Ukukhusela i-apnea yokulala (i-OSA) ithetha ukuba i-airway yomntu ophezulu ivalwe okwethutyana, okubangelwa ukuphosa okanye ukuphefumula komlomo. Ezi ziqendu zikhokelela ekuhlahleni kwamanqanaba e-oxygen kunye nokwanda kwinqanaba le-carbon dioxide egazini, kunye nokunciphisa umgangatho wokulala okuphumayo. Xa ushiywe ungaphenduliwe, ukulala nge-apnea kungabangela ukuxhatshazwa kwezonyango kunye neengqondo kubini abadala kunye nabantwana.
Zihlala Zingaphi Ukulala Kwama-Apnea Kwabantwana?
Ukulala nge-apnea kubantwana kaninzi kuhamba kungabonwa, ngokukodwa ukususela ngo-20% wabantwana abaqhelekileyo baya kukhwaza ngamanye amaxesha, kwaye kuphela ama-3% abantwana abancinci abane-OSA. Izingane zasesikolweni ezingabantwana bezona ziko liqela lokudala i-OSA, njengoko eli lixesha apho i-adenoid kunye ne-tonsillar hypertrophy ibonakala kakhulu-into ebalulekileyo yengozi ye-OSA. Ukufelwa kwe-apnea kuqhelekileyo kubafana, abantwana abangaphezu komzimba, nabantwana base-Afrika baseMerika.
Yintoni eyenzekayo ngexesha le-Apnea yokulala?
I-apnea yokulala ivame ukuvela ngenxa yezinto ezingaqhelekanga ezibangela ukunciphisa umoya ophezulu. Imiba ye-neurologic, njengokungabikho kwethambo le-muscle kwiimisipha zendlela ephezulu, inokudlala indima ekuphuhliseni i-OSA kubantwana. Ngexesha lokulala, izihlunu zikhululekile kwi-airway ephezulu, kwaye ukuba kukho i-tanue enwetshiwe okanye evuvukileyo kule ndawo (njengetoni ezikhulisiweyo, i-adenoids okanye izibilini zomsana ezibangelwa yi -rhinitis ye-allergen ), ukuphefumla kungonakali.
Ukungabikho komoya ohamba nge-airways kunye nemiphunga kubangela oksijini encinci kunye ne- carbon dioxide egazini. Oku kukhokelela emzimbeni ozama ukuhlawulela "ukuvuswa" (ukuvuswa) okwaneleyo ukwandisa ithoni ye-airway kunye nomzamo wokuphefumula, okukhokelela ekunciphiseni ukulala komgangatho.
Ngabani Abantwana Basengozini Yokulala Kwama-Apnea?
Ukwandiswa kweetoni kunye ne-adenoids yinto ebalulekileyo yengozi ye-OSA kubantwana. Ezinye izakhiwo ezingaqhelekanga eziphakamisa umngcipheko we-OSA zibandakanya ukungabikho komhlathi (i-micrognathia okanye i-retrognathia), ukungabikho komzimba obunobunzima, nokuba nolwimi olukhulu (macroglossia). Ukunyamekela, ukunyuka kwamanzi, izifo ze-neuromuscular, ukusetyenziswa kweyeza kunye neempembelelo ze-anemia, kunye neembali zentsapho ye-OSA yimiba yengozi yokuphuhliswa kokulala kwe-apnea kubantwana.
I-rhinitis ye-allergen kunye ne- non-allergenic rhinitis , okubangelwa ukudibanisa kwamanzi , yenye enye ingozi ebalulekileyo yokuphazamiseka kwe-apnea kubantwana. Kwakhona kubonakala ukuba iikhemikhali ezivuthayo ezikhutshwe ngumzimba ngenxa ye-rhinitis ye-allergen nazo zibaluleke kakhulu ekuphuhliseni i-apnea yokulala. Unyango lwe-rhinitis ye-allergen, ngokunciphisa ukudibanisa kwamanzi kunye neekhemikhali ezivuthayo eziveliswe ngenxa yeempembelelo zokugula, ziye zaboniswa ukuba zinciphise kakhulu iimpawu kunye neempawu zokugonya kwe-apnea.
