第 108 回日本精神神経学会学術総会教育講演 REM REM 索引用語はじめに. sleep psychiatry 26

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1 第 108 回日本精神神経学会学術総会教育講演 ,000 1 REM REM 索引用語はじめに sleep psychiatry

2 783 Ⅰ. 睡眠医学の研究の歴史 , Berger, H. von Economo 1953 Kleitman, N. REM rapid eye movement REM NREM non rapid eye movement video polysomnography V PSG 1970 Ⅱ. 睡眠覚醒のメカニズム 1 5,7,14,25 NAdAch LDT PPT 5 HT His Ach ,19 2 His Ach 7,14 7 GABA 25

3 GABA REM LDT PPT REM PGO ponto geniculo occipital wave REM REM withouot atonia REM 7,19,40,43 D 2 His , Per Timeless Clock autofeedback loop 33 Ⅲ. 睡眠障害の診断治療の原則 obstructive sleep apnea syndrome OSAS CSAS NREM REM REM REM sleep behavior disorder RBD 6 restless legs syndrome RLSperiodic limb movement disorder PLMD 7

4 The Center for Epidemiologic Studies Depression Scale Zung PSG V PSG Multiple Sleep Latency Test QOL Ⅳ. 睡眠と精神医学 1 12,13 16,31,34 1 OSAS OSAS OSAS 16,31,34 30

5 B12 MT 1 MT 2 NREM REM NREM REM SSRI 1 SNRI SSRI SNRI SSRI Ach HPA

6 787 CRHHPA axis Ad NAd HPA Ach 37 HPA NAd CRH CRH CRH1 HPA 37 HPA 2 HPA cortisol NAd 2 PSG stage 2stage 3 4 REM 8 29 RLS PLMD His 1 OSAS 29 OSAS OSAS 44 OSAS 3 11,20,24 PSG REM RLS PLMD

7 RBD 1 PSG 7,24 REM Ach 7,24, RBD REM RBD RBD RBD RBD 1,7,28,40 RBD 2 RBD RBD SSRI RBD SSRI REM REM sleep without atonia RBD 40,43 RBD ,6,7,9,10,17,18,19,21,22,23,39,41 Ach 2,6,7,9,10,17,18,19,21,22,23,39,40,41 6,7,17,18 6,17,19

8 789 19,39 2,19,18,40 PSG stage 1 REM with tonic electromyogram EMG excited stage 1 REM 1 REM PSG 40 RBD REM sleep without atonia RWA RBD PSG RBD RBD REM NREM 6,9,40 おわりに文献 1 American Academy of Sleep Medicine The International Classification of Sleep Disorders Diagnostic & Coding Manual, 2nd ed. American Academy of Sleep Medicine, Westchester, p ABC 56 p p p Geriatric Medicine p á la carte Medical

9 Technology p p , p Golbin, A. Z., Kravitz, H. M., Keith, L. G., ed. Sleep Psychiatry. Informa Healthcare, London, Clinical Neuroscience p Lee, E. K., Douglass. A. B. Sleep in psychiatric disorders where are we now? Can J Psychiatry, , Postuma, R. B., Gagnon, J. F., Vendette, M., et al. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology, , Rongve, A., Boeve, B. F., Aarsland, D. Frequency and correlates of caregiver reported sleep disturbances in a sample of persons with early dementia. J Am Geriat Soc, , Sculthorpe, L. D., Douglass, A. B. Sleep pathologies in depression and the clinical utility of polysomnography. Can J Psychiatry, , p p Tamura, Y., Chiba, S., Takasaki, H., et al. Biperiden induced delirium model in rats a behavioral and electroencephalographic study. Brain Res, , p REM Sleep Behavior Disorder CPAP

10 Powered by TCPDF ( 791 Sleep Psychiatry Shigeru CHIBA Department of Psychiatry and Neurology, School of Medicine, Asahikawa Medical University Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain EEG, sleep wake system, rapid eye movement REM sleep, and circadian rhythm system. Additionally, the advent of video polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease e. g., lifestyle related disease but psychiatric illness. According to The International Classification of Sleep Disorders(2005), sleep disorders are classified into 8 major categories 1 insomnia, 2 sleep related breathing disorders, 3 hypersomnias of central origin, 4 circadian rhythm sleep disorders, 5 parasomnias, 6 sleep related movement disorders, 7 isolated symptoms, and 8 other sleep disorders. Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. Moreover, sleep disorders may exacerbate underlying psychiatric disorders when left untreated. Therefore, psychiatrists should pay attention to the intimate relationship between sleep disorders and psychiatric symptoms. Sleep psychiatry is an academic field focusing on interrelations between sleep medicine and psychiatry. This mini review summarizes recent findings in sleep psychiatry. Future research on the bidirectional relation between sleep disturbance and psychiatric symptoms will shed light on the pathophysiological view of psychiatric disorders and sleep disorders. Author s abstract Key words insomnia, dementia, depression, REM sleep behavior disorder, lifestyle related disease

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FEP Medical Policy Manual Effective Date: October 15, 2018 Related Policies: 2.01.18 Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome Polysomnography for Non-Respiratory Sleep Disorders

第 108 回日本精神神経学会学術総会 教育講演 REM REM 索引用語 はじめに. sleep psychiatry 26

第 108 回日本精神神経学会学術総会教育講演 REM REM 索引用語はじめに. sleep psychiatry 26