Ukuhlaziywa Kwesifundo Sokulala

Ukuhlolwa kwe-Apnea yokulala e-Hyderabad

Ukuhlaziywa Kwesifundo Sokulala - Ukuhlaziywa Okuphelele Kochwepheshe Bezibhedlela Ze-CARE 

Empilweni yanamuhla esheshayo, ukulala kungase kukhathaze abantu banoma ibuphi ubudala. Kunabantu abaningi abakuthola kunzima ngempela ukulala. Uma ulwa nanoma yiziphi izinkinga zokulala, khona-ke ochwepheshe be-CARE Hospitals bakhona ukuze bakweseke. 

Qonda i-polysomnography - ukuhlolwa okuphelele kokuxilonga ukuphazamiseka kokulala

I-Polysomnography yaziwa njengocwaningo (ukuhlolwa okuphelele) kokuxilonga ukuphazamiseka kokulala. Isebenza ngokurekhoda amagagasi ebuchosheni bakho, izinga lomoya-mpilo egazini lakho, ukuphefumula nokushaya kwenhliziyo, ukunyakaza komlenze namehlo ocwaningweni. Ungakwazi uku-oda kithi ukuhlolwa kokuphazamiseka kokulala kodwa ngaphandle kokuqonda kochwepheshe bethu, ungase ukuthole kudida kakhulu kunokwaziswa. Ngakho-ke, lapha sizokunikeza izinyathelo ezihlukene zokuqonda umbiko wokuhlaziywa kwakho kokulala:- 

Izinkomba ze-RDI kanye ne-AHI

I-AHI imele inkomba ye-apnea-hypopnea, lokhu kubizwa ngokuthi i-metric eqondile yokunquma ukuthi isiguli siphethwe i-apnea noma cha. Ibala inani eliyisilinganiso lama-hypopneas nama-apneas. Ngamanye amazwi, izehlakalo zokuphefumula zinomthelela kulokhu okubangela ukwehla kokugeleza komoya okuthile isiguli esikubonayo ngehora. Ungakwazi ukukwazi njengoba ukulala kuyinto evamile uma i-AHI ingaphezu kuka-5 ngehora. Imnene, ingaphansi kuka-5 ngehora kodwa inkulu kune-15 ngehora. Imaphakathi, uma ingaphansi kuka-15 ngehora futhi ingaphezu kwama-30 ngehora futhi iqine ibe ngaphansi kwama-30. 

Ukuphazamiseka kokulala, okungukuthi, ukunyakaza, nokuvusa inkanuko

Lokhu kwaziwa ngokuthi i-apnea yokulala. Eqinisweni, inesithombe esivalekile sobuchopho nezenzakalo ezihlobene nokuphefumula ezingase ziphazamise ukulala kwesiguli. Izenzakalo eziningi ezihlukahlukene zingase zibe indaba ekhathazayo. I-Apneas ingase ibe imfanelo eyaziwa kakhulu yenkinga enjalo yokulala. Lokhu kwenzeka uma isiguli siyeka ukuphefumula cishe imizuzwana eyi-10. Kodwa-ke, i-hyopnea, ukumiswa kokugeleza komoya ngokwengxenye, kungase kubonakale kubucayi. Kukhona nokuvuka okusekelwe ekuphefumuleni okungase kuphazamise ukulala kwakho okujulile noma ukuphefumula ngaphandle kokufanelekela izehlakalo ezishiwo. Ngaphezu kwalokho, yethu wanikela ukufunda ukulala inikeza umbiko mayelana nokunyakaza ngokweqile kwemilenze. Sicabangela zonke izici ezinjalo ngenkathi sihlola izinga lokulala lekhwalithi. 

Izigaba zokulala 

Abantu banezigaba zokulala ezihlukene phakathi nobusuku njengokulala kwe-N1, 2, 3, ne-REM. Abantu abadala bavame ukungena kulezi zigaba izikhathi eziningi ngobusuku ngabunye. Lo mjikelezo ungase uhlukaniswe futhi uphazamiseke ngenxa yezinkinga ezithile zokulala futhi kwenze kube nzima ngesiguli ukuphumula okuvuselelayo nokujwayelekile. Isibonelo, i-apnea yokulala ingase iphumele ekuvukeni okuvimba abantu ukuthi bangene esigabeni sokulala esijulile. Uma ungekho umjikelezo omuhle, abakwazi ukuzizwa beshajwe kabusha. Ngesikhathi sokufunda ukulala, sisebenzisa iziqapha zobuchopho ukuze sigcine umkhondo omuhle wesigaba sokulala ositholayo futhi sivumele ochwepheshe babone ukuphazamiseka kokulala. 