Ziziphi Iimpawu Zokulala Kwe-Apnea?
Phantse bonke abantwana abane-OSA baya kukhwaza kakhulu, nangona i-apnea yokulala iphela ngo-10 ukuya ku-30% wabantwana abaqhwabayo (ngokunjalo ukugcoba akuthethi ukuba umntwana ulele i-apnea yokulala).
Ezinye iimpawu ziquka iiphampo zokuphefumla (i-apneas), ukugubha, ukugubha, okanye ukulwa ngexesha lokuphefumla. Kuqhelekile ukuba abantwana abane-apnea yokulala bajonge ebusuku, "baphosa kwaye baphenduke" kwaye babonakale "bephumle" ngelixa belele. Abantwana banokuzama ukunqoba ukuphazamiseka kwendlela yokulala ngomoya ngokulala neentamo ze-hyper-extended, ukulala behleli phantsi okanye ukusebenzisa imithwalo emininzi.
Ukuphulukana ne-apnea yokulala kunokuchaphazela impilo yengqondo yabantwana. Ngokungafani nabantu abadala abane-OSA, abafumana ukukhathala kwamasuku kunye nokulala, abantwana bafumana ukunyaniseka, ukuziphatha kakubi kwaye banokucaphuka. Abantwana abane-OSA banokuba neengxaki zokuvuka ekuseni, ukukhalaza ngeentloko zentlungu, kwaye bahlala besenza kakubi esikolweni.
Uxinzelelo lwezonyango lwe-apnea yokulala engaphelelwanga lunokubandakanya ukukhula okungahambi kakuhle, uxinzelelo oluphezulu lwegazi, uxinzelelo lwe- pulmonary and heart failure.
I-Apnea yokulala ifunyaniswe njani kubantwana?
Ukuxilongwa kwe-apnea yokulala ebantwini kubhetele ngokubakho nge- polysomnogram (ubuthongo bokulala) obwenziwe kwi-laboratory yokulala. Izindlela ezichanekileyo zokufumanisa i-apnea yokulala kubantwana ziquka ikhaya le-videotaping yomntwana olele, ukulinganisa i-oxygen concentration kwigazi ngobusuku, "i-nap polysomnogram" (isifundo sokulala esenzelwe iiyure ezingama-2 kuphela), kunye nokufunda kwindlu yokulala.
Ziziphi iindlela zokwelapha kwi-Apnea yokulala kwabantwana?
Ukunyangwa kwe-OSA kubantwana kubandakanya ukukhutshwa ngokukhawuleza kweetoni kunye ne-adenoids, ephilisa ingxaki kuma-80% wabantwana abachaphazelekayo. Ezinye iindlela zokuhlinzwa, ezifana ne- uvulopalatopharyngoplasty kunye ne- tracheostomy zigcinwe kwiindawo ezithile zabantwana abane-OSA, njenge-Down syndrome, ukukhubazeka kwe-cerebral okanye abantwana abaneempawu ezinzima.
Xa unyango olungagqirha alusebenzi, unyango oluqhubekayo lunokusetyenziswa ngoncedo lwezempilo lwe-OSA. Kubantwana abancinci (kunye nabantu abadala) kunye ne-OSA, ukulahleka kwesisindo kunokuba luncedo kakhulu kwaye kaninzi kunonyango. Xa i-rhinitis ye-allergen yinto ebangela abantwana abane-apnea yokulala, unyango kunye ne- corticosteroid nasal sprays , kunye / okanye i- montelukast (Singulair) , lunokunceda ukunciphisa iimpawu ze-OSA.
Umthombo:
UAlkhalil M, Lockey R. Ukukhusela i-Pediatric Sleeping Apnea Syndrome (OSAS) ye-Allergist: Ukuhlaziywa kuVavanyo noLawulo. Ann Annistry Asthma Immunol. 2011; 107: 104-109.