Iziphazamiso zokulala zixhaphake phakathi kwabantu abane- rheumatoid arthritis . Ukukhathala kubonwa njengengxaki enkulu kulabo abaphila nesi sifo. Ngesinye isikhathi, kwathiwa akucaci ukuba ukuphazamiseka kokuphazamiseka kokulala kwe-apnea kwakunxulumene nesifo se-rheumatoid arthritis. Ukuvuthwa kwe-apnea yokulala ingomnye weentlobo ezintathu ze-apnea yokulala.
Ucinga ntoni ngoku? Ingaba kukho umngcipheko ophezulu wokukhusela i-apnea yobuthongo obunqandekileyo ukuba une-rheumatoid arthritis?
Ngaba ubuthongo obunokubangela ukulala buhlungu ngenxa yokuphazamiseka kokulala nokukhathala kwezikhalazo eziqhelekileyo zabantu abane-rheumatoid arthritis? Makhe sihlolisise oko abaphandi baye bazimisela.
I-Rheumatoid Arthritis Basics
I-rheumatoid arthritis yinto engapheliyo, yokuzimela , yokuvuvukala kwe-arthritis . Ngoxa iintlungu ezidibeneyo kunye nomonakalo odibeneyo zizinto zesifo se-rheumatoid arthritis, kunokuba nemiphumo yesistimu kunye nokubonakaliswa kwangaphandle. Abantu abayi-1.5 yezigidi e-United States bane-arthritis ye-rheumatoid, ngokutsho kwamaziko okuLawula nokuLawulwa kwezifo (CDC).
Sleep Apnea Basics
Ukuphefumula ngokuphambana nokulala ngumbandezelo oqhelekileyo ophefumulayo. Ukuphefumula komntu, ukuphefumla komntu kukuphazanyiswa, okanye ukuyeka, ngexesha lokulala. KwiMntla Melika, ukukhula okuqikelelwayo-xa ukuphazamiseka kokulala kwe-apnea kuchazwa njenge-apnea-hypopnea index (AHI) yeziganeko ezingaphezu kwe-5 ngeyure njengoko zichongwe yi-polysonogram-i-20 kuya kwi-30 ekhulwini kumadoda kunye ne-10 ukuya kwi-15 ekhulwini phakathi kwamabhinqa.
Nangona i-apnea ibhekisela ekumiseni okwesikhashana ukuphefumula, i-hypopnea ibhekisela ekuphefumuleni okanye kuphefumle. Iipasiti zokugonya kwe-apnea ziphumela ekunciphiseni i-oxygen saturation.
Imiba yengozi echaphazelekayo yokulala i-apnea iquka:
- Ukukhula
- Ngokwesini
- Ukunyanya
- I-Craniofacial okanye iphezulu ye-tissue tissue engafanelekanga
Ezinye izinto ezinobungozi eziye zachongwa zibandakanya ukutshaya, ukudibanisa kwamanzi, ukuphuma kwindoda, kunye nomlando weentsapho zokulala. Iimeko ezithile zonyango ziye zadibaniswa nomgangatho ophezulu we-apnea yokulala, kubandakanya ukukhulelwa, isifo sokuphela kwesigxina, ukukhubazeka kwentliziyo, ukugula kwesifo samaphaphu kunye nesifo. Abaphandi baye bafumana unxibelelwano phakathi kwe-rheumatoid arthritis kunye nomngcipheko okhuselekileyo wokuphefumula ubuthongo obunzima.
I-Apnea yokulala ne-Rheumatoid Arthritis ingaxhunyezwa
Ngokutsho kweziphumo zophando ezipapashwe kwi-BMJ Open (2016), isantya sobungozi be-sleepiness apnea sasingama-75 ekhulwini kwiqela labantu abanesifo se-rheumatoid arthritis xa kuthelekiswa nabangenayo i-rheumatoid arthritis. Iziphumo zifunyenwe kwisifundo sokuqala sokuphindaphinda esasetyenziswe kwilizwe lonke. Izifundo zangaphambilini ze-apnea yokulala kunye nokubandakanywa kwayo kunye ne-rheumatoid arthritis zisekelwe kwiingxelo zeemeko okanye uphando lwamaxesha kunye nesayizi encinane yesampula.