Ukuma komzimba

Njengezigaba zokulala, ukuma komzimba nakho kunomthelela omkhulu we-apnea yokulala. Ochwepheshe bethu bakhuluma nesiguli ngokuningiliziwe futhi bahlole nokuma kweziguli ngokwazo. Ukuze bathole isifundo sokulala, bacela isiguli ukuba silale ngomhlane isikhathi esinqunyiwe futhi sisibheke ngokujulile. Bafunda nokulala ngokwesikhathi esichithwa kwesokudla, kwesokunxele, esiswini nangemuva. 

I-SaO2 (i-oxygen desaturation)

Uma isiguli siyeka ukuphefumula njalo phakathi nokulala, kusho ukuthi asiwutholi umoya-mpilo owanele egazini laso ngokwemfuneko yaso. Ukugcwala komoyampilo wakho kukalwa ngephesenti le-oxygen emzimbeni wakho isiguli esiwuhogelayo ngempela. Kubantu abaphethwe i-apnea yokulala, izinga lomoya-mpilo wabo lingase lehle ngaphansi kwama-60%. Lokhu kubonisa ukuthi isiguli sithola uhhafu womoya-mpilo wesidingo saso. Uma lokhu kugcwala kwenhliziyo kwehla ngaphansi kwama-95%, umzimba wakho nobuchopho akuhogeli umoya-mpilo owanele. Lokhu kungase kubangele izinkinga zenhliziyo nokulimala kobuchopho. \

Ngemva kwezifundo ezibalwe ngenhla, isinyathelo esilandelayo siphakamisa izindlela zokwelapha ezingcono kakhulu. Nasi isinyathelo esilandelayo sochwepheshe be-CARE Hospitals:-

Kuye ngokuhlaziywa kocwaningo lokulala, udokotela osebenza kuleli cala angase aphakamise ukuhlaziya kocwaningo lokulala lwezinga elilandelayo lokwelashwa kwe-CPAP. Ngezansi ezinye zezibonelo ezinhle kakhulu:-

• Esimweni lapho, isiguli sinesisekelo se-PSG esibonisa i-apnea yokulala. Lokhu kungase kudinge futhi ukubuyiselwa ku-titration ye-CPAP. 

• Uma kwenzeka, i-titration ye-CPAP ingaqediwe, khona-ke udokotela angase adinge ukubuyiselwa kwe-CPAP titration elandelayo noma kungase kube i-bi-level titration. 

• Kubantu abane-CPAP titration eyimpumelelo, khona-ke ukusethwa kwe-CPAP kungahlelwa. 

Kungani isifundo sokulala sidingeka?

Isifundo sokulala siyinqubo yokuxilonga esetshenziswa abahlinzeki bezempilo ukuze bakhombe noma bakhiphe izindaba ezihlukene zezempilo. Lokhu kuhlolwa kuvame ukunconywa kubantu abanezimpawu ezihlobene nokuphazamiseka kokulala ukuze banqume izinketho zokwelashwa ezifanele noma ukuhlola ukusebenza kokwelashwa okuqediwe. Lezi zinkinga zingathinta ubuchopho, isimiso sezinzwa, ukuphefumula nokusebenza kwenhliziyo.

Ezinye izimo isifundo sokulala esingasiza ukuzixilonga zihlanganisa:

• I-apnea yokulala evimbelayo nemaphakathi
• I-Narcolepsy
• Isifo sokunyakaza kwezitho ngezikhathi ezithile (okuhlanganisa i-restless legs syndrome)
• Insomnia
• Izinhlobo ezithile zokuquleka kanye nesifo sokuwa
• Ukwesaba ebusuku (ukwesaba ubuthongo)
• Ukuhlaselwa kovalo ebusuku
• Ukulala nokunye ukuphazamiseka kokuziphatha kokulala
• Ukukhubazeka kokulala
• Ama-parasomnia ahlukahlukene nokuphazamiseka kokulala.

Yiziphi izimpawu ze-Sleep Apnea?

Izikhathi eziningi, ngumuntu owabelana ngombhede nomuntu oqaphela izimpawu ze-Obstructive Sleep Apnea, hhayi umuntu onayo. Ezimweni eziningi, umuntu othintekile akaqapheli ukuthi unezinkinga zokulala. Nazi ezinye izimpawu ezivamile ze-Obstructive Sleep Apnea:

• Isinyoka esikhulu
• Ukuzizwa ukhathele emini
• Unenkinga yokulala kahle, ukuvuka njalo ebusuku
• Ukuvuka nomlomo owomile nomphimbo obuhlungu
• Ukuzizwa edabukile futhi ekhathazekile
• Ukujuluka kakhulu ebusuku
• Ukuba nezinkinga zocansi
• Ukuba ne-migraines

Abantu abane-Central Sleep Apnea bangase bavuke ngokuphindaphindiwe ebusuku noma babe nenkinga yokulala.

