ¯ã¹ãŠèšæ¶èª²é¡ã®æçžŸãæªãããšãç ç©¶ã§ããã£ãŠããŸãã
é¢äžããç¹å®ã®è³é å
ç¡ç ãšèšæ¶ã®é¢é£æ§ã«ã¯ãããã€ãã®è³é åãé¢äžããŠããŸãã
- æµ·éŠ¬ïŒæµ·éŠ¬ã¯æ°ããèšæ¶ã®åœ¢æã«äžå¯æ¬ ãªè³é åã§ããç¡ç äžã海銬ã¯èšæ¶ã倧è³ç®è³ªã«åçããããããåŸã ã«é·æä¿åã«çµ±åãããã®ãå¯èœã«ããŸãã
- 倧è³ç®è³ªïŒå€§è³ç®è³ªã¯ãèšæ¶ã®ä¿åãå«ã髿¬¡ã®èªç¥æ©èœãæ ãè³ã®å€å±€ã§ããæéãçµã€ã«ã€ããŠãèšæ¶ã¯æµ·éЬãã倧è³ç®è³ªã«è»¢éãããé·æçã«ä¿æãããŸãã
- ææ¡äœïŒææ¡äœã¯ææ ã®åŠçãšææ èšæ¶ã®åœ¢æã«é¢äžããŠããŸããã¬ã ç¡ç ã¯ææ èšæ¶ã®å®çã«éèŠãªåœ¹å²ãæãããšèããããŠããŸãã
ç¡ç ãããŸããŸãªçš®é¡ã®èšæ¶ã«äžãã圱é¿
ç¡ç ãèšæ¶ã«äžãã圱é¿ã¯ãåŠçãããèšæ¶ã®çš®é¡ã«ãã£ãŠç°ãªããŸãã
- 宣èšçèšæ¶ïŒå®£èšçèšæ¶ãšã¯ãäºå®ïŒæå³èšæ¶ïŒãåºæ¥äºïŒãšããœãŒãèšæ¶ïŒãªã©ãæèçã«æãåºãããšãã§ããèšæ¶ãæããŸããæ·±ãç¡ç ïŒãã³ã¬ã ç¡ç ã¹ããŒãž3ïŒã¯ã宣èšçèšæ¶ã®å®çã«ç¹ã«éèŠã§ããäŸãã°ã詊éšå匷ãããåŸã«ååãªç¡ç ããšãããšã§ããã®å å®¹ã®æ³èµ·ãå€§å¹ ã«åäžããŸãã
- æç¶ãèšæ¶ïŒæç¶ãèšæ¶ãšã¯ãèªè»¢è»ã«ä¹ã£ãããæ¥œåšãæŒå¥ããããããªã©ãã¹ãã«ãç¿æ £ã«é¢ããèšæ¶ãæããŸããã¬ã ç¡ç ã¯ãæç¶ãèšæ¶ã®å®çã«äžå¯æ¬ ã§ãããšèããããŠããŸããæ°ããã¹ãã«ãç·Žç¿ããåŸã«ååãªç¡ç ããšããšãç¿æ¥ã®ããã©ãŒãã³ã¹ãåäžããŸããæã¿ããã³ã°ã®ã·ãŒã±ã³ã¹ãåŠç¿ããç ç©¶ã§ã¯ãã¬ã ç¡ç åŸã«ããã©ãŒãã³ã¹ãåäžããããšã瀺ãããŸããã
- ææ èšæ¶ïŒææ èšæ¶ã¯ãåŒ·ãææ ã«é¢é£ä»ããããèšæ¶ã§ããã¬ã ç¡ç ã¯ãææ èšæ¶ãåŠçã»å®çãããåºæ¥äºã«å¯Ÿããç§ãã¡ã®ææ çåå¿ã調æŽããã®ã«éèŠãªåœ¹å²ãæãããšèããããŠããŸãã
ç¡ç é害ãèšæ¶ã«äžãã圱é¿