I-BMJ Open ingxoxo yokufunda ithi umngcipheko wokuphelisa ubuthongo obunqanda ukulala ungaphezulu kwamadoda kunabesifazana, kubantu abadala xa kuthelekiswa nabantu abancinci, kunye nalabo abanomdla. Umngcipheko we-apnea wokulala uyaziwa ukuba unxulumene nomfutho wegazi ophezulu, u-hyperlipidemia, isifo senhliziyo yesichemicic, kunye nokukhuluphala.
Ngokubhekiselele kwi-arthritis ye-rheumatoid, izinto ezithile zibonakala zinegalelo kumngcipheko ophezulu wokulala kwe-apnea, kubandakanywa i-micrognathia, ukungahambi kakuhle kwemithi yengqondo, ukubandakanyeka kokubambisana kwe-temporomandibular, ukubandakanyeka komxube we-cricoarytenoid kunye nokukhuluphala.
- I-Micrognathia yimeko apho umhlathi ongaphantsi uncinci kunesiqhelo. Oku kudla ngokuba ngumdla we -idiopathic arthritis . Kwakhona kunokwenzeka ukuba i-micrognathia efunyenwe ngumntu omdala ehambelana ne-rheumatoid arthritis, ngezinye iimeko ngenxa yokutshatyalaliswa kwendibano ye-temporomandibular, ekhokelela ekukhuselweni kwe-airway engenhla kunye nokuphazamiseka kokugula kwe-apnea.
- Imiba yomlomo wesibeleko inokuvela kwi-arthritis ye-rheumatoid, ngokukodwa, ukungazinzi kwintambo yomlomo wesibeletho, ukuchithwa kwe-occipital-colervical region, kunye nezinye izinto ezingaqhelekanga, ezifana nobukho be- osteophytes . Ukungalungiswa komlomo wesibeleko kunokubangela ukunyuka kweendlela ezihamba phambili, ukunyanzeliswa kwengqondo, kwaye kunokuchaphazela ubunzima bokuphefumula. I-Occipital-cerervic (floral) i-fusion inokukunceda ukulungisa loo nto engavamile kunye nokuphucula i-apnea yokulala.
- Ukubandakanyeka ngokubambisana kwe-Temporomandibular-Ukuchithwa kwendibano ye- temporomandibular ehambelana ne-rheumatoid arthritis inokunciphisa ubukhulu bendlela engaphezulu kunye negalelo lokulala ne-apnea kulabo abachaphazelekayo.
- Ukubandakanyeka ngokubandakanyekileyo kweCricoarytenoid-Amalungu angama- cricoarytenoid atholakala phakathi kwee-cricoid kunye ne-carrylages ezidibeneyo ezibini ezikwindonga yangasemva kwe-larynx. Amalungu e-cricoarytenoid avulekileyo, avule, kwaye aqinise iintambo zezwi ngelixa ethetha nokuphefumla. Ukungaqhelekanga kunokuncedisa ukulala ngophalamende kubantu abane-arthritis ye-rheumatoid.
Izifo ze-Genetic, ukunyuka kweemeko ezithile zendalo, ezinye izinto eziphathekayo, kunye nokuziphatha okukhethayo okanye ukuziphatha okufana nokutya okungaphantsi kokutya (umzekelo, ushukela oluninzi okanye amanqatha), ukusela kakhulu okanye ukutshaya, kunye nokuzivocavoca ngokwaneleyo kunokuba negalelo .
Kwakhona kwacetyiswa ukuba umbutho owaziwayo phakathi kwesifo se-cardiovascular and rheumatoid arthritis , ngenxa yoko, ungenxa yokugula kwe-apnea. Ukuvuthwa kwe-apnea yokuvuthwa kuye kwahlanganiswa nokuqhaqhaqhaqhaqha , ukuguqulwa , kunye nokuphela kokungasebenzi . Njengoko kubonelelwe izinto ezibangeleyo, imbangela kunye nomphumo kubonakala ngakumbi kwaye imfuneko yokulawula nganye into ibonakala.
Iimpawu maziqwalaselwe ngombono wendlela izifo zesifo se-rheumatic ezihlobene ngayo ne-apnea yokulala. Ngokomzekelo, kunqunywe ukuba abantu abane-apnea yokulala ngokuphazamiseka baye baphakamisa ama-reactants-phase reaction ( CRP , rate sed ) kunye nama- cytokines angaphangeliyo. Kuye kwaxelwa ukuba ezinye i-interleukines, ngokukodwa, i-IL-1, i-IL-2, i-IL-6, i-Il-8, i-IL-18, kunye ne-TNF-alpha ikhuthaza ukungabikho kwe-REM (ukuhamba kwamehlo okukhawuleza) ukulala. IL-4, IL-10, IL-13, kunye ne-TNF-beta inqanda ukulala okungabikho kwe-REM.