Ezinganeni, izimpawu zingase zingabi lula ukuzibona futhi zingabandakanya:

• Ukungenzi kahle esikoleni
• Ukuzizwa unobuthongo noma ukunganaki ekilasini
• I-Bedwetting
• Izithukuthuku ebusuku
• Izinkinga zokunaka kanye ne-hyperactivity

Sisebenza kanjani isifundo sokulala?

Isifundo sokulala sisebenzisa izinzwa ezahlukahlukene ukuhlola ikhwalithi yokulala kwakho, njengoba izici eziningi zingakuthonya. Ngokusebenzisa izinhlobo ezihlukene zezinzwa eziqapha amasistimu athile omzimba noma izinqubo, abahlinzeki bezempilo bangathola ukuqonda okuphelele kokulala kwakho, okubalulekile ekuxilongeni ukuphazamiseka okuthile okuhlobene nokulala.

Nazi izinzwa nezindlela zokuqapha ezisetshenziswa ocwaningweni lokulala:

• I-Electroencephalography (EEG): Le ndlela isebenzisa izinzwa ezimbozwe ngejeli enamathelayo, esebenza ngogesi ukuze ibambelele ekhanda lakho. Lezi zinzwa zibona futhi zirekhode ukusebenza kukagesi kobuchopho, noma amaza obuchopho, ngenkathi ulele. Izinhlobo ezahlukene zamaza zenzeka ngezigaba ezihlukahlukene zokulala, okwenza lokhu kube ithuluzi elibalulekile lokuhlonza izinkinga zokulala.
• I-Electrocardiography (EKG noma i-ECG): Inzwa eyodwa ye-EKG ibekwa esifubeni sakho ukuze iqaphe ukusebenza kukagesi wenhliziyo phakathi nocwaningo. Lokhu kuvumela abahlinzeki bezokunakekelwa kwempilo ukuthi bahlole noma yikuphi ukungahambi kahle kusigqi senhliziyo yakho nohlelo lukagesi.
• I-Electromyogram (EMG): Lezi zinzwa zinamathiselwe esikhumbeni, ngokuvamile ebusweni bakho nasemlenzeni, ukuqapha ukunyakaza kwemisipha. Ngokungafani ne-EMG evamile, engashukumisa ukufinyela kwemisipha, lezi zinzwa zisetshenziselwa izinjongo zokuqapha kuphela.
• I-Electro-oculography (EOG): Lokhu kuhlola kuhilela ukubeka izinzwa ezinamathelayo eduze kwamehlo akho ukuze ulandelele ukunyakaza kwamehlo. Uzoba nezinzwa ezine phakathi nesifundo sokulala, ezimbili ezimiswe eduze kweso ngalinye.

Ngisilungiselela kanjani isifundo sokulala?

Ukulungiselela isifundo sokulala kubalulekile ukuze uqinisekise imiphumela enembile. Nazi ezinye izinyathelo ongazilandela ukuze uzilungiselele:

• Xhumana Nodokotela Wakho: Khuluma nomhlinzeki wakho wokunakekelwa kwezempilo mayelana nanoma yimiphi imiyalelo ethile noma amalungiselelo adingekayo esifundweni sakho sokulala.
• Gwema Izikhuthazi: Gwema ukudla i-caffeine ne-nicotine okungenani amahora angu-24 ngaphambi kocwaningo, njengoba lezi zinto zingathinta amaphethini akho okulala.
• Londoloza Umjikelezo Wakho: Zama ukunamathela esimisweni sakho sokulala esivamile ezinsukwini eziholela esifundweni. Gwema izinguquko ezinkulu emikhubeni yakho yokulala.
• Nciphisa Ukulala: Uma kungenzeka, gwema ukuthatha isihlwathi isikhathi eside phakathi nosuku ngaphambi kokutadisha kwakho kokulala, njengoba lokhu kungase kube nomthelela ekhonweni lakho lokuzumeka ebusuku.
• Geza Izinwele Zakho: Ngobusuku bangaphambi kocwaningo, geza izinwele zakho futhi ugweme ukusebenzisa noma yimiphi imikhiqizo yezinwele njengamajeli noma izifutho, njengoba lokhu kungaphazamisa izinzwa.
• Gqoka Izimpahla Ezinethezekile: Khetha izingubo ezixegayo nezinethezekile ozozigqoka ngesikhathi socwaningo. Ezinye izinsiza zingakunikeza ingubo.
• Letha Izinto Zomuntu Siqu: Uma unanoma yiziphi izinto ezikusiza ukuthi ulale, njengomcamelo noma ingubo, cabanga ukuza nazo ukuze wenze indawo yakho yokulala ibe ntofontofo.
• Xoxa Ngemithi: Yazisa udokotela wakho nganoma yimiphi imithi oyiphuzayo, ikakhulukazi leyo ethinta ukulala. Bangase banikeze isiqondiso esiqondile sokuthi bathathwe yini ngaphambi kocwaningo.

