I-Apnea-Hypopnea Index Incedo ekunqumeni ukulala kwe-Apnea Inzima
Ukuba ufunde ukulala ubusuku obuthongo obubizwa ngokuba yi- polysomnogram , ugqirha wakho unokukunika ingxelo eneenkcukacha, kuquka umlinganiselo obizwa ngokuba yi- apnea-hypopnea index (AHI) . Iyintoni intsingiselo ye-AHI kubantu abadala abane-apnea yokulala? Uhambelana njani nobukhulu be- apnea yokulala ? Funda ngeenkcazo ze-AHI ezisetyenziselwa ukuvavanya nokulala kunye noko kuthetha ntoni kuwe.
Ukuqonda indlela i-AHI elinganiselwa ngayo
I-AHI ibalo lokubaluleka okubalulekileyo esekelwe kwiziphumo zesifundo sombuthano wokulala ubusuku obusuku obubizwa ngokuba yi-polysomnogram okanye kwi-home sleep apnea test. Njengengxenye yale mvavanyo, kukho iinzwa ezibekwe ekhaleni okanye kufuphi nomlomo olinganisa ukunyakaza kwomoya. Kukho neebhanti ezibekwe kwindawo yesifuba nesisu esiswini njengoko kuphefumula. Iziganeko ze-Apnea zenzeka xa umoya womoya uvalwe ngokupheleleyo kwaye akukho moya wokungena kwomoya ofunyanwa ngempumlo nangomlomo nangona kunzima ukuvela njengoko kubalwa ngesibindi kunye namabhande esisu. Ukuba ukuhamba komoya kuyancitshiswa kuphela, kodwa ubuncinane ubuncinane ngama-30 ekhulwini njengoko kuqikelelwe kwigrafu yesignali, kuthiwa yi- hypopnea .
Ezi ziganeko zicatshangelwa ukuba zibalulekile xa zenzeka kumxholo weziganeko ezimbini: i-oksijini yenqanaba liyehla okanye livuke ekuphumeni. I-oxygenation yegazi ilinganiswa kunye ne-oximeter, inzwa encinci ekhanyisa ukukhanya okubomvu ngokusetyeni.
Xa izinga le-oxygen liwa, oku kubizwa ngokuba yi- deaturation , kwaye amaconsi okungenani ama-3 ekhulwini anengxaki. Izifundo zokulala eziqhelekileyo ziphinde zirekhode ukuvusa ukusuka ekujuleni kokulala ukulala nokuze zivuke nge- electroencephalogram (i-EEG) . Ezi zivuko zinokuqhekeza ubuthongo, zenze ukuba zibuyiselwe, kwaye zikhokelela ekulele ubusuku.
I-Apneas kunye ne-hypopneas zichazwa njengeziphazamisayo xa zidibene kunye ne-oxygen desaturations okanye i-arousals.
I-AHI yilinganisi ephakamileyo. Kubalwa ngokuthatha inani elipheleleyo le-apnea okanye imicimbi ye-hypopnea ehlulwe yi-total amount of time spent spent sleeping hours. Ngamanye amagama, yimizuzu yezihlandlo ngeyure yokulala (okanye ukurekhoda) ukuba i-airway iqeshwe okanye idibene ngokupheleleyo, ekhokelela ekuhlaleni kwamanzi amanqanaba e-oksijini okanye ovusayo ukusuka kwinqanaba lokulala. Ukuba i-AHI yakho ineminyaka eyi-15, oku kuthetha ukuba, ngokuqhelekileyo, amaxesha ama-15 ngeyure yokulala ukuphefumla kwakho yanyanzeliswa kwaye oku kwaholela kwimiphumo emibi.
Kukho izibonelelo zokulala ezisetyenziselwa ezinye iindlela zokuvavanya eli nqanaba lobunzima. Inkcazo yokuphefumula (RDI) ingasetyenziselwa ukuba imilinganiselo yokumelana nokuhamba kwamanometer kunye noxinzelelo lwe-manometer yoxinzelelo iphinde ifakwe kwisifundo. I -index ye-oksijini-desaturation index (ODI) izama ukubala inani le-apnea okanye i-hypopnea iziganeko kwiyure ezikhokelela ekuhlaleni kwe-oxygen okungenani ama-3 ekhulwini. Oku kucingelwa ukuba kubalulekile ekuhloleni umngcipheko wexesha elide lomzimba (uxinzelelo oluphezulu lwegazi, ukuhlaselwa kwintliziyo, nokungaphumeleli kwentliziyo) okanye imiphumo ye-neurocognitive (stroke and dementia).
