Kusuruvara Kunokonzera Utano Hwakakosha Migumisiro, Kubudirira Kwokurapa
Kurara kwepabhesi ndizvo zvakajairika zvinokanganisa mamiriyoni eAmerica. Chirwere chisingaperi chinopfufidza umo munhu anoramba achifema mukati meusiku kungave nekukonzera kusina kukwana kana kukwana (kana kukoromoka) kwepamusoro pemugwagwa wepamusoro , zvinowanzokonzera nheyo yerurimi uye chirwere chiri nyore.
Izvo zvinogonawo kuitika nekuda kwechiratidzo chinodzvinyirirwa kubva muuropiyo kuti utange kufema.
Izvi zviitiko zvinopera mashure gumi kana kupfuura, uye zvinogona kuitika mazana emamwe usiku humwe. Mumwe munhu ane chirwere chekurara chinogona kuve nenzwi guru, kuvhara kwenguva pfupi mukufema, uye kubuda mukati. Muzviitiko zvepnea, iyo yerojeni yeropa inodonha, kuwedzera kwomwoyo kunowedzera, uye kurara kunovhiringidzika apo munhu ane hanya anosimudza kuti adzoke kufema. Izvi zvinogona kuva nemigumisiro inokosha pahutano hwehusiku, basa remasikati, uye hutano hwakakwana.
Sub-Types
Kurara kweputika ishoko rechiito rinosanganisira chirwere chipi chinokonzera kupera mukufema panguva yehope. Iko kunogona kukanganisa mumwe munhu pane imwe nguva, asi kuwandisa kwekurara kwepabhesi kunowedzera kudarika makore emukati. Iko kune mashoma mashoma-maitiro, kusanganisira:
Kurara kwepabhesi haisi iyo dambudziko chete rinogona kutungamirira kumatambudziko kufema munguva yehope. Kune zvimwe zvishoma zvinetso zvisingaiti kukwana kwakakwana mukufema asi zvingave zvichiri kuoma, zvakadai se:
Zvakakoshawo kuziva kuti okisijeni mazinga anogona kudonha panguva yehope kana mapapu ese akanganisa nemhaka yezvirwere zveplm, uye izvi zvingadikanwa zvakasiyana.
Zviratidzo
Kunze kwekumhanya kwekufema izvo zvinowanzoita zvechirwere, pane zvimwe zvakawanda zviratidzo zvinowanikwa muhope yepamusoro.
Zviratidzo izvi zvinogona kusanganisira:
- Yakaderera, inogara isingagumi
- Choking kana kupera munguva yehope
- Kupupurira kunomira pakufema munguva yehope
- Waking nguva zhinji kuti urinate ( nocturia )
- Mazino achikuya kana kubata ( bruxism )
- Dry nehuro kana muromo paanomuka
- Nocturnal palpitations kana kukwikwidza kwemwoyo
- Night sweats
- Nocturnal heartburn
- Anogara achidzoka usiku uye kumarara
- Kuwedzerwa kwekurara kwezuva masikati
- Morning headache
- Mhedziso yenguva pfupi yekudzidza kana matambudziko
- Kunzwa kusuruvara
- Kutambura kuisa pfungwa kana kufunga
- Kuchinja kwemafungiro, kusanganisira kuora mwoyo
Hazvirevi zviratidzo izvi zvose zvinofanira kuvapo kuti chiitiko chiitike, uye vana vane chirwere chekurara vanogona kuunza nemakwikwi akasiyana sehutano hwekukura, kucherechedza kushaya simba kwehutano, uye kurara kusingaperi.
Zvinokonzera
Pane zvishoma zvinokonzera zvipembenene zvekudzivirira kubheta uye mamiriro ezvinhu angaita kuti zviwedzere kuipa, kusanganisira:
- Kunyanya kuwandisa kana kuoma (kusanganisira musara mukuru wemutsipa )
- Abnormal upper airway anatomy (kusanganisira septum yakatsauka )
- Kushandisa mishonga, zvinodhaka, kana doro
- Kukwegura
- Kurara shure
- REM kana kurota hope
- Kusvuta
Mukuwedzera, kuputika kwepabonde kwepakati kunogona kuitika nekuda kwekurohwa, mwoyo kusakundikana, kana kushandiswa kwemishonga yemarwadzo emakumbo kana opioid. Kukanganiswa kwepomea yakaoma kunowanikwa nemamwe mushonga.
Inowirirana Sei
Kurara kwepabhesi kunonyanya kufanana. Apo kurara kwepabhesi kunorondedzerwa sokunge kune zviitiko zvinopfuura 5 zvepneic paawa izvo zvinoita kuti zviratidzo (zvakadai sekurara kwemasikati masikati), uye vamwe 2 kusvikira ku 9 muzana yevanhu vachatambura nehope yepamusoro. Kana ichitsanangurwa seine zviitiko zvinopfuura 5 zvepneic paawa pasina mazviratidzo, zvinopararira ndezvi 9-24% muhuwandu hwevanhu. Nokuti zvinetso zvepfungwa zvekurara kwepabhesi zvinowira pasinei nekuvapo kwemasikati masikati zviratidzo zvakadai sokurara, inotevera inonzi inofanirwa kupararira.
Iyo yakawanda inowedzera kubva pamakore gumi nemasere kusvikira kune makumi mashanu uye inozosvika kumunda kubva kumakore makumi mashanu kusvika kune makumi matanhatu nemashanu.
Kana mumwe munhu achizoita apnea yehope, ivo vanozoita saizvozvo nezera iroro. Inenge kaviri inowanzoonekwa pakati pevarume.
