Excessive daytime sleepinessを呈するパーキンソン病患者への生活リズム再構築に向けた探索的マルチコンポーネント介入

An exploratory multicomponent intervention to restructure the rhythm of life in excessive daytime sleepiness in patients with Parkinson's disease: A case study

要旨：【目的】日中の過度な眠気（EDS）により日常生活に制限を呈したパーキンソン病患者（PD患者）に対し，睡眠マネジメントや食事調整など状況に応じた非薬物的介入を探索的に検討した．【症例】60代男性．H＆Y重症度分類3度のPD患者で通所リハを利用中にEDSが出現し，日常生活に制限が生じた．【方法】本人と家族に夜間・日中の睡眠マネジメント，食事量の調整を指導し，段階的に運動療法を実施した．【結果】UPDRS Part3は50点から41点．PDSS 2の得点は43点から21点と改善した．【結論】家族の協力を得て生活様式の是正を図り，通所リハで運動療法を実施し，EDSの軽減と日常生活動作が改善した．

　Purpose: We investigated non-pharmacological interventions such as sleep management and dietary adjustment for a patient with Parkinson's disease (PD) who experienced excessive daytime sleepiness (EDS), which limited his ADL. Case: A 60-year-old male patient with H&Y severity class 3 PD developed EDS during daytime rehabilitation, which limited his ADL. Methods: The patient and his family were instructed on nighttime and daytime sleep management, dietary adjustment, and step-by-step exercise therapy. Results: The UPDRS Part 3 score improved from 50 to 41, and the PDSS 2 score improved from 43 to 21. Conclusion: The patient's lifestyle was corrected with the cooperation of her family, and exercise therapy was conducted at a daytime rehabilitation center, which reduced EDS and improved activities of daily living.