Ukuba isifundo sakho sokulala asiqukethe le miqathango ethile, akuyikukhathazeka.
I-AHI kunye nobunzima be-Apnea yokulala
Inani lexabiso linani njengoko lichazwe ngumbutho we-AHI kunye nobunzima be-apnea yokulala? Nangona imigangatho iyakwamkelwa ngokubanzi kuwo wonke ummandla wamachiza okulala, ama-cutoffs kwizigaba ngasinye ayamkelekanga. Ngokusekelwe kuphando, amaqela alandelayo asetyenziswa kubantu abadala:
- Uhlobo oluqhelekileyo: 0 ukuya ku-5
- I-apnea ebuthongo yokulala: 5 ukuya ku-15
- Ukuphefumula okuphambili kokulala: 15 ukuya ku-30
- Ukuphefumula okuphambili kokulala: 30 nangaphezulu
Ngokuqhelekileyo, le miqathango ibaluleke ngakumbi xa kukho ubungqina bezinye iziphumo ezimbi ezibangelwa ukulala kwe-apnea, kubandakanywa nokuphakama kokulala kwe- Epworth ngaphezu kwe-10, uphawu lokulala ngokugqithiseleyo emini.
Le ngcaciso ingasetyenziselwa xa uhlola iindlela zokonyango. Ngokomzekelo, ukuphefumula okunyanzelekileyo kuya kuyingqamaniso yokulala i-apnea yokulala iyakwazi ukuphathwa ngenyxinxu eqhubekayo yomoya (CPAP) kunye kunye nezixhobo zomlomo . Ulwaphulo lwezithuba kunye nezinye iindlela ezingenelelo lunokuqikelela. Ngaphezulu koko, unyango oluthile lunokuba luncedo ngakumbi ekuphiliseni imeko kulabantu abane-apnea yobuthongo obunzima.
Kukho ukuphikisana ngabantu abanobukhulu obukhulu bokulala kwe-apnea. Ngaloo mbonakalo ingaba ngabafazi basengaphambili be-menopausal (abakhuselwe ngamahomoni e-estrogen kunye ne-progesterone) okanye abantu bobunzima bomzimba obuqhelekileyo, kunokuba babe ne-apnea yokulala, kunokuba babe ne- high-resistance-resistant syndrome (UARS) .
Kufuneka kuqwalaselwe ukuba abantwana banokuba ne-apnea yokulala i-AHI ephantsi. Ngokuqhelekileyo, i-AHI icingelwa ukuba ayinqabile xa iphezulu kune-1 (nangona le mvume yayingaphambili ngaphambili). Oku kuyinkimbinkimbi ngenguqu yentuthuko eyenzeka ekukhuleni. Iintsholongwane eziye zagqitywa ngokukhula kwazo ezinkulu zi novavanyo olufanelekileyo ngokusebenzisa uluhlu lwabantu abadala. Olu vavanyo kunye nokuzimisela zenziwe ngcono ngokusekelwe kwisigqibo seklinikhi yengcali yokulala kwengane yakho.
I-AHI ingaba luncedo ekujongeni impendulo yakho kwindlela yokwenza utyando oluqhubekayo lwe-airway (CPAP). Injongo kukuba kuluhlu oluqhelekileyo, kunye neentsuku ezingaphantsi kwe-5 ngeyure, kodwa inani elingaphantsi libhetele. Ngokuqhelekileyo kunokwenzeka ukwandisa izicwangciso zokufumana i-AHI phantsi kweyoku-1 okanye kwe-2.
Ukuba unemibuzo engakumbi malunga ne-AHI ithetha kuwe, thetha nogqirha wakho malunga neziphumo zokuvavanya kunye neendlela ezingcono zokonyango ukujongana neemfuno zakho.
> Umthombo:
> Kryger, MH et al . "Imigaqo kunye nokuSebenza kweMithi yokulala." Elsevier , i-6th edition. 2016.