Kuziva
Kunyanya kufungidzirwa kwekurara kweperesi kunowanzoenderana nekunyatsocherechedza uye kuongorora kwepanyama nechiremba anodiwa, bhodhi-anozivikanwa mushonga wekurara. Kuwedzerwa kuedzwa kwakaitwa kuburikidza nehutano hwekuyera kuongororwa , izvo zvingangosanganisira:
- Polysomnography
- Musha Wokurara Apnea Kuedzwa
- Kuwanda Kwemazuva Okurara Kwekupedzisira (MSLT)
- Kugadziriswa Kwekumuka Test (MWT)
- Overnight Oximetry
- Epworth Kurara Kwakawanda
- Kurara Mugore
Nenzira yakawanda, kana kuonekwa kwepokugara kwepasea yekugara mumba kana kuti iyo inopinda kuongororwa kwepolymnogram inowanikwa munzvimbo yekuedza ndiyo chete inongororwa kuti iongorore kugadzikana kwepnea.
Mishonga
Kurara kwepabhesi kunogona kubatwa zvakanaka nenzira dzakasiyana-siyana. Muzhinji, vanhu vakawanda vachaedzwa kuenderera mberi kwakanaka kwemafambisi emhepo (CPAP) . Izvi zvinoda kusarudza maPaski mask . Chirwere chakafanana chinonzi bilevel positive airway pressure (BiPAP) inoshandiswawo dzimwe nguva. Zvinogona kutora nguva kuti zvienzaniswe nemishonga iyi, uye kune mamwe mazano anogona kubatsira kugadzirisa zvinetso . Iko kune dzimwe nzvimbo dzakadai sedhinha inogona kudzivirira muromo kufema . Mukuwedzera, zvakakosha kuchengeta CPAP yako yakachena . Zvinogonawo kuongorora yako CPAP kushandisa .
Kune avo vasingakwanisi kubvumira CPAP, kune dzimwe nzira dzokurapa kune CPAP . Izvi zvinogona kusanganisira midziyo yemuromo , positional therapy, kana kuti kuvhiyiwa . Mune zvimwe zviitiko, kana kurara kwezuva masikati kuchiramba kuchiri pasinei nekurapa, zvinokurudzira zvakadai saRitalin , Provigil , uye Nuvigil zvingave zvakafanira kurapa kurara. Kunyange dzimwe nzira dzakadai sekutamba dogeridoo dzakaratidzwa kuva mushonga unoshanda. Vamwe vanhu vanogona kuwana zvikomborero kubva ku caffeine kana kunyangwe pasi. Sezvinogara nguva dzose, vanhu vane matambudziko ekurara vanobatsirwa nekucherechedza mazano akanaka ekurara .
Migumisiro Kana Kuruboshwe Kusina Kutongwa
Ikoko kunogona kuva nemigumisiro yakakomba - kunyange yakaurayisa - kusaputirwa nehope dzisina kurara, dzakadai se:
- Kurwiswa kwechirwere chepachike kana kuti chenguva pfupi
- Coronary heart disease
- Heart failure
- Kusagadzikana kwepfungwa
- Kumira kurova kwemoyo
- High blood pressure
- Kushungurudzika uye reflux
- Chirwere cheshuga
- Erectile dysfunction
- Dambudziko rekufunganya uye yekuyeuka
- Kuora mwoyo
- Kungoerekana kwafa
Pane zvikamu zvakasiyana zvekurara kwepabonde muvana , izvo zvinogona kusanganisira kushaya simba , kukurumidza kukura, uye kupera kweuchenjeri.
Mhedziso
Kurara kwepabhesi ndeyechirwere chisingawanzoitiki chinosanganisira kupera mukufema kunoitika panguva yehope. Kune mhando dzakasiyana-siyana dzekurara kwepabhesi, uye inogona kuva yakawanda mune dzimwe nzvimbo dzakasiyana. Zviratidzo zvinokonzera zvinowanzobatanidza kurara kwemasikati masikati, asi zvinogonawo kuva zvakakomba - uye kunyange zvinouraya - migumisiro. Pane mamiriro ezvinhu mazhinji anogona kukonzera kurara kwepnea kana kuti kuipa. Kuongororwa kunowanzochengetedza munhoroondo yakanyatsocherechedza uye kuongororwa kwechiremba nachiremba uye chidzidzo chehope zvakadai semuviri wekushaya apnea test or in-center polysomnogram. Kurapa kunogona kuitwa kuburikidza nekushandiswa kwekuenderera kwakanaka kwemafambisi emhepo (CPAP) kana dzimwe nzira dzokurapa dzakadai sedzomumuviri midziyo kana kunyange kuvhiyiwa. Ikoko kunogona kunge kune dzimwe dzimba dzinofanirwa kurongeka kuitira kuti kuwedzerwa kurapwa kwekodzero. Nenzira yakanaka, kurara kwepabhesi kunogona kugadziriswa kubudirira nemigumisiro yakanaka.
Sources:
American Academy Yokurara Mushonga. "Munyika yose maitiro ekurara kwehope: Bhuku rekuongorora nekunyora." 2nd ed. 2005.
Collop, N. "Izvozvo zvinokonzerwa nekudzivirira kubata kwepabonde pane zvirwere zvisingaperi zvoutano." Cleveland Clinic Journal of Medicine . 2007 74: 1.
Durmer, J et al. "Vanachiremba Vanorara Mishonga." American Academy of Neurology Continuum. 2007; 153-200.
Epstein, LJ et al. "Chikamu chinotungamirirwa chekuongorora, kutarisira, nekuchengetedza nguva refu kwekudzivirira kuparara kwemahope muvanhu vakuru." J Clini Kurara Med. 2009; 5: 263.
Jennum, P et al. "Epidemiology yekurara apnea / hypopnoea syndrome uye kufema-kunetseka kufema." Eur Respir J. 2009; 33: 907.