I-Anatomy, Indawo yokulala, kunye neMigangatho yokulala Zonke iimfuno zoxinzelelo lwe-Impact
Ukuba unikwe umyalelo wokuqhubeka unyango olukhuselekileyo lwe- airway (CPAP) ukuze uphephe ukukhubazeka kwakho kokulala , unokuzibuza ukuba: ngaba ubunzima be-apnea yokulala bulinganiswa ne-AHI yokubambisana nexinzelelo olufunekayo lwe-CPAP ukuze unyango olusebenzayo? Funda ukuba (kwaye njani) indlela yokubeka i-CPAP ehambelana nayo ihambelana nesigxina se-apnea yokulala kunye naziphi ezinye izinto ezinokuthi zibandakanyeke ukucacisa unyango lwakho olufanelekileyo, kubandakanya ukuma, ukulala, kunye neziganga zokulala.
Indlela Ubuthongo Bokulala Ngayo Ubundlobongela Oxhomekeke Kuxinzelelo
Kuyinto engokwemvelo ukucinga ukuba kuya kuba nolwalamano phakathi kokumiselwa kokunyanzeliswa kwe-CPAP kunye nezinga lokukhusela ukugula okuphazamisayo. Ukuba udinga unyango lwexinzelelo lwegazi, umthamo ophezulu ngokwemvelo uza kuba nempembelelo enkulu, akunjalo? Ewe, ngelishwa, ulwalamano aluxhomekeke ngqo xa unyango lwe-apnea yokulala.
I-apnea yokulala yokuvuthwa (i-OSA) ifunyaniswa ukuba ifundele ubusuku bokulala okanye uvavanyo lwe-apnea lwasekhaya lokuhlola i-apnea yokuvavanya inani leeyure ngeyure yokulala apho umoya ophezulu ugobile, okubangele ukuhla kwezinga le-oksijeni yegazi okanye ukuvuswa kokulala. Ukuba i-airway igqabhuke ngokupheleleyo le nto ibizwa ngokuba yi-apnea kwaye ukuba iyahlukana ngokukodwa oku kuthiwa yi-hypopnea. Inani elipheleleyo le mi ganeko ngehora lokulala li -index ye-apnea-hypopnea (AHI) .
I-AHI ivumela udidi oluqhelekileyo lobunzima be-apnea yokulala.
Ukuba kukho iziganeko ezingaphantsi kwama-5 ngeyure, oku kubonakala kuyinto eqhelekileyo. Ukuba iziganeko ezi-5 ukuya kwezi-15 ngeyure zirekhodwa, oku ku-OSA. Ukuba kukho ngaphezulu kwe-15 kodwa kungaphantsi kweziganeko ezingama-30, le nto ibonwa njenge-OSA. Ekugqibeleni, ukuba iziganeko ezingaphezu kwe-30 zibhalwa ngeyure yokulala, oku kubonakala njenge-OSA enzima.
Unokucinga ukuba i-OSA enzima idinga ukusetyenzwa kwe-CPAP ephezulu ukuze uyiphathe. Ngokwenene, oku akunjalo ngaso sonke isikhathi njengoko kukho izinto ezininzi ezibandakanyekayo ekuqaliseni izilungiselelo ezifunekayo. Ngokuqhelekileyo, unyango luqala kwisimo esiphantsi kwaye ngokunyuka kwanda ukuxazulula zonke iziganeko ze-apnea kunye ne-hypopnea kunye nokunyusa. Ukusekwa kweyona nto ephantsi kunazo zonke kumashishini we-CPAP ingaba ngu-4 kuya ku-5 centimitha yoxinzelelo lwamanzi (isicatshulwa njengecenti ye-H20 okanye i-CWP). Uninzi lwabantu ludinga uxinzelelo oluninzi kunolu hlobo olusezantsi. Isimiso esiphezulu sihluka kunye nohlobo lomshini, kodwa lunokuba luphakamileyo malunga ne-25 okanye i-30 CWP.
Ukuqulunqa uxinzelelo lweCPAP olufunekayo ukuxazulula ukulala kwe-Apnea
Ukuba isicwangciso se-CPAP sinqunywe njengenxalenye yecwaningo lokubhaliweyo ngobusuku obunobumba bokulala , i-polysomnography yezobuchwephesha iya kugcina indlela yokuphefumula kwaye ilungele ukubeka phezulu xa ulala. Oku kwenziwa ngokukude ukusuka kwelinye igumbi, ukwenjenjalo ukuphazamiseka. Injongo kukuphelisa i-apnea yokulala kunye nokugcina ubuthongo obunzulu, kuquka ukuhamba kwamehlo okukhawuleza (REM) ukulala. Esi silungiselelo sifanele senziwe kakuhle xa silala ngokugqwesileyo (ngasemva kwakho), xa ukulala kwe-apnea kudla kakhulu.
