Ukucindezeleka Kwesikhashana Kuholela Ekutheni Akunamandla Okuphefumula
Kungase kube nezimbangela eziningi zokuphazamisa ukuphefumula ngesikhathi sokulala, kanti omunye wabo yi-apnea yokulala ebalulekile, kodwa yini i-apnea yokulala ebalulekile? Kungabangela ukuphumula ngesikhathi sokuphefumula ebusuku, kodwa ngenxa yokuthi imbangela eyimbangela ihluke ekuphefumuleni kwe-sleepiness obstructive , idinga ukwelashwa okukhethekile. Thola izimpawu ezivame kakhulu, izimbangela, ukuxilongwa, kanye nokwelashwa okuthandwayo (njenge-bilevel therapy) ye-apnea yokulala ephakathi.
Ziyini Izimpawu Zokulala Okukhulu Kwe-Apnea?
I-apnea yase-Central yokulala iwumgudu wokuphefumula okwenzeka ngesikhathi sokulala futhi imiphumela lapho ubuchopho buhluleka ukuvuselela imisipha yokuphefumula. Lokhu kuholela ekuphumeni okufushane ekuphefumuleni okungase kuthathe imizuzwana engu-10 noma ngaphezulu. Ngokungafani ne-apnea yokulala engavamile yokuvimbela ubuthongo - okubangelwa lapho umoya ongenhla uvinjelwa okwesikhashana - ngaphakathi kwe-apnea yokulala, umzamo wokuphefumula uyeka futhi akukho ukuvinjelwa okucacile kwendiza.
Nakuba imbangela ihluke kancane, umphumela we-apnea wokulala ebusweni ufana. I-apnea ivela esiGriki futhi isho ukuthi "akukho moya". Njengoba kunjalo, lihlotshaniswa namaconsi emazingeni e-oxygen egazini. Ubuchopho bubona lokhu futhi kukhona umzamo wokuvusa umuntu ohluphekile ukuze abuyisele ukuphefumula. OFakazi bangabona ukuphefumula komsindo noma okungavamile ebusuku futhi bangase babone nokuyeka ukuphefumula. Umcimbi we-apneic uholela ekuvusweni okuncane kusuka ebuthongweni.
Njengoba lokhu kwenzeka ngokuphindaphindiwe phakathi nobusuku, kuholela ebuthongweni obuhlukene nokulala okujulile . Lokhu kungabangela ukuleleka nokulala ngokweqile kwansuku zonke .
Yini Ebangela Ukulala Kwe-Apnea Ephakathi?
Isizathu esiqondile sokuphefumula okuphakathi kokulala akukwaziwa. Isikhungo sokulawula ukuphefumula ebuchosheni ngokuvamile silawula ukuphefumula.
Uma amazinga e-carbon dioxide eyancipha ngaphansi kwejwayelekile noma uma kunomonakalo emigwaqweni yezingqinamba ezihilelekile ekulawuleni ukuphefumula, kungase kube nokuphazamiseka ekuphefumuleni. Njengoba kuphawuliwe ngenhla, ngokungafani ne-apnea yokuvimbela ubuthongo, umoya womoya awuvinjelwe.
I-apnea yokulala esezingeni elivamile ivame ukuguquka phakathi kokulala nokuvuka, kepha kungase kuqhubekele nasezigabeni zokulala ezibizwa ngokuthi i- NREM . Kungase ngezinye izikhathi kwenzeke emva kokuvusa, futhi kuthiwa yi-central post-stimous in this case.
Ukungazinzeki kokulawula ukuphefumula kuvame ukubonakala ezinkingeni eziningi ze-neurologic, kufaka phakathi isifo sikaParkinson kanye ne- multiple system atrophy . Kungase kubonakale ngemva kokushaya, ikakhulukazi uma ubuchopho be-brainstem bonakalisiwe. Kungenzeka futhi ngokubambisana nephethini yokuphefumulela i-Cheyne-Stokes ebonwe ezigulini ezinezinhliziyo ezihlulekayo .
Kungase kwenzeke kakhulu phakathi kwalabo abasebenzisa imithi yokuhlunguphaza i-narcotic noma i-opioid. Ngenhlanhla, kuleli cala, lizoxazululwa ngokuqeda ukwelashwa.
Kubalulekile ukuhlukanisa i-apnea yokulala ebusweni eqhubekayo ekuphenduleni ukucindezela okuqhubekayo kwe-airway (CPAP). Kungase kube nzima uma izingcindezi ziphezulu kakhulu. Lokhu kuthiwa yi- apnea yokulala eyinkimbinkimbi . Ezingamaphesenti angu-98, lolu hlobo lwe-apnea lokulala oluphakathi luzoxazululwa ngokuhamba kwesikhathi, kaningi izinyanga eziningana, ngokuphathwa kokwelashwa.
Akudingi ezinye izinguquko ekwelapheni.
Ukuxilongwa Nokuphathwa Kwe-Central Sleep Apnea
I-apnea yokulala yase-Central ingatholakala ukuthi inesifundo esijwayelekile sokulala okuthiwa i-polysomnogram. Lokhu kuzobonisa ukuphazamiseka okuphindaphindiwe ekuphefumuleni ngesikhathi sokulala nokuntuleka komzamo wokuphefumula. Izindwangu zembatho zimbozwe isisu sakho nesifuba zisetshenziselwa ukukala umzamo wokuphefumula. Iqukethe inzwa engakwazi ukubona ukunyakaza, futhi ngaphakathi kwe-apnea yokulala esemaphakathi umzamo uzokwehlisa noma uqede ngokuphelele. Kungenzeka futhi ukuba ubhale phansi amaconsi ezingeni le-oksijeni yegazi kanye nezinguquko ku- EEG okuphakamisa ukuhlukaniswa kokulala.
Ukwelapha kuvame ukufezwa nge- bilevel therapy (ngezinye izikhathi ibizwa nge-BiPAP noma i-VPAP) ngokuhlinzeka ukugeleza komoya okwenziwe ngesikhumba somzimba obugqoke ngenkathi ulele. Ukucindezelwa okumisiwe kuhamba phakathi kwamazinga amabili: okuphefumula ku (IPAP) kanye nokuphefumula (EPAP). Umoya ucindezelwa umshini omncane futhi uhanjiswe nge-plastic ukuhoxisa emasikini. I-oksijeni ingasetshenziswa futhi. Amanye amadivaysi akwazi ukuletha ukuphefumula okwengeziwe uma kuqhubeka isikhathi eside ekuphefumuleni kwethu okubonile. Kwezinye izimo, ukuguqulwa okuzenzakalelayo noma oku-autovoventilation (ASV) kungaboniswa.
Uma ukhathazekile ukuthi ungase uhlaselwe i-apnea yokulala, khuluma nodokotela wakho wokulala mayelana nezinketho zakho zokwelapha.
> Umthombo:
> Mowzoon, N et al . "I-Neurology Yezinkinga Zokulala." Ukubukezwa kweBhodi ye-Neurology: Umhlahlandlela odwetshiwe. 2007; 726.