I-apnea yokulala engavimbelekile (i-OSA) isho ukuthi umoya ophezulu womuntu othile uvinjelwe okwesikhashana, okuholela ekugubheni noma ekuphefumuleni komlomo. Lezi ziqephu ziholela ekunciphiseni kwamazinga e-oksijeni nokwanda kwamazinga e-carbon dioxide egazini, nokunciphisa izinga lokulala ngokuphumula. Uma ushiywe ungaphathwa, ukulala ne-apnea kungabangela ukucindezeleka okuningi kwezokwelapha nangokwengqondo kokubili abadala nabantwana.
Ukulala Nge-Apnea Kwenzeka Kanjani Ezinganeni?
Ukuphunga i-apnea ezinganeni ngokuvamile kuvame ukungatholakali, ikakhulukazi kusukela ngo-20% wezingane ezijwayelekile ziyokhamba ngezikhathi ezithile, futhi izingane ezintathu kuphela ezingenayo i-OSA kuphela. Izingane zasenkulisa zasenkulisa ziyiqembu elidala kakhulu lokuthuthukisa i-OSA, njengoba lokhu kuyinyaka lapho i-adenoid kanye ne-tonsillar hypertrophy ibonakala kakhulu-into ebalulekile engozini ye-OSA. I-apnea yokulala ivame kakhulu kubafana, izingane eziqine kakhulu, kanye nezingane zase-Afrika zaseMelika.
Kwenzekani Ngesikhathi Sokulala Kwe-Apnea?
I-apnea yokulala ivame ukuvela ngenxa yokungahleleki kwesakhiwo okubangela ukwehlisa umoya ophezulu. Izici ze-neurologic, ezifana nokuntuleka kwethambo lomzimba emisipha ye-airway engenhla, zingabamba iqhaza ekwakhiweni kwe-OSA ezinganeni. Ngesikhathi sokulala, imisipha ikhululekile kakhulu emoyeni ophezulu, futhi uma kunezicubu ezinwetshiwe noma ezivuvukile kule ndawo (njengamathani amancane, ama-adenoids noma ama-nasal avuvukile abangwa yi- rhinitis ye-allergen ), ukuphefumula kuphelelwe amandla.
Ukuntuleka komoya okuhamba emoyeni nasemaphandleni kubangela umoya ophansi kanye ne- carbon dioxide engaphezu kwegazi. Lokhu kuholela emzimbeni ozama ukukhokhela "ukuvuswa" (ukuvuswa) okwanele ukwandisa ithoni ye-airway ithonya nomzamo wokuphefumula, okuholela ekwehleni kwezinga eliphezulu.
Ikuphi Izingane Ezengozini Yokulala Nge-Apnea?
Ukwandiswa kwama-tonsils kanye ne-adenoids yinkinga ejwayelekile kakhulu engozini ye-OSA ezinganeni. Ezinye izimo ezingalungile ezandisa ingozi ye-OSA zibandakanya ukungalingani kwemifino (i-micrognathia noma i-retrognathia), ukungaboni kahle kobuso obuseduze, nokuba nelulimi olukhulu (macroglossia). Ukukhuluphala ngokweqile, imithi ye-nasal, izifo ze-neuromuscular, ukusetshenziswa kwemithi nemiphumela yokudambisa, i-sickle cell anemia, nomlando womndeni we-OSA yizona zinto eziyingozi ekuthuthukiseni i-apnea yokulala ezinganeni.
I-rhinitis ye-allergen ne- non-allergenic rhinitis , okubangelwa ukungqubuzana komzimba , ingenye into ebalulekile engozini yokuphefumula kwe-apnea ezinganeni. Kubuye kubonakale ukuthi amakhemikhali okuvuvukala akhululwe ngumzimba ngenxa yokuhlushwa kwe-rhinitis nawo ayimbangela ebalulekile ekuthuthukiseni i-apnea yokulala. Ukwelashwa kwe-rhinitis ye-allergen, ngokunciphisa ukucinana komswakama kanye namakhemikhali okuvuvukala akhiqizwa ngenxa yokusabela okweqile, kuye kwaboniswa ukuthi kunciphise kakhulu izimpawu nezimpawu zokuphefumula ukulala.
