Izinguquko ze-hormone, ukuphakama kwesisindo kungase kuphazamise ukuphuza ukulala
Ukuphefumula ngesikhathi sokulala kungashintsha ngesikhathi sokukhulelwa: njengoba ukukhulelwa kuvela, kungase kube khona ukucaca okuqhubekayo okuvela ekunciphiseni kuya phezulu, ngisho nokuyeka noma ukuphazamiseka kokuphefumula okuchaza isimo esibizwa ngokuthi i- apnea yokulala . Ukuphefumula kokuphefumula njengoba kwenzeka ngesikhathi sokukhulelwa kubonakala ngokucacile ukuthi kunezici eziyingozi, izimpawu, kanye nokwelapha. Thola ukuthi i-obnetive obne sleep apnea ingathinta kanjani ukukhulelwa nokuthi yini engenziwa ukuze uphathe kahle isimo ukuqinisekisa impilo yomama nomntwana.
Izingozi Ze-Sleep Apnea Ekukhulelweni
Ukunweba kwanda ngokukhudlwana ekukhulekeni kanye nokuvama ngesikhathi sokukhulelwa, kanti lapho umoya ophazamisayo uphazamiseka nakakhulu, i-apnea yokulala ingase ivele. I-apnea yokulala ibonakala ngezikhathi zokuphefumula ngesikhathi sokulala okugcina okungenani imizuzwana engu-10, futhi lokho kuhlotshaniswa nokuvuswa (okubizwa ngokuthi i- arousals ) futhi kwehla emazingeni e-oxygen wegazi (okuthiwa ama- desaturations ). I-apnea yokulala ingase ibe nemiphumela ebalulekile, futhi abesifazane abathile bangase babe engozini enkulu yokuthuthukisa isimo.
Ngenhlanhla, ingozi enkulu yokuthuthukisa i-apnea yokulala ngesikhathi sokukhulelwa iphansi kakhulu, ngenxa yezici ezimbalwa: okokuqala, ama- progesterone aphezulu ngesikhathi sokukhulelwa-isimo esivame ukuzivikela, ngoba i-hormone isebenza emisipha ehamba emoyeni. Ngaphezu kwalokho, i-progesterone ikwandisa ukuphendula kwengqondo kumakhemikhali e- carbon dioxide , futhi ukulethwa kwe-oksijini emathisini omzimba nakho kuthuthukisa ngokukhula kwenhliziyo nokukhuliswa kwemithwalo yegazi yomzimba.
Okwesibili, ngenxa yokungazi kahle ngokomzimba okuhlobene nokukhulelwa kwesikhathi, isikhathi esincane sichithwa ukulala ngemuva , okuhlobene nengozi yokugula i-apnea yokulala.
I-apnea yokulala ingenzeka nakanjani. Nakuba ukusabalalisa okuqondile kungaziwa, kulinganiselwa ukuthi kuthinta u-10% wabesifazane abakhulelwe. I-apnea yokulala ivela kaningi kulabo besifazane abakhuluphele ngokweqile noma abakhuluphele kakhulu, futhi ukuzuza ngokweqile ngokweqile ngesikhathi sokukhulelwa kungakwandisa ingozi.
Abesifazane abanesayizi enkulu yentamo banokuphefumula okungaphezulu kokulala. Ngaphezu kwalokho, ukungqubuzana kwamanzi ngenxa yamazinga aphezulu we-progesterone kungabangela isimo. Izindleko zomthamo zingancishiswa ngenxa yomshoshaphansi we-fetus okhulayo, okuholela ekutheni izinga lokuphefumula landa. Ukuveza ukubhema kuyisici esicacile sokwenza i-apnea yokulala.
Izimpawu Zokulala Nge-Apnea Ekukhulelweni
Abesifazane abanesifo sokuphefumula sokulala ekukhulelweni baveza izimpawu ezifana nesimo lapho kwenzeka kwezinye izimo. Lezi zimpawu zihlanganisa:
- Snoring
- Ukuyeka ukuphefumula noma ukuphefumula kokulala ebuthongweni
- Ukukhuphuka ngokuchofoza, ukugcoba, noma ukuyeka
- Ukulala ngokweqile kwamalanga
- Ukuvuthwa njalo ebusuku ( nocturia )
Lesi simo cishe singatholakali. Kungase kubalulekile ukufuna ukuhlolwa kusuka ochwepheshe bezinkinga, ikakhulukazi emva kwenyanga yesithupha yokukhulelwa, lapho izimpawu zingase zibe nzima kakhulu. Abesifazane abasengozini enkulu ngokukhuluphala, i-preeclampsia, isifo sikashukela sokukhulelwa, nokuphuza ukukhula kwe-intrauterine kufanele kuhlolwe. Lokhu kungabandakanya ukutadisha ubusuku bokulala okuthiwa i- polysomnogram .
Ukunakekelwa kokukhulelwa-Okuhlobene ne-Apnea yokulala
Kubalulekile ukuphatha i-apnea yokulala ngokuphathelene nokukhulelwa, ngoba ingabangela imiphumela emibi kokubili umama nesisu.
I-apnea yokulala ihlotshaniswa nesifo somfutho wegazi ophezulu, isifo sikashukela, kanye nezigaba ze-Caesarian ezingakahlelwa. Kungase futhi kuholele ekunciphiseni ukukhula kwe-fetal nokusebenza isikhathi eside. Abesifazane abathintekile kakhulu bangase bathuthukise ukukhuluphala kwe-hypoestilation syndrome .
Emva kokulethwa nokulahlekelwa kwesisindo, i-apnea yokulala izoba ngcono. Ucwaningo lubonisa ukuthi ukuqina okunamandla okulala okubizwa ngokuthi i- apnea-hypopnea index (AHI) kuvamile emva kokulethwa.
Ngesikhathi sokukhulelwa, kungasiza abesifazane ukuba balale ezinhlangothini zabo. Ukwelashwa okujwayelekile kwegolide kuyisimo sokucindezela okuqhubekayo kwe-airway (CPAP) . Ezimweni ezinzima ngokukhuluphala okuhambisanayo, noma ekukhulelweni kwamawele, i- bilevel therapy ingase isetshenziswe.
Izilungiselelo zokucindezela ezisetshenziswa kulezi zindlela zizodinga ukulungiswa ngesikhathi sokukhulelwa. Njengoba ukutholakala kwesisindo semvelo kwenzeka, ukucindezela kuyodingeka futhi kwandiswe. Ezimweni ezingavamile, ukusetshenziswa kwe-oxygen eyengeziwe, noma inqubo yokuhlinzwa ebizwa ngokuthi i- tracheostomy , ingadingeka.
Uma unomuzwa wokuthi unezibonakaliso noma izimpawu ezibonisa ukuphefumula ukulala ngesikhathi sokukhulelwa, kufanele uxhumane nodokotela wakho ukuze uxoxe ngokuhlela ukuhlolwa okudingekayo nokwelapha ukukusiza ukuphumula nokuphefumula kulula.
Umthombo:
Kryger, MH et al . "Izimiso Nemikhuba Yokulala Imithi." I-ExpertConsult , umagazini we-5, 2011, iphe. 1576-1577.