Abanye abantu bathunyelwa ekhaya kunye nomatshini we-CPAP ozilungisayo, ngezinye iinkhathi ubizwa ngokuba yi-AutoCPAP okanye i-APAP.
Kulo mzekelo, ugqirha ugunyaza uvumela uluhlu lweengcinezelo, kwaye umatshini uza kuqala kwaye ahlahlele phezulu njengoko kufunekayo ekuphenduleni ukuxhatshazwa kweendlela zokuhamba kwamanzi (okubonisa ukusila okuqhubekayo kwezicubu ezinothile ezifana nesiseko seelwimi okanye isalathisi esincinci emqaleni ). I-CPAP inika iifom zangaphakathi zengcinezelo yomoya ophezulu ukuvavanya ukungqinisiswa kwaye, ngokubanzi, ingaba i-airway ephezulu iyawa. Ukuba i-airway ivuliwe kwindawo ekhoyo yangoku ye-CPAP, igcinwa.
Uxinzelelo lwe-CPAP olufunekayo aluhambelani ngokuthe ngqo kunye nobunzima be-apnea yokulala.
Abanye abantu abane-OSA abanobuchule badinga uxinzelelo oluphezulu kunye nabanye abantu abane-OSA ezinzima badinga ukunyanzeliswa ngokunyanisekileyo. Oko kuthethwa, abantu abane-apnea ebuthongweni obunzima kakhulu badla ngokufuna iimpompo eziphezulu kwi-CPAP, okanye nangonyango lwama-bilevel . Oku kuyinyani ngokukodwa kwimeko yokunyamezela okanye ukuvinjelwa kwamanzi. Abantwana banokufuna iimpembelelo ezifanayo kubantu abadala, nangona ubuncinci besayizi yabo yomoya.
Ziziphi iimeko eziqinisekisa ukulungiswa koxinzelelo lweCPAP? I-anatomy ye-airway engenhla kunye nesimo sokukhutshwa kwendlela yokuhamba ngomoya inendima enkulu. Ukuba i-apnea yokulala ivela ngenxa yeengcambu ezivaliweyo ngenxa ye-allergies okanye i- septum ekhethiweyo , i-palum edibeneyo , okanye ulwimi oluwa e-airway, ixabiso elingafaniyo lomoya kufuneka litshintshe ezi zicubu.
Ukongezelela, ukugqithisa okanye ukugqithisa kungadlukisa izinto. Enyanisweni, xa abantu belahlekelwa ngu-10% womzimba wabo, kunokufuneka ukuba ulungelelanise izicwangciso ze-CPAP ngokuziguqula.
Utywala, unyango olulondoloze izihlunu zomoya (njenge- benzodiazepines ), kwaye ukulala emhlane wakho konke kungongeza kwimiqathango yengcinezelo yakho.
Ekugqibeleni, u-REM ukulala ngokusa kusenzela izihlunu kunye nokunyusa ukulala kwe-apnea.
Ukumisela ngokufanelekileyo iMeyi ixhomekeke ekuhlaziyweni kwe-AHI yokuhlala
Ngoko ke, njengoko kuchazwe ngasentla, akulula ukuqiqa ukuba yintoni uxinzelelo lwe-CPAP omele uyenze ukuyiphatha izinga lokulala ngomoya. Iyakwazi ukuhluka ngokukhawuleza ngexesha lobusuku kuxhomekeke kwisithuba sakho sokulala nokulala. Ukuba uxinzelelo luphantsi kakhulu, i-apnea yakho yokulala ayiyi kulawulwa ngokwaneleyo. Ukuba iphakame kakhulu, unokuba nemiphumo emibi njenge-mask uvuza okanye umoya ugwinya .
Kubalulekile ukuba umatshini ubekwe ngokufanelekileyo ngumbono wokulala ukuze kuqinisekiswe amava amahle kunye neenzuzo ezinkulu. Izixhobo zanamhlanje zinganika ulwazi nge-AHI eseleyo kwaye oku kunokunceda ukukhokela ukulungiswa kwengcinezelo. Kungaba lunqweneleka ukusebenzisa umshini we-AutoCPAP okwazi ukulungelelanisa nale miba.
ILizwi
Ukuba uqhubeka unempawu, funda kwakhona ngogqirha wakho wezobubhozo obungqina bokuba uqinisekise ukuba imeko yakho iyaphathwa ngokwaneleyo ngocingo lwezitshixo zakho. Musa ukutshintsha isethingi ngokwakho ukuba awukwazi ukuqonda ngokupheleleyo iinguqu ezinokubangela ubunzima obunokuba nazo.
Umthombo:
Kryger, MH et al . "Imigaqo kunye nokuSebenza kweMithi yokulala." Elsevier , edition 6, 2017.