Iingxaki kunye neZonyango ezahlukileyo kwi-Apnea yokulala
Ukupheka kwe-apnea kunokuba nzima ukuyiqonda, ngokuyininzi ngenxa yamagama anzima aphonswa apha. Ngelishwa, nabanikezeli bonyango abanokungaqondi kakuhle intsingiselo yezifo ezahlukeneyo. Oku kungakhokelela kwiimvavanyo ezixabisekileyo kwaye ezingadingekile kwaye unyango. Kubaluleke kakhulu ukuqonda iimpawu kunye nempawu zokuxilongwa ngokuthe ngqo: ukuxilwa kwe-apnea ebunzima.
Yintoni eyinkimbinkimbi okanye unyango-ukuphuphuma kwe-apnea yokulala? Funda malunga nale meko, iimpawu kunye nezizathu, ukuba zifumanisa njani, kwaye unyango olusebenzayo (kwaye ukuba unyango luyimfuneko).
Sibanzi
I-apnea yokulala yinkimbinkimbi ikwabizwa ngokuba yi-apnea yokulala, kwaye le nto yinto ebalulekileyo yenkcazo. I-apnea yokulala yinkimbinkimbi iyenzeka xa umntu owayesandul 'ukulala ngomoya okhulayo ahlakulela ukulala okuphambili ngenxa yokusetyenziswa kwonyango kunye noxinzelelo oluqhubekayo lwengqondo (CPAP) . Oku kuninzi ukukhupha, ngoko-ke maye sichitha amagama apha.
Okokuqala, i-apnea yokulala yokhuseleko iyakwenzeka xa i-airway engenhla (okanye umqala) iyanqamuka ngexesha lokulala. Oku kunokubangela ukuhla kwamanqanaba e-oksijeni yegazi kunye nokuvuswa okanye ukuvuswa kokulala. Ngokusekelwe kwisifundo sokulala sengqondo sokuthi i- polysomnogram , le meko ikhona xa kukho iziganeko ezihlanu okanye ngaphezulu ezithintekayo kwiiyure zokulala.
Ezi zinyama zihamba ngamagama ahlukeneyo, kubandakanya i-apneas eziphazamisayo, i-apneas ezixubekileyo, i-hypopneas, kunye neziphakamiso ezinxulumene nokuphefumula (i-RERAs).
Xa ukuphazamiseka kokugula okuphazamisayo kubonakala, ukusetyenziswa ngonyango oluqhelekileyo kunye nokusetyenziswa ngonyango lwe-CPAP. Olu unyango lunikeza ukuqhuma komoya rhoqo kumaski ebuso.
Lo moya ongezelelweyo ugcina uhambo olungabonakaliyo, okanye luphazamise, kwaye luze luzimisele ukurhoxisa. Kwezinye iimeko, kunokubangela utshintsho ekuphefumla okubangelwa ukuphefumula, imeko ebizwa ngokuba yi-apnea yokulala.
Ngenkcazo, i-apnea yobuthongo obunzima iyenzeka ngokusetyenziswa kwe-CPAP unyango. Iziganeko ezithintekayo zixazululwe kwaye iziganeko eziphambili ze-apnea zivela okanye ziqhubeka nokunyango. Ezi ziganeko eziphambili ze-apnea kufuneka zenzeke ubuncinane amahlanu ngeyure kwaye zimele zenze ngaphezu kwe-50% yenani le-apnea kunye ne-hypopnea. Ngoko ke, ukuba unesiganeko seziganeko eziyi-100 ze-apnea eziphawulwe ngelixa usebenzisa i-CPAP unyango, kwaye kuphela 49 (okanye mhlawumbi kuncinci) iziganeko eziphambili ze-apnea, awunayo i-apnea yokulala ebunzima. Kuqhelekile ukuba ezinye iziganeko eziphambili ze-apnea zivela, kodwa azinakufuna nongenelelo olongezelelweyo ngaphaya kwexesha.
Ukukhula
I-apnea yokulala yinkimbinkimbi ingaqhelekanga ngexesha lokuqala lonyango nge-CPAP okanye nangonyango lwama-bilevel . Ezi ziganeko eziphambili ze-apnea azichazwa bhetele ngokusetyenziswa kwamachiza (njengama-narcotics okanye amayeza eentlungu ze-opioid) kwaye azibangelwa ukuhluleka kwentliziyo okanye ukubetha. Ku nokuba nenani eliphakamileyo lokuvuswa ekulala kunye nokuvuswa komntu ngamnye kunokulandelwa yinkxalabo ephakamileyo.
Ezi ziganeko ziyabonakala ngokugqithiseleyo ekuphumeni kokungabikho kwe-REM kwaye zinokuphucula kancane kwisiteji sesi-3 okanye i-wave-wave wave.
Ziyinto eqhelekileyo yinto ephazamisayo yokulala kwe-apnea? Lo ngumbuzo onzima ukuphendula. Iziganeko zinyani kunye neqondo lokunyamezela alichazwa kakuhle, ngenxa yokuba ihlala isombulula ngendlela efana neyokwelapha kwePAP. Kucinganiselwa ukuba zichaphazeleke kwi-2% ukuya kwi-20% yabantu njengoko ziqala ukusebenzisa i-CPAP unyango kwaye zingabonwa ngokuphindaphindiweyo ngobusuku bokuqala okanye obusibini bokusetyenziswa. Ngoko ke, inokuthi ichongiwe ngaphezulu njengenxalenye yesifundo sokubhaliweyo kwiziko lokulala. Ngethamsanqa, kuqhubeka kuphela unyango malunga nama-2% abantu.