ç¡ç é害ã¯ãèšæ¶ãèªç¥æ©èœã«éå€§ãªæªåœ±é¿ãåãŒãå¯èœæ§ããããŸããäžè¬çãªç¡ç é害ã«ã¯ä»¥äžã®ãããªãã®ããããŸãã
- äžç çïŒäžç çã¯ãå¯ã€ããæªããç ãç¶ããããªãããŸãã¯å埩æã®ãªãç¡ç ãç¹åŸŽãšããŸããæ ¢æ§çãªäžç çã¯ãèšæ¶åãéäžåãæ³šæåã®äœäžã«ã€ãªããå¯èœæ§ããããŸããäžç çã«å¯Ÿããèªç¥è¡åçæ³ïŒCBT-IïŒã¯éåžžã«å¹æçãªæ²»çæ³ã§ãã
- ç¡ç æç¡åŒåžçå矀ïŒç¡ç æç¡åŒåžçå矀ã¯ãç¡ç äžã«åŒåžãç¹°ãè¿ã忢ãããå§ãŸã£ããããç¶æ ã§ããããã«ãããæççãªç¡ç ãé žçŽ ã¬ãã«ã®äœäžãèªç¥æ©èœã®äœäžã«ã€ãªããå¯èœæ§ããããŸããæªæ²»çã®ç¡ç æç¡åŒåžçå矀ã¯ãèšæ¶é害ãèªç¥çã®ãªã¹ã¯å¢å ãšé¢é£ããŠããŸããæç¶éœå§åŒåžçæ³ïŒCPAPïŒãäžè¬çãªæ²»çæ³ã§ãã
- ããããèçå矀ïŒRLSïŒïŒRLSã¯ãèãåãããããšããæããããè¡åãåŒãèµ·ããç¥çµçŸæ£ã§ããã°ãã°äžå¿«ãªæèŠã䌎ããŸããRLSã¯ç¡ç ã劚ããæ¥äžã®ç²åŽãèªç¥é害ã«ã€ãªããå¯èœæ§ããããŸãã
- ãã«ã³ã¬ãã·ãŒïŒãã«ã³ã¬ãã·ãŒã¯ãè³ã®ç¡ç èŠéãµã€ã¯ã«ã調ç¯ããèœåã«åœ±é¿ãäžããç¥çµçŸæ£ã§ãããã«ã³ã¬ãã·ãŒã®äººã¯ãæ¥äžã®é床ã®ç æ°ãçªç¶ã®çåäœäžïŒã«ã¿ãã¬ãã·ãŒïŒãå¹»èŠãçµéšããŸãã
ç¡ç é害ãçãããå Žåã¯ã蚺æãšæ²»çã®ããã«å»çå°éå®¶ã«çžè«ããããšãäžå¯æ¬ ã§ããç¡ç é害ã«å¯ŸåŠããããšã§ãèšæ¶åãšå šäœçãªèªç¥æ©èœãå€§å¹ ã«æ¹åã§ããŸãã
èšæ¶ååäžã®ããã«ç¡ç ãæé©åããå®è·µçæŠç¥
ç¡ç ç¿æ £ãæ¹åããããšã¯ãèšæ¶åãšèªç¥èœåã«å€§ããªåœ±é¿ãäžããŸãã以äžã«ãç¡ç ãæé©åããããã®å®è·µçãªæŠç¥ãããã€ã玹ä»ããŸãã
äžè²«ããç¡ç ã¹ã±ãžã¥ãŒã«ã確ç«ãã
鱿«ãå«ããæ¯æ¥åãæéã«å°±å¯ã»èµ·åºããäœã®èªç¶ãªç¡ç èŠéãµã€ã¯ã«ïŒãµãŒã«ãã£ã¢ã³ãªãºã ïŒãæŽããŸããããäžè²«æ§ãå¥åº·çãªç¡ç ãã¿ãŒã³ãä¿é²ããéµã§ãã
ãªã©ãã¯ã¹ã§ããå°±å¯åã®ç¿æ £ãäœã
