Ukuphefumula kokulala okuphakathi

I-apnea yokulala ephakathi yisifo sokulala lapho ukuphefumula kuyeka kaninginingi ngesikhathi sokulala.

Ukuphefumula ubuthongo okuphakathi kuba khona lapho ubuchopho buyeka okwesikhashana ukuthumela amasiginali emisipheni elawula ukuphefumula.

Isimo ngokuvamile sivela kubantu abanezinkinga ezithile zezokwelapha. Isibonelo, ingaqala kumuntu onenkinga ngendawo yobuchopho ebizwa nge-brainstem, elawula ukuphefumula.

Izimo ezingabangela noma ziholele ekuphefumuleni kokulala okuphakathi zihlanganisa:

• Izinkinga ezithinta i-brainstem, kufaka phakathi ukutheleleka kobuchopho, isifo sohlangothi, noma izimo zomgogodla womlomo wesibeletho (intamo)
• Ukukhuluphala ngokweqile
• Imithi ethile, njengezibulala zinhlungu ze-narcotic

Uma i-apnea ayihlotshaniswa nesinye isifo, ibizwa ngokuthi i-idiopathic central sleep apnea.

Isimo esibizwa ngokuthi ukuphefumula kweCheyne-Stokes singathinta abantu abanesifo esibi senhliziyo futhi singahlotshaniswa ne-apnea yokulala emaphakathi. Iphethini yokuphefumula ifaka phakathi ukuphefumula okujulile nokusindayo ngokuphefumula okungajulile, noma okungaphefumuli, imvamisa ngenkathi ulele.

I-apnea yokulala ephakathi ayifani nokuphefumula kokulala okuvimbelayo. Ngokuphefumula kokulala okuvimbelayo, ukuphefumula kuyama futhi kuqale ngoba indlela yomoya incishisiwe noma ivinjiwe. Kepha umuntu angaba nezimo zombili, njengenkinga yezokwelapha ebizwa nge-obesity hypoventilation syndrome.

Abantu abane-apnea yokulala ephakathi baneziqephu zokuphazamiseka kokuphefumula ngesikhathi sokulala.

Ezinye izimpawu zingafaka:

• Ukukhathala okungapheli
• Ukulala kwasemini
• Ukuphathwa ikhanda ekuseni
• Ukulala okungenakuphumula

Ezinye izimpawu zingase zivele uma i-apnea ingenxa yenkinga yesistimu yezinzwa. Izimpawu zincike ezingxenyeni zesistimu yezinzwa ezithintekile, futhi zingafaka:

• Ukuphelelwa umoya
• Izinkinga zokugwinya
• Izinguquko zezwi
• Ubuthakathaka noma ukuba ndikindiki emzimbeni wonke

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Ukuhlolwa kuzokwenziwa ukuthola ukuthi kunesimo esingakanani sezempilo. Isifundo sokulala (i-polysomnography) singaqinisekisa ukuphefumula kokulala.

Olunye uvivinyo olungenziwa lubandakanya:

• I-Echocardiogram
• Ukuhlolwa komsebenzi wamaphaphu
• I-MRI yobuchopho, umgogodla, noma intamo
• Ukuhlolwa kwegazi, njengamazinga wegesi yegazi

Ukwelapha isimo esibangela ukuphefumula okuphakathi kokulala kungasiza ukuphatha izimpawu. Isibonelo, uma ukuphefumula kokulala okuphakathi kungenxa yokuhluleka kwenhliziyo, umgomo ukuphatha ukwehluleka kwenhliziyo uqobo.

Kunganconywa amadivayisi asetshenziswa ngesikhathi sokulala ukusiza ukuphefumula. Lokhu kufaka phakathi ingcindezi yomoya oqhubekayo oqondile (CPAP), ingcindezi ye-bilevel positive airway (BiPAP) noma i-adaptive servo-ventilation (ASV). Ezinye izinhlobo ze-apnea yokulala ephakathi ziphathwa ngemithi evuselela ukuphefumula.

Ukwelashwa kwe-oxygen kungasiza ekuqinisekiseni ukuthi amaphaphu athola i-oxygen eyanele ngenkathi elele.

Uma umuthi we-narcotic ubangela i-apnea, isilinganiso singadinga ukwehliswa noma umuthi ushintshwe.

Ukwenza kahle kangakanani kuncike esimweni sezokwelapha esibangela ukuphefumula okuphakathi kokulala.

Umbono uvame ukuthandeka kubantu abane-apnea yokulala ephakathi kwe-idiopathic.

Izinkinga zingase zibangelwe yisifo esiyisisekelo esidala ukuphefumula kokulala okuphakathi.

Shayela umhlinzeki wakho uma unezimpawu zokuphefumula kokulala. I-Central apnea yokulala ivame ukutholakala kubantu asebevele begula kakhulu.

I-apnea yokulala - emaphakathi; Ukukhuluphala - ukuphefumula kokulala okuphakathi; I-Cheyne-Stokes - ukuphefumula kokulala okuphakathi; Ukwehluleka kwenhliziyo - i-apnea yokulala emaphakathi

I-Redline S. Ukuphefumula okungalali kahle nesifo senhliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 87.

URyan CM, uBradley TD. Ukuphefumula kokulala okuphakathi. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 89.

UZinchuk AV, uThomas RJ. I-apnea yokulala emaphakathi: ukuxilongwa nokuphathwa. Ku: Kryger M, Roth T, Dement WC, ama-eds. Izimiso Nokwenza Kwendlela Yokulala. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2017: isahluko 110.