Izizathu
Iimbangela ezibalulekileyo zokuphefumula obunzima bokulala bengaziqondi kakuhle. Kukho inokubambisa inani, kwaye akusiyo yonke into ngenxa ye-CPAP. Abanye abantu banokubekwa phambili kwiimeko ngenxa yokungazinzi ekulawuleni ukuphefumla. Kungenzeka ngokuqhelekileyo phakathi kwalabo abanenkinga yokugcina ubuthongo, ezifana nokulala. Kubonakala ngathi ibangelwa yizinga elincinci le-carbon dioxide kwezinye. Ukuba umntu unesifo esibuhlungu kakhulu sokulala ngomoya (kunye ne- AHI ephezulu) okanye uneziganeko eziphambili ze-apnea eziphawulwe phambi kokunyanga, oku kunokunyusa ingozi. Kwakhona kubonakala ukuba kwenzeka ngaphezulu kwamadoda.
Kuyathakazelisa ukuphawula ukuba ezinye iindlela zokwelapha zokugonya kwe-apnea zibonakala zandisa umngcipheko wokwakha i-apnea yokulala ebunzima. Ugqirha kunye nokusetyenziswa komnxeba womlomo kuye kwabikwa ukuba kubangele ukuphazamiseka kokulala kwephene. Kungenzeka kwakhona ukuba iingcinezelo zonyango lwe-PAP ziphezulu kakhulu okanye ziphantsi kakhulu, njengoko zibekwe ngexesha lokufunda okanye ukusetyenziswa kwekhaya.
Iimiphumo kunye neNyango
Nangona i-apnea ebuthongweni obunzima ixazulula ixesha elide, kukho i-2% yabantu abahlala kuyo le meko kwaye kukho enye imiphumo. Abanye bala bantu banokufuna ezinye iindlela zokunyanga ukulungisa isifo.
I-apnea yokulala yinkimbinkimbi ingaqatshelwa ukuqhubeka nokukhuphela kwedatha yokuthotyelwa kwe-PAP. Oku kuya kubakho kwi-aphoyintimenti yokulandela ukulandelelana kunye nesifo sakho sokulala kwiinyanga ezintathu zokuqala zokusetyenziswa. Ukuba iziganeko ezingaphezu kwetlanu ze-apnea eziphambili zenzeka ngehora, nangona iziganeko eziphazamisayo zokulala kwe-apnea zixazululwa, oku kungakhokelela utshintsho. Kutheni le nto ingaba
I-apnea yokulala ebunzima eqhubekayo enxulumene ne-AHI ephezulu ye-AHI ingabangela ukuqhubeka kokulala kunye nokuchithwa kwe-oksijini. Oku kunokukhokelela ekubuthweni kwemini kunye neminye imiphumo yempilo yexesha elide. Okubaluleke kakhulu, oku kungakhohlisa kwakhona unyango lwe-PAP: umsebenzisi angabika ingeniso encinci kwaye abe nokunyamezela kwexesha elide kunyango.
Kubalulekile ukuba uqaphele ukuba kunokuhleka ubusuku nobusuku. Kwimiqathango yenkqubo yakho yokuqala, ezinye iziphakamiso kwi-AHI zinokunyamezela ukuba impendulo ngokubanzi kunyango ifanelekile. Nangona izixhobo zingabonelela ngeemeko eziphambili ze-apnea, ezi zinto zingagqibekanga, kwaye oku kungaphononongwa kangcono nge-polysomnogram ephezulu.
Isixazululo sobuthongo obunzima bokulala singathembela ekujonganeni nezizathu ezingundoqo. Ngokomzekelo, ukuba iingcinezelo ezisetyenzisiweyo ziphezulu kakhulu (okanye, ngokuthe rhoqo, ziphantsi), ukulungiswa okulula kunokusombulula loo mbandela. Ukuba ukuvuswa kuyenzeka ngenxa yokuvuza imfino, ukufaneleka okufanelekileyo kunokunceda. Kwezinye iimeko, kunokuba kuyimfuneko ukutshintshela kwi-ST (ngefomati yokuphefumula efikelelwe ngexesha lokuphefumula) okanye u-ASV unyango. Ezi ndlela zonyango ziza kufuna ukuba kufundwa ngokubhaliweyo ukufumana izicwangciso zesistim.
Unonophelo olunonophelo luhlala lusebenza kakhulu: ixesha. I-apnea yokulala yinkimbinkimbi iya kuphucula ngo-98% amatyala njengoko unyango luqhubeka. Akunakudinga ukungenelela kwangakumbi ngaphandle kokulinda nokubukela iziganeko eziseleyo.
Imithombo:
I-American Academy yoLondolozo lweMpilo. Ulwahlulo lwamazwe ngamazwe okuphazamiseka kokulala , 3 rd ed. Darien, IL: I-American Academy yoLwazi lweMpilo, ngo-2014.
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