I-Apnea Yakho Yobuthongo Yobuthongo Inquma Ukuthi Yini Okufanele Wena
Uma uthola ukuthi une- apnea yokulala , cishe uye waziswa okungenani okunye okukhethwa kukho ukwelashwa okungenzeka. Ukwelashwa okuvame kakhulu (futhi okuphumelelayo) kuyindlela eqhubekayo yokucindezela umoya (CPAP). Ungase ube nesifiso sokwazi umehluko phakathi kwezinketho ezimbili zokwelapha ezifanayo: CPAP neBiPAP (noma i-bilevel) . Ngaphezu kwalokho, yimuphi ukwelashwa kwe-ASV?
Thola ulwazi oluthe xaxa mayelana nalezi zinhlobo zedivayisi yokwelapha nokuthi ubani angakulungela wena.
Iyini Ukwelashwa kwe-CPAP ye-Apnea yokulala?
Ukwelashwa okujwayelekile kwe-apnea yokuvimbela ukulala kungukusebenzisa umshini ohlinzeka ukusekela ukugcina umoya wakho uvulekile lapho ulele. Lokhu kungafezwa ngokucindezela okuqhubekayo kwe-airway (CPAP) lapho ukugeleza okuqhubekayo kwegumbi lokucindezela umoya kuhlinzekwa nge- mask ebuso .
I-CPAP isebenza kanjani ukuphatha i-apnea yokulala nokuthi yimuphi ukucindezeleka okudingekayo? Ukumiswa kwengcindezi yalokhu kuphuma kwe-air ngokuvamile kuvunywa udokotela okusekelwe ezidingweni zakho. Lokhu kungahlolwa njengengxenye yokufunda ukulala noma kungalinganiselwa ngokusekelwe ezinkingeni zakho, njenge-anatomy yakho nesisindo. Ukumiswa kwengcindezi okuphumelelayo kuhloswe ukuvimbela kokubili i-apnea nokuhlunga futhi kufanele kuncishiswe i- apnea-hypopnea index (AHI) ngezansi kwe-5, kanye nokuthuthukisa ezinye izimpawu ezihlobene ne-apnea yokulala.
Uhlobo oluthile lwezokwelapha yi-AutoCPAP, noma i-APAP, lapho kunezinkinga eziningi ezihlinzekwa yidivayisi. Uma ukuphikiswa emgwaqweni ongenhla (ezingeni le-palate elithambile noma isisekelo solimi emphethweni) kutholakala, ukucindezelwa okuzolethwa kuyozilungisa ngokwezigaba ezibekiwe.
Yini i-BiPAP noma i-Bilevel Therapy ye-Sleep Apnea?
Ukwelashwa okufanayo kubizwa nge-bilevel, noma i- BiPAP , kodwa kuhluke ngezindlela ezibalulekile.
I-BiPAP yisifingqo esichazwe ngumkhiqizi we-Respironics we-bilevel enamandla emoyeni. (Ibizwa ngokuthi i-VPAP ngenye ikhiqizi enkulu, i-ResMed.) Ingxenye "ye-bilevel" ibhekisela eqinisweni ukuthi kukhona ngempela izingcindezi ezimbili, umshini okwazi ukuzenza phakathi kwazo.
Lokhu kukuvumela ukuba uphefumule ngokucindezela okuphakeme futhi uphefumule ngaphandle kokucindezela kancane kancane. Lokhu kungasiza labo abahlukumezayo ukuba bahambisane ne-CPAP. Kungase kuthuthukise ukugwinya emoyeni (okuthiwa i-aerophagia). Kungasiza futhi nge-claustrophobia. I-Bilevel ingadingeka uma izingcindezi ziphakeme ukuze zithuthukise induduzo, ikakhulukazi ekucindezelekeni kwe-PAP okungu-15 cm wezingcindezi zamanzi noma ngaphezulu.
Ngaphandle kwelebuli noma umbala ohlukile, kusuka ngaphandle, umshini angase ungaboni ngokuhluke kakhulu ku-CPAP. Kusadingeka ukuthi kube nokubheja okufanayo nokubhekene nemaski esetshenziswa ekwelapheni kwe-CPAP. Kungaba ngempumelelo kakhulu ezimweni ezikhethiwe, njengalezo ezichazwe ngenhla, noma kunjalo.
Ngidinga i-CPAP noma i-BiPAP ukuze ngiphathe i-My Sleep Apnea?
