Kune avo vanotambura nemigumisiro yakaipa yekutambudzika kwekurara, dzakawanda zvirwere zvekuongorora zvinowanikwa zvinogona kutungamirira kunzwisisiro zviri nani yechinetso chacho. Ngatitaurei nezvekusarudza.
Overnight Oximetry
Usiku huno oximetry imwe yezvinyorwa zvisinganzwisisiki uye, kazhinji, zvidzidzo zvekurara zvekare kare zvingaitwa. Inosanganisira kushandiswa kwepurogiramu (yakafanana neyekuvhara nguo) iyo yakafukidzwa pamunwe kana earlobe iyo inoramba ichitarisa mazinga e oxygen uye kutora mwoyo.
Izvi zvinogadziriswa nemuviri mutsvuku uye sensor inoona kuchinja kwemuvara weropa unogona kuratidza desaturations (kana kurasikirwa kwe okisijeni) iri kuitika.
Uyu muedzo uchawanzoitwa pamba uchirara. Inogona kuona vanhu vari panjodzi yekushaiwa kwepfungwa usiku. zvakadai sokuputika kwehope , uye inogona kushandiswa kuzivisa avo vanoda kuwedzerwa kuongororwa, zvakadai se polysomnogram.
Polysomnography (PSG)
Izvi zvinonyanya kuonekwa sehutano hwegoridhe hwekuongororwa kwezvirwere zvehope. Inosanganisira kushanyira pane imwe nzvimbo yehope, iyo inogona kunge yakagadzirirwa makamuri akatsaurwa muchipatara, laboratori yokurara, kana kunyange imwe nzvimbo yehotera yakagadzirirwa. Izvi zvidzidzo zvehope zvinosanganisira kugara kweusiku kunochengetedzwa neyanyanzvi akadzidziswa.
Zvimwe zvakasiyana-siyana zvepanyama zvinotariswa zvinongororwa apo munhu akarara, kusanganisira EEG , EKG, kupemha, oksijeni maitiro, mutsindo wemaviri, uye maziso uye kumativi ekufamba.
Panewo vhidhiyo uye rerekodhi rerekodhi inopa runyoro rwekurara kweusiku. Iyi miedzo inogona kuongorora zvirwere zvakawanda zvekurara- kubva pakubata kwepabhesi kusvika kune makumbo musingaregi kusvika parasomnias-uye inogona kunge yakakosha mukuronga zvimwe zvinokonzera kusuruvara .
Kudzidza Kudzidza
Kutumira neChirangaridzo Chakanaka Airway Pressure (CPAP) inowanzoitwa panguva imwechete yeusiku sekuongorora chirwere chepolysomnogram (PSG) kuchengetedza nguva yekumirira, kuderedza mari kune murwere, uye kubata chirwere chekurara nokukurumidza nokukurumidza.
Kurapa kwokutanga kunogona kuderedza zvinetso zvepfungwa zvekurara kwepabonde . Muchidimbu, nyanzvi inowedzera zvishoma kuwedzera CPAP yekumanikidzwa (yakamanikidzwa mumhepo yakasimba kwete oxygen) inopiwa kuburikidza nemasikisi anonyorera kusvika kumazinga anobvisa zvachose kana zvikamu zvose zvekuguma kwekupema. Iyi nhamba yeCPAP inomanikidzwa ichagadzirirwa kumusha wekurapa.
Murwere anowanzotanga usiku pamusana pamanikidziro yeCAPAP kana bileledvel yavo. Apo munhu wacho anoenda kunorara, ivo vacharongedzwa nokuda kwekuvhiringidzika mukufema. Chero mhemberero, zvipfeko zvepneic, kana kubhurwa zvinokurudzira unyanzvi wekurara kuti agadzirise kushandiswa kwemichina yeMAPAP kure. Zvakare, munhu wacho achaongororwa pamusana pekumanikidza kwavo. Chinangwa ndechokudzikisa apnea uye hypopnea zviitiko uye kubvisa kunonoka.
Izvo zvakakoshawo kuti murwere agadziriswe kune anoshanda zvakanaka supine (kumushure kwavo) uye munguva dzekurumidza kwekufamba kweziso (REM) kurara. Izvozvi zviitiko zviviri zvinowanzoita kuti munhu ave nehope yakanyanya kufema , saka kushanda kwakasimba mumamiriro ezvinhu aya kunofadza zvikuru.
Kakawanda kumucheto wekudzidza uku, zvinetso zvingawedzerwa kunyanya. Izvi zvinobvumira chiremba anoongorora kuti aenzanise pakati pezvinetso zvakasiyana-siyana.
Uyewo, zvinogona kujekesa kuchinja kunoda kuitwa mumatambudziko ekugadzirisa kwakanakisisa kwepabonde yekurara yemunhu.