Imiphumela emibi yokutadisha kokulala

Ngokuvamile kuba nemiphumela emibi embalwa kakhulu noma izinkinga ezihlobene nocwaningo lokulala. Izinkinga ezivame kakhulu zihlanganisa ukucasuka noma ukungezwani nezinto ezinamathelayo noma amateyipu asetshenziselwa ukunamathisela izinzwa. Ukwengeza, abantu abaningi bangase bangalali kahle noma isikhathi eside ngenxa yendawo abangayijwayele.

Nakuba ezinye izinkinga ezingase zenzeke, azivamile futhi zingahluka kumuntu nomuntu. Kungcono ukuthintana nomhlinzeki wezempilo ukuze uthole ulwazi oluthile oluhlobene nesimo sakho.

Indlela yokwelapha i-Apnea yokulala?

Izimo ezimaphakathi ze-Obstructive Sleep Apnea zingelashwa ngempumelelo ngezindlela ezingahlanyisi.

Ukwelashwa okungahlaseli:

• Ukulahlekelwa kwesisindo: Ukulahlekelwa ngisho nesisindo esincane kungaba usizo kakhulu, ikakhulukazi kubantu abakhuluphele ngokweqile, njengoba kunganciphisa iziqephu zokuphazamiseka kokuphefumula ngesikhathi sokulala.
• Ukugwema utshwala namaphilisi okulala: Kunconywa ukuthi ugweme uphuzo oludakayo kanye nemithi eyenza umuntu alale ngoba angenza isimo sibe sibi.
• Indawo yokulala: Ukulala ngomhlane kungenza isimo sibe sibi kakhulu, ngakho-ke kungcono ukulala ngohlangothi. Ungasebenzisa imicamelo ekhethekile noma amadivaysi ukusiza ngalokhu.
• Izinsiza zamakhala: Uma unezinkinga ze-sinus, ukusebenzisa izifutho zamakhala kanye nemigqa yokuphefumula kungakhuthaza ukuphefumula okungcono ngesikhathi sokulala.

Amadivayisi e-Mandibular Advancement: Lawa madivayisi awusizo kubantu abane-Obstructive Sleep Apnea emaphakathi kuya komaphakathi. Asebenza ngokuhambisa umhlathi ongezansi phambili, okusiza ukuvimbela ulimi ukuthi ungavimbeli umphimbo futhi ugcine umoya wokuphefumula uvulekile ngenkathi ulele.

Ukuhlinzwa: Izinqubo zokuhlinza ziyinketho yabantu abane-Obstructive Sleep Apnea kanye nalabo abahonayo kodwa abangenaso isimo. Ukuhlinzwa kungabhekana nezinkinga ezingokomzimba ezibangela izinkinga zokuphefumula ngesikhathi sokulala.

Okunye ukuhlola okunconyelwe i-apnea yokulala 

I-EEG ebizwa nangokuthi i-electroencephalogram isetshenziselwa ukurekhoda nokulinganisa umsebenzi wamaza obuchopho. 

I-EOG yaziwa nangokuthi i-electrooculogram futhi inconywa ukurekhoda ukunyakaza kwamehlo. Lokhu kunyakaza kubhekwa njengokubalulekile ekunqumeni izigaba zokulala ezihlukahlukene, ikakhulukazi ukulala kwesiteji se-REM. 

I-EMG, ebizwa nangokuthi i-electromyogram, isetshenziselwa ukurekhoda imisebenzi yemisipha efana nokugedla kwamazinyo, ukunyakaza kwemilenze, ama-twitches, nokulala kwesiteji se-REM. I-EKG eyaziwa nangokuthi i-electrocardiogram iyanconywa ukuze kuqoshwe isigqi nokushaya kwenhliziyo kwesiguli. 

Ukuhlolwa kwethu kokulala e-Hyderabad e-CARE Hospitals kunikeza i-akhawunti engcono kakhulu yalokho okwarekhodwa emahoreni ayisithupha kuya kwayisishiyagalombili okulala. Odokotela bethu babuyekeza umbiko wocwaningo futhi bahlobanise isiguli ngokwezikhalazo zokulala. Ngokombono, siphakamisa izinqumo ezingcono kakhulu zokuphathwa komtholampilo ukuze wenze amaphethini okulala abejwayelekile futhi aholele ekuzijwayezeni ukulala okuhlanzekile, ugweme izinsiza zokulala ezitholakala ngaphandle kwekhawunta, kanye nemilaliso kadokotela. Ngakho-ke, khetha ukuhlaziya kwethu isifundo sokulala futhi uqaphele izinguquko phakathi nesikhathi esinqunyiwe. 

Chofoza lapha ukuze uthole okwengeziwe mayelana nenani lalokhu kwelashwa.