å°±å¯åã«ãªã©ãã¯ã¹ããããã®ç¿æ £ã身ã«ã€ããŸããããæž©ããã颚åã«å ¥ããæ¬ãèªããèœã¡çãã鳿¥œãèŽããçæ³ãæ·±åŒåžãªã©ã®ãªã©ã¯ãŒãŒã·ã§ã³ææ³ãå®è·µãããªã©ããããŸããå°±å¯ã®å°ãªããšã1æéåã«ã¯ãã¹ããŒããã©ã³ãã¿ãã¬ãããã³ã³ãã¥ãŒã¿ãŒãªã©ã®ã¹ã¯ãªãŒã³ã¿ã€ã ãé¿ããŸãããããããã®ããã€ã¹ããçºãããããã«ãŒã©ã€ãã¯ç¡ç ã劚ããå¯èœæ§ããããŸãã
ç¡ç ç°å¢ãæé©åãã
ç¡ç ã«é©ããç°å¢ãäœããŸããããå¯å®€ãæããéãã§ãæ¶Œããä¿ã€ããšãæå³ããŸããé®å ã«ãŒãã³ãè³æ ããã¯ã€ããã€ãºãã·ã³ã䜿çšããŠãæ°ãæ£ãããã®ãæå°éã«æããŸããããçæ³çãªå¯å®€ã®æž©åºŠã¯ãéåžžãè¯æ°60床ãã67åºŠïŒææ°15.5床ãã19.5床ïŒã®éã§ãã
ã«ãã§ã€ã³ãšã¢ã«ã³ãŒã«ã®æåãå¶éãã
å°±å¯ééã®ã«ãã§ã€ã³ãšã¢ã«ã³ãŒã«ã¯é¿ããŸããããã«ãã§ã€ã³ã¯ç¡ç ã劚ããèŠéå€ã§ãããã¢ã«ã³ãŒã«ã¯å€éã®ç¡ç ã劚ããå¯èœæ§ããããŸããæŒé£åŸä»¥éã®ã«ãã§ã€ã³æåããå°±å¯ã®æ°æéåããã®ã¢ã«ã³ãŒã«æåã¯é¿ããã®ãæåã§ãã
宿çãªéå
宿çãªèº«äœæŽ»åãè¡ããŸãããããã ããå°±å¯ééã®æ¿ããéåã¯é¿ããŠãã ãããéåã¯ç¡ç ã®è³ªãåäžãããããšãã§ããŸãããæ¥äžã®æ©ãæéã«è¡ãã®ãæé©ã§ããååŸã®è»œããŠã©ãŒãã³ã°ããšã¬ã¯æçã§ãã
ã¹ãã¬ã¹ã管çãã
ã¹ãã¬ã¹ã¯ç¡ç ã劚ããå¯èœæ§ããããŸããçæ³ããšã¬ãæ·±åŒåžãªã©ã®ã¹ãã¬ã¹ç®¡çæè¡ãå®è·µããŸããããæ¥èšãã€ããããšããå°±å¯åã«èªåã®èããææ ãæŽçããã®ã«åœ¹ç«ã€æ¹æ³ã§ãã
é£äºã«é¢ããèæ ®äºé
å°±å¯ééã®å€§éã®é£äºã¯é¿ããŸãããã軜ãã¹ããã¯ã¯åé¡ãããŸããããç¡ç ã劚ããå¯èœæ§ã®ããéããèã£ããããŸãã¯èŸãé£ã¹ç©ã¯é¿ããŠãã ãããäžé¢é³¥ãããããçš®åãªã©ãããªãããã¡ã³ãè±å¯ãªé£åã¯ç¡ç ãä¿é²ããå¯èœæ§ããããŸãã
ç¡ç æ¥èšãæ€èšãã