Kuwanda Kwemazuva Okurara Kwekupedzisira (MSLT)
Kuwanda Kwemazuva Okurara Kwekupedzisira (MSLT) inowanzonziwo kuongorora nap. Izvo zvakafanana mukugadzirisa ku polysomnogram (PSG) inotsanangurwa pamusoro apa.
Dzidzo idzi dzinowanzoitwa mushure mekutanga kwekudzidza kweGPG usiku hwose. Mushure mokumuka, mumwe munhu angave akaronga nguva nenguva. Izvi zvinowanzoitika maawa maviri.
Kazhinji, murwere anoiswa pamubhedha uye anobvumirwa kurara ipapo kwemaminitsi makumi maviri nechinangwa chekuvata.
A technician achacherechedza kuti kutanga kwehope uye, kunyanya, kurara REM. Mushure maminitsi makumi maviri, munhu wacho achamutswa kana kuti akaudzwa kuti nguva yekuvhara yapera. Zvadaro, mumaawa maviri eawa, izvi zvinodzokororwa. Kazhinji izvi zvichaitika paawa 10.
Iyi miedzo inobatsira pakuratidza kuora mwoyo kwezuva masikati. Izvi zvinogona kunge zviripo mune zvinetso zvakawanda, zvakadai sokurara kwepabonde , idiopathic hypersomnia ( kurara zvakanyanya pasina chikonzero), uye kushaya chirwere chinopisa. Kunyanya, kutanga kwekutanga kwe REM munguva idzi dzekurara kunogona kuratidza kuti chikwata chinotyisa.
Actigraphy
Actigraphy ndiyo kuenzanisa kwebasa nekushandiswa kwechidiki, chigadzirwa chechigunwe chekristwatch. Ichi chigadziri chekucherechedza kufamba uye chinogona kushandiswa kutarisa kurara , kana circadian rhythms, pane nguva yakareba. Vangave vakapfeka kwemavhiki kana kunyange mwedzi.
Zvirongwa zvinobatsira kuziva kana kukanganiswa mukati mekurara-kuitika, kune zvakawanda zvinoitika mu circadian rhythm kushungurudzika zvakadai sehutachire hwechirwere chetachiona, kunonoka kurara kwechirwere chirwere, kana kunyange nekushaya hope . Izvi zvinowanzogadziriswa ne diary yokurara.
Dhipari Yokurara
Dary diary, kana gomba rehope, dzimwe nguva inobatsira pakuongorora circadian rhythm disorders kana kusuruvara , kunyanya mu adjunct kune actigraphic data. Izvi zvingashandiswawo kuongorora zvinetso zvehope pakati pevana.
Nenzira yakawanda, ivo mapepa uye mapepa ekurara uye kumuka kwemavhiki nemwedzi. Nguva dzokurara uye nguva-dzinomira dzinozivikanwa. Chero nguva dzekumuka usiku kana naps mukati mezuva zvakanyorwa zvakare. Dzimwe nguva kushandisa caffeine , doro, kana mishonga inogona kunyorwa zvakare.
Pamba Chidzidzo
Vanhu vazhinji vanoziva kuti vanovata zvakanyanya kumba kwavo kupfuura ivo vangave mune imwe nzvimbo yekurara. Izvi ndezvechokwadi, uye vazhinji vari kukurudzirwa kukudziridza unyanzvi hunoita kuti mvumo yeimba yekushungurudzwa kwekurara. Izvi zvinogona kusanganisira zvidzidzo zvishoma izvo zvinotarisa matanho ekurara, zvakadai seokisijeni maitiro, moyo yemafungiro, uye kufamba kwechifu uye mimba ine mabhanhire chaiwo. Zvimwe zvidzidzo zvekudzidzira zvinogona kuitwa pamba kuburikidza nekushandiswa kwemushonga weCPAP, zvakadai sezvidzidzo zvemotokari.
Mukuwedzera, hutenga hutsva huri kuongororwa hunogona kutungamirira kune dzimwe kuongorora. Nenzira yakawanda, hutenga hutsva huri muhucheche uye data haigoni kuva yakavimbika seyiyo yegoridhe inoyevedza yekuongorora, iyo inonzi polysomnogram yeusiku inobatwa mune imwe nzvimbo yekurara yakagamuchirwa.
Sources:
> Littner, M. et al. Ita maitiro emishonga yekurapa kwemahombekombe akawanda ekuzorora latency uye yekuchengetedzwa kwekumuka kwemuviri. Kurara ; 28: 113.
> Mitler, M. naMiller, J. Nzira dzekuedza kurara. Behav Med; 21: 171.
> Stepanski, E. et al . Migumisiro yokurara kwekurara pamasikati ekurara muhope huru. Kurara ; 23: 215.