Ziyini Izimpawu Zokulala Kwe-Apnea?
Cishe zonke izingane ezine-OSA zizokhamuluka ngokuzwakalayo, nakuba ukuphefumula kwe-apnea kulala cishe ku-10 kuya ku-30% kwezingane ezishaya (ngakho ukuhlunga akusho ukuthi ingane ilele i-apnea yokulala).
Ezinye izimpawu zihlanganisa ukuhamba ngokuphefumula (i-apneas), ukuqhuma, ukuvuza, noma ukubhekana nokucindezeleka ngesikhathi sokuphefumula. Kubuye kuvame ukuba izingane ezine-apnea yokulala zikhukhumeze ebusuku, "ziphonsa futhi ziphenduke" futhi zibonakala "ziphumule" ngenkathi zilele. Izingane zingase zizame ukunqoba ukuvinjelwa kwamanzi ngokulala ngezintamo zazo hyper-extended, ukulala ehlezi ngqo noma usebenzisa imithwalo eminingi.
I-apnea yokulala ingathinta impilo yengqondo yezingane. Ngokungafani nabantu abadala abane-OSA, ababhekana nokukhathala nosuku lokulala, izingane zithola ukungahloniphi kahle, ukuziphatha okubi futhi kungase kuthukuthele. Izingane ezine-OSA zingase zibe nenkinga yokuvuka ekuseni, zikhononda ngezinhloko zekhanda njalo, futhi zivame ukwenza kahle esikoleni.
Ukucindezeleka kwezokwelapha kwe-apnea yokulala okungalashwa kungabandakanya ukukhula okuncane, ukucindezeleka kwegazi, ukucindezeleka kwegazi , nokuhluleka kwenhliziyo.
I-Apnea Yokulala Ithola Kanjani Ezinganeni?
Ukuxilongwa kwe-apnea yokulala ezinganeni kwenziwa kangcono nge- polysomnogram yokulala (ebuthongweni bokulala) eyenziwa ebhokisini lokulala. Izindlela ezingezona eziqondile zokuthola i-apnea yokulala ezinganeni zifaka i-home videapaping yengane yokulala, ukulinganisa ukuhlushwa kwe-oxygen egazini ebusuku, "i-nap polysomnogram" (isifundo sokulala esenziwa amahora amabili kuphela), nesifundo sokulala ekhaya.
Yiziphi Izinketho zokwelashwa zokulala nge-Apnea ebantwaneni?
Ukwelashwa kwe-OSA ezinganeni ngokuvamile kuhilela ukukhishwa kwe-tonsils ne-adenoids, ephilisa inkinga kuma-80% wezingane ezithintekile. Ezinye izinhlobo zokuhlinza, ezifana ne- uvulopalatopharyngoplasty ne- tracheostomy zigcinelwe abantu abathile abane-OSA, njenge-Down syndrome, i-cerebral palsy noma izingane ezinezimpawu ezinzima.
Uma ukwelashwa okuhlinzekwayo kungasebenzi, ukwelashwa ngedivaysi eqhubekayo yokucindezela umoya (CPAP) kungasiza ekunakekeleni izingane nge-OSA. Kubantwana abakhulu kakhulu (kanye nabantu abadala) abane-OSA, ukulahlekelwa isisindo kungaba usizo kakhulu futhi kaningi ukuphefumula. Uma i-rhinitis ye-allergen iyinkinga yabantwana abane-apnea yokulala, ukwelashwa nge- sprays ye-corticosteroid yama-nasal , kanye / noma i- montelukast (Singulair) , ingasiza ukunciphisa izimpawu ze-OSA.
Umthombo:
I-Alkhalil M, Lockey R. Ukuvimbela Izifo Ukulala I-Apnea Syndrome (OSAS) ye-Allergist: Buyekeza ku-Assessment and Management. Ann Ukuzivocavoca Isifo Somoya Immunol. 2011; 107: 104-109.