ç¡ç æ¥èšãã€ããŠãèªåã®ç¡ç ãã¿ãŒã³ã远跡ããæœåšçãªåé¡ãç¹å®ããŸãããã就坿éãèµ·åºæéãç¡ç ã®è³ªããããŠã«ãã§ã€ã³æåéãã¹ãã¬ã¹ã¬ãã«ãè¬ãªã©ã®ç¡ç ã«åœ±é¿ãäžããå¯èœæ§ã®ããèŠå ãèšé²ããŸãããã®æ å ±ã¯ããã¿ãŒã³ãç¹å®ããç¡ç ç¿æ £ã調æŽããã®ã«åœ¹ç«ã¡ãŸãã
æ è¡è ã®ããã®ç¡ç è¡çïŒæå·®ãŒããæå°éã«ããèšæ¶åãæå€§åãã
æµ·å€æ è¡è ã«ãšã£ãŠãæå·®ãŒãã®ããã«è¯å¥œãªç¡ç è¡çãç¶æããããšã¯ç¹ã«å°é£ãªå ŽåããããŸããæå·®ãŒãã¯ãè€æ°ã®ã¿ã€ã ãŸãŒã³ãç§»åããããšã«ãã£ãŠäœã®èªç¶ãªç¡ç èŠéãµã€ã¯ã«ãä¹±ãããšãã«çºçããŸãã以äžã¯ãæ è¡äžã«æå·®ãŒããæå°éã«æããèšæ¶åãæå€§åããããã®ãã³ãã§ãã
- ç¡ç ã¹ã±ãžã¥ãŒã«ãåŸã ã«èª¿æŽããïŒå¯èœã§ããã°ãæ è¡ã®æ°æ¥åã«ç¡ç ã¹ã±ãžã¥ãŒã«ã®èª¿æŽãéå§ããŸãã就坿éãšèµ·åºæéãåŸã ã«ç®çå°ã®ã¿ã€ã ãŸãŒã³ã«è¿ã¥ããŠãããŸãã
- å ãæµŽã³ãïŒå ãæµŽã³ãããšã§ãäœã®ãµãŒã«ãã£ã¢ã³ãªãºã ããªã»ããããã®ã«åœ¹ç«ã¡ãŸããæ±ãžæ è¡ããå Žåã¯æã«ãè¥¿ãžæ è¡ããå Žåã¯å€æ¹ã«æããå ãæµŽã³ãŸãããã
- ã¡ã©ããã³ãµããªã¡ã³ãïŒã¡ã©ããã³ã¯ç¡ç ã調ç¯ãããã«ã¢ã³ã§ããã¡ã©ããã³ãµããªã¡ã³ããæåãããšãäœã®ãµãŒã«ãã£ã¢ã³ãªãºã ããªã»ããããæå·®ãŒãã軜æžããã®ã«åœ¹ç«ã¡ãŸããã¡ã©ããã³ãæåããåã«å»çå°éå®¶ã«çžè«ããŠãã ããã
- æ°Žåè£çµŠãæ ããªãïŒè±æ°Žã¯æå·®ãŒãã®çç¶ãæªåãããå¯èœæ§ããããŸãããã©ã€ãäžããã³ç®çå°å°çæã«ååãªæ°Žã飲ã¿ãŸãããã
- ã¢ã«ã³ãŒã«ãšã«ãã§ã€ã³ãé¿ããïŒãã©ã€ãäžã¯ã¢ã«ã³ãŒã«ãšã«ãã§ã€ã³ãé¿ããŸãããããããã¯ç¡ç ã劚ããå¯èœæ§ããããŸãã
- éåãããïŒãŠã©ãŒãã³ã°ãªã©ã®è»œãéåã¯ãè¡è¡ãæ¹åããæå·®ãŒãã軜æžããã®ã«åœ¹ç«ã¡ãŸãã
- ã«ãŒãã³ã確ç«ããïŒç®çå°ã«å°çããããã§ããã ãæ©ãèŠåæ£ããç¡ç ã¹ã±ãžã¥ãŒã«ã確ç«ããŸããããç²ããŠããŠããæ¯æ¥åãæéã«å°±å¯ã»èµ·åºããŸãã
