Kulabo ababhekene nemiphumela emibi yokuphazamiseka kokulala, izivivinyo eziningi zokuhlola zikhona ezingaholela ekuqondeni kangcono ukuthi iyiphi inkinga. Ake sixoxe ngezinketho.
Overnight Oximetry
Ngobusuku oximetry ungenye yezinto ezilula futhi, ngokuvamile, zokuqala zokulala ezingahle zenziwe. Kuhilela ukusetshenziselwa iphenyo (efana ne-texspin) egqoke umunwe noma i-earlobe eqhubeka ngokulinganisa amazinga e-oksijeni nokukala kwenhliziyo.
Lokhu kufezwe ngokukhanya okubomvu nenzwa ethola izinguquko embala wegazi ongase ukhombise ama-desaturations (noma ukulahlekelwa oksijeni) okwenzekayo.
Lokhu kuhlolwa kuzokwenziwa njalo ekhaya ngenkathi ulele. Kungase kubonakale abantu abasengozini yokuphazamiseka kokuphefumula ebusuku. ezifana ne- apnea yokulala , futhi ingasetshenziselwa ukukhomba labo abadinga ukuhlolwa okungeziwe, njenge-polysomnogram.
I-Polysomnography (PSG)
Lokhu kubhekwa njengendlela ejwayelekile yegolide yokuxilongwa kwezifo zokulala. Kuhilela ukuvakashela isikhungo sokulala, esingaba namakamelo akhethekile esibhedlela, i-laboratory yokulala, noma ngisho negumbi lehhotela elihlomele ngokukhethekile. Lezi zifundo zokulala zihilela ukuhlala ubusuku bonke obuqashwe ngumchwepheshe oqeqeshiwe.
Imingcele ehlukahlukene yemvelo ihlolwe ngenkathi umuntu elala, kuhlanganise ne- EEG , EKG, ukuphefumula, amazinga e-oksijeni, ithoni ye-muscle, nokunyakaza kwamehlo nokuphela.
Kukhona futhi ukurekhoda kwevidiyo nokulalelwayo okunikeza irekhodi lokulala ebusuku. Lezi zivivinyo zingakwazi ukuthola izifo eziningi zokulala- kusukela ekuphefumuleni kwe-sleep apnea kuya kwi-parasomnias-futhi kungase kube usizo ekulawuleni ezinye izimbangela zokuqwashisa .
Isifundo se-Titration
I-Titration ne-Continuous Positive Airway Pressure (CPAP) ivame ukwenza ngesikhathi sobusuku obufana ne-polysomnogram yokuhlola (i-PSG) ukulondoloza isikhathi sokulinda, ukunciphisa izindleko kumguli, nokuphatha i-apnea yokulala ngokushesha ngangokunokwenzeka.
Ukwelashwa okuphuthumayo kunganciphisa ukucindezeleka kwengqondo ye- apnea yokulala . Ngamafuphi, uchwepheshe uzothuthukisa kancane kancane ukucindezela kwe-CPAP (igumbi lokucindezela emoyeni hhayi oksijini) elinikezwa nge-mask esithambile kuze kube sezingeni eliqeda iningi noma zonke iziqephu zokuphefumula. Leli phuzu lomshoshaphansi we-CPAP lizobekwa umuthi wokwelapha ekhaya.
Isiguli ngokuvamile siqala ubusuku ngokucindezela okuphansi kwe-CPAP yabo noma i-bilevel. Njengoba lo muntu elala, bazobe bebhekwa ngenxa yokuphazamiseka ekuphefumuleni. Noma yimaphi ama-hypopneas, imicimbi ye-apneic, noma i-snoring izothuthukisa isazi sokulala ukulungisa ukucindezelwa komshini we-CPAP ukude. Nakulokhu, lowo muntu uzobe esebhekene nengcindezi yabo ephakeme. Umgomo ukunciphisa imicimbi ye-apnea ne-hypopnea nokuqeda ukuhlehlisa.
Kungcono futhi ukuba isiguli sifakwe ekucindezelweni okuphumelelayo ngaphezulu (ngemuva kwawo) nangesikhathi sokulala kwe-eye ngokushesha (REM) ukulala. Lezi zimo ezimbili zizoholela ekuphefumuleni okubhebhetheke kakhulu , ngakho-ke ukucindezela okuphumelelayo kulezi zimo kuyoba kuhle kakhulu.
Ngokuvamile ekupheleni kwalolu cwaningo, izingcindezi zingase zande nakakhulu. Lokhu kuzovumela udokotela okubukeza ukuba enze ukufaniswa phakathi kwezincindezi ezihlukahlukene.
Futhi, kungase kuveze izinguquko ezidinga ukwenziwa ezinkingeni zokuphathwa okuphumelelayo kakhulu kwe-apnea yokulala yomuntu.
