I-apnea yokulala ephakathi

I-apnea yokulala esembindini sisifo sokulala apho ukuphefumla kuyeka ngaphezulu nangaphezulu xa ulele.

Ukuphefumla ubuthongo obuphakathi kubangela xa ingqondo iyeka okwethutyana ukuthumela imiqondiso kwizihlunu ezilawula ukuphefumla.

Imeko ihlala isenzeka kubantu abaneengxaki ezithile zonyango. Umzekelo, inokukhula kumntu onengxaki ngendawo yengqondo ebizwa ngokuba yingqondo, elawula ukuphefumla.

Iimeko ezinokubangela okanye zikhokelela ekuphefumlweni kokulala okuphakathi kubandakanya:

• Iingxaki ezichaphazela i-brainstem, kubandakanya usulelo lobuchopho, ukubetha, okanye iimeko zomqolo wesibeleko (intamo)
• Ukutyeba kakhulu
• Amayeza athile, anjengezithomalalisi zentlungu

Ukuba i-apnea ayihambelani nesinye isifo, ibizwa ngokuba yi-idiopathic central sleep apnea.

Imeko ebizwa ngokuba yi-Cheyne-Stokes yokuphefumla inokuchaphazela abantu abanesifo sentliziyo esomeleleyo kwaye inokunxulunyaniswa ne-apnea yokulala esembindini. Iphethini yokuphefumla ibandakanya ukutshintshana okunzulu kunye nokuphefumla okunzima ngokungaphefumli, okanye nokuba ungaphefumli, ngesiqhelo xa ulele.

I-apnea yokulala ephakathi ayifani ne-apnea yokulala yokuthintela. Xa kukho ubuthongo obuthintelayo, ukuphefumla kuyayeka kwaye kuqala kuba indlela yomoya inciphile okanye ivalekile. Kodwa umntu unokuba nazo zombini iimeko, ezinje ngengxaki yezonyango ebizwa ngokuba kukukhuluphala kwe-hypoventilation syndrome.

Abantu abane-apnea yokulala ephakathi baneziqendu zokuphazamiseka kokuphefumla ngexesha lokulala.

Ezinye iimpawu zingabandakanya:

• Ukudinwa okungapheliyo
• Ukulala emini
• Intloko yentsasa
• Ukulala ngokungapheliyo

Ezinye iimpawu zinokuthi zenzeke ukuba i-apnea ibangelwa yingxaki yenkqubo yemithambo-luvo. Iimpawu zixhomekeke kumalungu enkqubo ye-nervous echaphazelekayo, kwaye inokubandakanya:

• Ukuqhawukelwa ngumphefumlo
• Ukuginya iingxaki
• Ilizwi liyatshintsha
• Ubuthathaka okanye ukuba ndindisholo emzimbeni wonke

Umboneleli wezempilo uya kwenza uvavanyo lomzimba. Kuya kwenziwa iimvavanyo ukufumanisa imeko yonyango engaphantsi. Isifundo sokulala (i-polysomnography) sinokuqinisekisa i-apnea yokulala.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Echocardiogram
• Ukuvavanywa kokusebenza kwemiphunga
• I-MRI yengqondo, umqolo, okanye intamo
• Uvavanyo lwegazi, njengamanqanaba erhasi yegazi

Ukunyanga imeko ebangela ukuphefumla okuphakathi kokulala kunokunceda ukulawula iimpawu. Umzekelo, ukuba i-apnea yokulala phakathi ngenxa yokusilela kwentliziyo, injongo kukunyanga ukusilela kwentliziyo uqobo.

Izixhobo ezisetyenziswe ngexesha lokulala ukunceda ukuphefumla kunokucetyiswa. Oku kubandakanya uxinzelelo lwempumlo oluqhubekayo lwe-airway (CPAP), uxinzelelo lwomoya lwe-bilevel (i-BiPAP) okanye i-servo-ventilation eguqukayo (ASV). Ezinye iintlobo zokuphefumla okuphakathi kunyangwa ngamayeza akhuthaza ukuphefumla.

Unyango lweoksijini lunokunceda ekuqinisekiseni ukuba imiphunga ifumana ioksijini eyaneleyo ngelixa ileleyo.

Ukuba iyeza le-narcotic libangela i-apnea, idosi inokufuna ukwehliswa okanye iyeza litshintshe.

Ukwenza kakuhle kuxhomekeke kwimeko yonyango ebangela ukuphefumla okuphakathi kokulala.

Umbono uhlala uthandeka kubantu abane-apnea yokulala ebuthongweni.

Iingxaki zinokubangelwa sisifo esisisiseko esibangela ukuba ubuthongo obuphakathi bokulala.

Shayela umnikezeli wakho ukuba unempawu zokugula komzimba. I-Central apnea yokulala ihlala ifunyaniswa kubantu esele begula kakhulu.

I-apnea yokulala-ephakathi; Ukutyeba kakhulu-ubuthongo obuphakathi bokulala; I-Cheyne-Stokes - i-apnea yokulala ephakathi; Ukungaphumeleli kwentliziyo-ubuthongo obuphakathi bokulala

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URyan CM, uBradley TD. Umphefumlo wokulala ophakathi. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; Ngo-2016: isahluko 89.

UZinchuk AV, uThomas RJ. I-apnea yokulala okuphakathi: ukuxilongwa kunye nolawulo. Ku: Kryger M, Roth T, Dement WC, ii-eds. Imigaqo kunye nokuziqhelanisa neyeza lokulala. Umhla wesi-6. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 110.