Amanqanaba e-cytokine avuthayo ahambelana nokuqina komoya wokulala. Amanqanaba aphezulu e-TNF-alpha ahlanganiswe ne-apnea ebuthongweni obunzima kunye ne-hypoxia. Oku kungachaza ukuba kutheni abantu abane-rheumatoid arthritis abaphathwa nge- TNF blockers bafumana ukuba izinga labo lokukhathala liphucula. Kufuneka kwenziwe olunye uphando ukuze ufikelele kwisigqibo malunga nempembelelo yonyango lwe-rheumatoid arthritis.
Kufaneleka Kulawulwa Njani?
Ukubambisana kwe-rheumatoid arthritis kunye ne-apnea yokulala kungabangela igalelo elikhulu ekunyuseni ukuxhatshazwa nokufa kwabantu abantu abanezimo zombini. Ukuba umbutho unokuba negalelo ekwandiseni ingozi yesifo senhliziyo kwisigulane se-rheumatoid arthritis mhlawumbi siyabonakala.
I-Rheumatologists imele ikhangele iimpawu zokugonya kwe-apnea kwizigulane zabo xa zidliwano-ndlebe kwaye zihlolisise kwaye, ukuba ziboniswe, zibhekisela kwingcali yokulala okanye ekliniki yokulala. I-apnea yokulala ilawulwa ngokusetyenziswa kwezixhobo ze-CPAP . Ukuthobela amadivayisi we-CPAP yinkinga kwabanye. Kungase kube bhetele kukuchazwe njengento enzima. Eminye indlela efanelekileyo yokulawulwa kwe-apnea yokulala ibandakanya isikhundla esithile somzimba ngexesha lokulala ukuze kugcinwe i-airway, ukulahleka kwesisindo, kunye nokusetyenziswa kwezixhobo ukuhambisa i-ambellance phambili ukuze kuncitshiswe umqobo womoya. Ngokuqinisekileyo, ingxaki ayifanele inganyanzelwanga.
Ngaphantsi
Xa umntu one-arthritis ye-rheumatoid ekhononda ugqirha wayo malunga nokukhathala, akufanele kuqale ukuxothwa njengento eqhelekileyo ehambelana nesi sifo. Akufanele kucingelwe ukuba ukukhathala kuhambelana nokuphazamiseka kokulala nokulala kwesahluko ehambelana nentlungu. Nangona oko kunokuba kunjalo kwiimeko ezininzi, umsebenzi onzima wokumisela isizathu kufuneka uyenze. I-apnea yokulala kufuneka ilawulwe ngaphakathi okanye ngaphandle. Imiphumo emihle yokungabikho kokugula okungapheliyo i-apnea yokulala ingaphezulu kakhulu.
> Imithombo:
> Ataka, H. et al. I-Fusion Occupical Fusion inokuthi ikwazi ukuphucula i-Apnea yokulala kwizigulane ezine-Rheumatoid Arthritis kunye nezilonda zomlomo wesibeletho. Isihlwele. 2010 Sept 1; 35 (18): E971-5.
> Shen, Te-Shun et al. Umngcipheko wokukhusela i-Apnea yokulala kwizigulane ezine-Arthritis ye-Rheumatoid: I-National Population Based Based Retrospective Cohort Study. BMJ Open. 2016; 6 (11): e013151.
> Shoda, Naoki et al. I-Apnea yokulala kwi-Rheumatoid Arthritis Izigulane ezinezilonda ze-Occipitocervical: Iziganeko eziPhezulu kunye neziNxulumene neeRajografi. Journal of Spine Journal. 2009 ngoJuni; 18 (6): 905-910.
> Strohl, Kingman P MD. Ubume bemiSebenzi yokuLawula i-Apnea yoBudala kubantu abadala. Isemgangathweno. Ukuhlaziywa ngoJuni 24, 2016.
> Taylor-Gjevre, Regina M., Nair, uBindu V., kunye noGjevre, uJohn A. Ukuvimbela ukulala kwe-Apnea ngokubhekiselele kwiiRheumatic Disease. I-Rheumatology (2013) 52 (1): 15-21.