ç¡ç ã®ã¢ãã¿ãªã³ã°ãšæ¹åã«ããããã¯ãããžãŒã®åœ¹å²
ãã¯ãããžãŒã¯ãç¡ç ã®ã¢ãã¿ãªã³ã°ãšæ¹åã«ãããŠéèŠãªåœ¹å²ãæããããšãã§ããŸããç¡ç ãã¿ãŒã³ãç£èŠããç¡ç 段éã远跡ããç¡ç ã®è³ªã«é¢ããæŽå¯ãæäŸããããŸããŸãªç¡ç ãã©ãã«ãŒãã¢ããªãå©çšå¯èœã§ãã
- ãŠã§ã¢ã©ãã«ç¡ç ãã©ãã«ãŒïŒã¹ããŒããŠã©ããããã£ãããã¹ãã©ãã«ãŒãªã©ã®ãŠã§ã¢ã©ãã«ç¡ç ãã©ãã«ãŒã¯ãã»ã³ãµãŒã䜿çšããŠç¡ç ãã¿ãŒã³ãç£èŠããŸããç¡ç æéãç¡ç 段éãå¿ææ°ãç¡ç äžã®åãã远跡ã§ããŸãã
- ç¡ç 远跡ã¢ããªïŒç¡ç 远跡ã¢ããªã¯ãã¹ããŒããã©ã³ã®å é床èšã䜿çšããŠç¡ç äžã®åãã远跡ããŸãããŸãããã³ããªã©ã®ç¡ç äžã®é³ãé²é³ããããšãã§ããŸãã
- ã¹ããŒããããïŒã¹ããŒããããã¯ãã»ã³ãµãŒã䜿çšããŠç¡ç ãã¿ãŒã³ãç£èŠããç¡ç ãæé©åããããã«ãããã¬ã¹ã®ç¡¬ããæž©åºŠãèªåçã«èª¿æŽããŸãã
- ãã¯ã€ããã€ãºãã·ã³ïŒãã¯ã€ããã€ãºãã·ã³ã¯ãäžè²«ããå¿å°ããé³ãçæããæ°ã«ãªãéšé³ããã¹ãã³ã°ããŠç¡ç ãä¿é²ããŸãã
ãã¯ãããžãŒã¯ç¡ç ã®ã¢ãã¿ãªã³ã°ã«åœ¹ç«ã¡ãŸãããä»ã®ç¡ç è¡çæŠç¥ãšäœµçšããããšãéèŠã§ããæ ¹æ¬çãªç¡ç åé¡ã«å¯ŸåŠããã«ãã¯ãããžãŒã ãã«é Œãããšã¯å¹æçã§ã¯ãªããããããŸããã
çµè«ïŒããéæãªæèã®ããã«ç¡ç ãåªå ãã
ç¡ç ãšèšæ¶ã®é¢é£æ§ã¯åŠå®ã§ããŸãããç¡ç ãåªå ããããšã¯ãæé©ãªèªç¥æ©èœãç¶æããèšæ¶ã®å®çãä¿é²ããå šäœçãªå¹žçŠæãåäžãããããã«äžå¯æ¬ ã§ããç¡ç ãšèšæ¶ã®é¢é£æ§ã®èåŸã«ããç§åŠãçè§£ããç¡ç ãæé©åããããã®å®è·µçãªæŠç¥ãå®è¡ããããšã§ãããéæãªæèãšããå å®ãã人çãžã®ç§å¯ãè§£ãæããããšãã§ããŸããããªãã詊éšã«åããåŠçã§ãããæé«ã®ããã©ãŒãã³ã¹ãç®æãå°éå®¶ã§ããããããã¯åã«èªç¥çãªå¥åº·ãåäžãããããšèããŠãã人ã§ãããç¡ç ãåªå ããããšã¯ãããªãã®æªæ¥ãžã®æè¯ã®æè³ã®äžã€ã§ãã