Amathani Amandla Akhulisiwe, Ukukhuluphala Kungenzeka Ukuphazamisa Ukushisa Kwesikhathi Sebusuku
Ukuphefumula kwe-apnea kuyisimo esivamile kubantu abadala, futhi kungenzeka futhi kubantwana. Yiziphi izimbangela ezibangela ukuba i-apnea yokulala ivele ezinganeni? Kukhona iminikelo ehlukahlukene engaholela ekunciphiseni noma ukungazinzile kwe-airway engenhla, okungaholela ekuphumeni kwesimo sokuphefumula somoya wokulala. Njengoba i-apnea yokulala ingaba nemiphumela emibi ezinganeni - kuhlanganise nemithelela ekukhuleni, ekuhlakanipheni nasekuziphatheni - kubalulekile ukuthola izizathu ezifanelekile.
Uma ucabangela izizathu ezingase zibe zikhona ezinganeni zokuthuthukisa i-apnea yokulala, lezi zigaba zingahlukaniswa ngezigaba eziningana:
Amathani anamandla ne-adenoids
Mhlawumbe umnikelo owodwa ovame kakhulu wokulala ne-apnea ebantwaneni uhlobana nokunciphisa ukuma kwe-airway engenhla. Izishubhu ezingemuva komlomo nomphimbo okuthiwa ama-tonsils kanye nama-adenoids cishe asolwa. Kungenxa yokuthi ukukhuliswa kwalezi zicubu kukhona akusho ukuthi ingane izoba ne-apnea yokulala. Kodwa-ke, labo bantwana abane-apnea yokulala abaye bathulisa ama-tonsils kanye nama-adenoids bangasiza kakhulu ngokususa. Cishe amaphesenti angu-10 wezingane awaphuthuki ngemuva kokuhlinzwa, futhi kungenzeka ukuthi abe nezinye izici ezenza ukuba zibe nesimo sabo.
Ukukhuluphala
Ukukhuluphala ngokweqile phakathi kwezingane kuyanda, futhi kungase kube nendima enkulu ekwenzeni i-apnea yokulala njengoba lezi zindlela ziqhubeka. Njengoba inani lamafutha elifaka umoya ohamba emoyeni likhula, lingase liholele ekuqhumeni nasekunciphiseni ngaphakathi kwendiza.
Ngaphandle kwalokho, isisindo esingeziwe ngaphandle kwe-airway singase sisebenze ingcindezi futhi siholele ekuweleni kwezindiza, okubangelwa imicimbi ye-apnea.
Ukungajwayelekile kwe-craniofacial
Kunezinhlobo ezingavamile zekhanda noma ubuso (okubizwa ngokuthi yi-craniofacial abnormalities) ezingabangela ingozi eyengeziwe yokuthuthukisa i-apnea yokulala.
Izimo ezinciphisa ubukhulu bekhala, umlomo, nomphimbo zingabangela ukuwa kwe-airway ngesikhathi sokulala. Isibonelo, ulimi olwandisiwe (olubizwa ngokuthi i- macroglossia ) lungasiza . Ezinye izimo zihlanganisa:
- I-Midfacial hypoplasia (i-under-development of the nose kanye nesimo esiphakathi)
- I-retrognathia noma i-micrognathia (umhlathi omisiwe noma omncane)
- I-arch maxillary encane (phezulu komlomo)
Izingane ezine-Down's syndrome zingozi kakhulu ekuthuthukiseni lezi zinkinga.
I-Mucopolysaccharidoses
Kukhona iqembu lezinkinga ezingavamile ezibizwa ngokuthi ama-mucopolysaccharidoses, noma ama-mucolipidoses, angase abeke izingane engozini enkulu yokulala ne-apnea yokulala. Lokhu kwenzeka ngenxa yezicubu ezisezingeni eliphezulu eziqoqa ama-molecule amakhulu nokuvuvukala ngosayizi. Kukhona okungavamile ukuthuthukiswa okungafani okuboniswa ngesikhathi sokuzalwa noma esemncane, ngakho abazali abaningi bayokwazi ukuthi ingane yabo inalesi simo.
Izici ze-neuromuscular
Ukulahlekelwa ukulawulwa kwemisipha yendawo engenhla kungase kuholele ekuphefumuleni kwe-apnea. Ukushintsha kwezwi le-muscle (elibizwa nge-hypotonia uma liphansi, noma i-hypertonia uma liphakeme) linganikela. Ukucindezeleka kwe-brainstem (njengoba kungase kwenzeke ku- Arnold Chiari ukungasebenzi kahle noma ku-tumors) kungabangela ukuba i-apnea yokulala.
Kukhona ezinye izinto eziphuthumayo, ezifana ne-Down syndrome, eziholela engozini enkulu yalesi simo. Ngokuvamile, ezinye izinkinga zizobonakala ngaphandle kwe-apnea yokulala ukukhombisa ukuthi ubungozi bezimo ezimbi kakhulu.
Uma ukhathazekile ukuthi ingane yakho ingaba nezimpawu noma izibonakaliso ezibonisa ukuthi i-apnea yokulala, unganqikazi ukukhuluma nodokotela wezingane zakho. Uma uzizwa sengathi ukuxoshwa kwakho kukhishwa, cabanga ngemibono yesibili kusuka kuchwepheshe wezingane zokulala. Indlela kuphela yokuhlola ngokucophelela i-apnea yokulala ezinganeni yinkinga yokulala ebusweni esikhungweni sokuhlola; cindezela ukuthola eyodwa uma ukhathazekile ngokuphefumula kwengane yakho ngesikhathi sokulala.
Imithombo:
Arens, R et al . "I-Pathophysiology yokuvimbela umoya ophezulu: isimo sengqondo sokuthuthukisa." Ukulala ngo- 2004; 27: 997.
I-Bixler, i-EO et al . "Ukuphefumula okuphazamisekile ukulala ezinganeni ngesampula esiphezulu sabaningi: izibalo ezithintekayo nezingozi." Ukulala ngo- 2009; 32: 731.
Rosen, GM et al . "Izindlela kanye nezimo ezibeka phambili ekubhekaneni nokulala ukuphefumula ezinganeni." UpToDate Online . Ifinyelele ngo-Novemba 2, 2009.
I-Verhulst, SL et al . "Ukuphefumula ukulala-ngokuphazamiseka ekukhunjweni nasezintweni ezingaphezu komzimba nokukhululeka kwezingane kanye nentsha: ukusabalalisa, izici kanye nendima yokusabalalisa amafutha." I-Arch Dis Child Child 2007; 92: 205.