Ukuvivinya Kwama-Sleep Latency amaningi (MSLT)
Ukuhlola okuningi kwe-Sleep Latency (MSLT) futhi kuvame ukubizwa ngokuthi ucwaningo lwe-nap. Kuyafana nokusetha ku-polysomnogram (i-PSG) echazwe ngenhla.
Lezi zifundo ziyokwenziwa ngokujwayelekile ngemva kokucwaninga kokuqala kwe-PSG. Ngemuva kokuvuka, umuntu uzobe ehleliwe izikhathi zokulala naphakathi nosuku. Lokhu kwenzeka njalo emahoreni amabili.
Ngokuvamile, isiguli silala futhi sivunyelwe ukulala lapho imizuzu engu-20 ngenhloso yokulala.
Uchwepheshe uzoqapha ukuqala kokulala futhi, ikakhulukazi, ukulala kwe-REM. Ngemuva kwemizuzu engu-20, lo muntu uzovuswa noma utshele ukuthi isikhathi sokuphumula siphelile. Khona-ke, ngezinkathi ezimbili zehora, le nqubo iphindaphindiwe. Ngokujwayelekile lokhu kuzokwenzeka esikhathini esingamahora angu-10.
Lezi zivivinyo ziwusizo ekuboneni ukulala ngokweqile kwamalanga. Lokhu kungase kube khona ezinkingeni eziningi, ezifana ne- apnea yokulala , idiopathic hypersomnia ( ubuthongo obuningi ngaphandle kwesizathu), kanye ne-narcolepsy. Ngokuyinhloko, ukuqala kokuqala kwe-REM kulezi zikhathi zokulala kungase kusiphakamise ukuhlukumeza.
I-Actigraphy
I-Actigraphy yilinganiso yomsebenzi osebenzisa idivayisi encane, i-wristwatch-size. Le divayisi ilondoloza ukunyakaza futhi ingasetshenziselwa ukuhlola imijikelezo yokulala , noma izilinganiso ze-circadian, esikhathini esengeziwe. Bangase bagqoke amasonto noma ngisho nezinyanga.
Amadivaysi asiza ekunqumeni ukuthi kukhona ukuphazamiseka emjikelezweni wokulala, eziningi zikhona ezinkingeni ze-circadian izifo ezifana ne-sleep phase phase syndrome, ukubambezeleka kwesigaba sokulala se-syndrome, noma ngisho nokuqwashisa . Le miphumela ivame ukuhambisana nedayari yokulala.
Idayari lokulala
I-diary yokulala, noma i-log yokulala, ngezinye izikhathi iwusizo ekuhloleni izidakamizwa zesigqi se-circadian noma ukuleleka , ikakhulukazi ngokuchasene nedatha ye-actigraphic. Lezi zingasetshenziswa futhi ukuhlola izinkinga zokulala phakathi kwezingane.
Ngokuvamile, ziyirekhodi lamaphephandaba kanye nedokhumenti yokulala nokuvuka esikhathini esingamasonto nezinyanga. Izikhathi zokulala nezikhathi zokuvuka ziphawulwa. Noma yiziphi izinkathi zokuvuka ebusuku noma naps phakathi nosuku nazo zilotshiwe. Ngezinye izikhathi ukusetshenziswa kwe- caffeine , utshwala noma imithi kungabhalwa.
Isifundo Sekhaya
Iningi labantu liyaqaphela ukuthi balala kangcono ekhaya kunokuba bangase esikhungweni sokulala. Lokhu kuyiqiniso ngempela, futhi abaningi bayashukumisela ukuthuthukisa ubuchwepheshe obungavumela ukuhlolwa kwekhaya kwezinkinga zokulala. Lokhu kungabandakanya izifundo ezilinganiselwe eziqapha imingcele eyisisekelo yokulala, njengamazinga e-oksijeni, amazinga wenhliziyo, nokuhamba kwesifuba nesisu ngesibhande esikhethekile. Ezinye izifundo ze-titration zingenziwa ekhaya ngokusebenzisa umshini we-CPAP, njengezifundo zokuzithumela ngokuzenzakalela.
Ukwengeza, ubuchwepheshe obusha bucwaningwa ukuthi kungaholela kwezinye ukuqapha. Ngokuvamile, lobu buchwepheshe obusha busemncane futhi idatha ingase ingathembeki njengezinga eliphezulu legolide lokuxilongwa, okuyi-polysomnogram yobusuku obubanjwe esikhungweni sokulala esivunyelwe.
Imithombo:
> Littner, M. et al. Imikhawulo yokuzivocavoca ekusetshenzisweni kwemitholampilo yokuhlolwa kwe-multiple latency yokulala nokugcina ukuhlolwa kwe-wakefulness. Ukulala ; 28: 113.
> Mitler, M. noMiller, J. Izindlela zokuhlola ukulala. I-Behav Med; 21: 171.
> Stepanski, E. et al . Imiphumela yokulala kokulala ebuthongweni obusemini ekulaleni okuyisisekelo. Ukulala ; 23: 215.