Abantu abanesimo esivame kakhulu sokuphefumula kokuphuza ukulala ngokuvamile baqala ukwelashwa nge-CPAP noma i-AutoCPAP. Kumele kuqashelwe ukuthi i-bilevel, noma i-BiPAP, ivame ukusetshenziselwa ukuphatha i- central apnea yokulala .
Lesi simo sibonakala ngezikhathi zokuphefumula ngaphandle kokuvinjelwa komoya futhi kubonakala njengengxenye yocwaningo lokulala. Kungase kwenzeke kaningi kubantu abaye benesifo senhliziyo, isifo sokushaya isifo, noma kulabo abasebenzisa izidakamizwa zobuhlungu be-narcotic. Ngezinye izikhathi kungenziwa kubangelwe yi-CPAP ngokwayo, kodwa lokhu okungajwayelekile ukuphikelela ngaphezu kwezinyanga ezimbalwa zokuqala zokusetshenziswa.
Idivaysi ye-BiPAP ingasethwa ukukhokhela lezi zikhathi zokuphefumula ngokukhahlela emoyeni owengeziwe uma kudingeka. Amanye amadivaysi ayinkimbinkimbi kakhulu, ahlukana nokugeleza komoya okunikezwa ukukhokhela ukuphefumula nokuphefumula kwe-neuromuscular okuthinta nokuphefumula.
Lezi ziphazamiso zihlanganisa izifo ezingavamile zokuphefumula (COPD), i-amyotrophic lateral sclerosis (ALS), nezinye izimo.
Ingabe Kunamanye Amashini Noma Izinketho Zokusetha?
Ngaphandle kwe-CPAP ne-BiPAP, kunezilungiselelo ezengeziwe zemishini engalawulwa ngumpetha wakho wokulala . Imishini eminingi, ngokuvamile ephethe isiqalo esithi "I-Auto," ibe nesici esizenzekela ngokuzenzakalela evumela ukuthi uhla lwezincindezi lusetshenziswe. Amadivaysi e-Auto angaba kokubili kwe-CPAP noma ye-bilevel. Idivaysi iyakwazi ukusabela ekuqhekekeni okucashile emoyeni futhi ingakwazi ukucindezela njengoba kudingeke ebusuku. Lokhu kungasiza uma i-apnea yokulala ibuhlungu ngenxa yezinguquko endaweni yokulala (njengokulala emhlane) noma ngenxa yokulala kwe-REM okwenza kube nemicimbi ekhuphukile.
Kukhona futhi uhlobo lwe-bilevel engakwazi ukuletha ukuphefumula okuphelelwe isikhathi (okuvame ukubizwa ngokuthi i-bilevel ST). Lokhu kungaqinisekisa ukuthi inombolo encane yokuphefumula ngomzuzu yenzeke. Lokhu kungabaluleka ekuphepheni kokulala okuphakathi.
Kuyini Ukwelashwa Kwe-ASV?
Okokugcina, kunomunye umshini onomshini obizwa ngokuthi i-autovotion adaptive servo ventilation (ASV) enezici ezengeziwe zokugcina ukuphefumula okuvamile. Kungashintsha ivolumu yomoya ehanjiswe kanye nesivinini lapho amaphaphu ahlunga khona futhi ahlanjululwa, phakathi kwezinye izilungiselelo. Lawa madivayisi avame ukugcinwa kubantu abadinga ukusekelwa okungaphezulu kwe-ventilatory ngenxa yezifo ze-neuromuscular, ze-cardiac, noma ze-pulmonary.
Izwi elivela
Uhlunga kanjani lokhu? Ngenhlanhla, akudingeki! Ochwepheshe bakho bokulala kufanele akwazi ukuzimisela ngokufanele izidingo zakho zokwelashwa ngokusekelwe emiphumeleni yokufunda kwakho kokulala nokuhlola kwakho emtholampilo. Xoxa ngezinketho zakho ekuvakasheni kwakho futhi ube noxhumana naye oseduze uma uhlangabezana nanoma yikuphi ubunzima bokuphathwa kwe-apnea yakho yokulala. Ngokusekelwe kwedatha yokusetshenziswa, uma izinguquko zokwelashwa kwakho zidinga, lezi zingalungiswa uma ubonakala ekulandeleni okujwayelekile. Ngezinye izikhathi kuyadingeka ukuhlela isifundo se-titration lapho lezi zindlela ezihlukahlukene zingahlolwa ngayo ngendlela elawulwayo.
> Umthombo:
> Kryger, MH et al . "Izimiso Nemikhuba Yokulala Imithi." Elsevier , edition 6, 2017.