Ukuqwasha - Izimbangela, Izimpawu, Ukuxilongwa, kanye Nokwelashwa

Ukuqwasha noma ukungalali ezejwayelekile ukuphazamiseka kokulala lokho kungakwenza kube nzima ukulala, kube nzima ukuhlala ulele, noma kokubili, noma kubangele ukuthi uvuke ekuseni kakhulu futhi ungakwazi ukuphinde ulale.

Kuthinta izigidi zabantu emhlabeni jikelele. I-National Institute of Health ilinganisela ukuthi cishe u-30% wabantu emhlabeni wonke unenkinga yokulala futhi cishe u-10% phakathi kwabo ulala emini.

Kuyini Ukuqwasha?

Ukuqwasha kungaphazamisa ukusebenza kwengqondo kanye nezinga lempilo. Ukulala ngokwanele kuyisici esibalulekile sendlela yokuphila enempilo. Umuntu omdala udinga okungenani amahora angu-7 kuya kwangu-8 okulala ngosuku. Nokho, izindlela zokulala ziyashintsha ngokuya ngeminyaka. Ngokwesibonelo, abantu abadala asebekhulile bangase balale kancane ebusuku futhi balale njalo emini. Ukungalali kwenza umuntu azizwe ekhathele, ecindezelekile, futhi uyacasuka. Iphinde yehlise ukugxilisa ingqondo futhi inciphise ikhono lomuntu lokwenza imisebenzi yakhe yansuku zonke. Ukuqwasha kuhambisana nokushintshashintsha kwemizwelo, ukucasuka, Futhi ukukhathazeka. Iphinde kwandisa ukushaya kwegazi kanye nobungozi bezifo ezingapheli ezifana sikashukela.

Wonke umuntu uba neziqephu zokuqwasha ngezikhathi ezithile ezifika zidlule ngaphandle kokudala izinkinga ezinkulu. Kodwa, kwabanye abantu, iziqephu zokuqwasha zihlala izinyanga noma iminyaka futhi zibe nomthelela omkhulu eqophelweni lempilo.

Ukuqwasha kutholwa ngokuyinhloko ngokusekelwe emlandweni wokulala wesiguli. I-Polysomnography iwuhlobo locwaningo lokulala, olwenziwa kuphela ezigulini ezinezinkinga zokulala ezifana nokuphazamiseka kwezitho zomzimba ngezikhathi ezithile (PLMB) noma i-obnetive obstructive sleep apnea (OSA). Ukwelashwa kokuqwasha kuhlanganisa inhlanganisela yemithi, ukuziphatha noma izindlela zokwelapha ngokwengqondo, kanye nokuguqulwa kwendlela yokuphila.

Ukuqwasha kuvame ukudalwa ngenxa yesifo esiwumsuka noma isimo. Ezinye zezimbangela ezivame kakhulu zokuqwasha yilezi:

• Ubuhlungu: Ubuhlungu obunamandla obungokomzimba obufana nobu amazinyo, ubuhlungu besisu nokunye kubangela ukuphazamiseka kokulala kuze kuphele ukuvuvukala nobuhlungu.
• Imikhuba Emibi Yokudla: Ukudla ngokweqile noma ukudla isidlo esikhulu ebusuku kakhulu kuphazamisa umzimba. Iphinde iphazamise umjikelezo wokulala futhi ibangele ukuqwasha.
• Ukuhamba kanye ne-Jet Lag: Ukuhamba usuka kwenye indawo yesikhathi uya kwenye kushintsha isigqi esivamile somzimba we-circadian futhi kubangela ukuqwasha kwesikhashana.
• Izinguquko Ku-Shift Yomsebenzi: Izinguquko emsebenzini zibangela ukuqwasha kwesikhashana kwabanye abantu njengoba bedinga isikhathi sokulungisa kabusha iwashi lomzimba wabo.
• Ukucindezeleka: Abanye abantu bayakhathazeka noma bakhathazeke ngezinto ezingasho lutho futhi baphelelwe ubuthongo. Nokho, kungokwemvelo ukukhathazeka ngomcimbi wakamuva noma isigameko esingalindelekile, kodwa akumele kuthinte ikhwalithi nenani lokulala.
• Ukukhathazeka Nokuxineka: Ukukhathazeka noma ukucindezeleka kuthinta ukulala futhi kubangela ukuqwasha.
• Izimbangela Zebhayoloji: Izinguquko zebhayoloji njengokuguga zithinta iphethini yokulala. Abantu abadala bavame ukulala kancane futhi bavuke kaningi ebusuku.
• Izinguquko zeHormonal: Ukungalingani kweHormonal kubangela ubunzima bokulala ikakhulukazi kwabesifazane ngesikhathi ukukhulelwa futhi menopause. Lezi zinguquko ngokuvamile zibangelwa izinguquko emazingeni e-estrogen.

Imibandela Yezokwelapha

Izimo ezithile zezempilo eziphazamisa ukulala yilezi:

• Asthma
• Isifo Sokuqaqamba Kwamalunga
• isilungulela
• I-Hyperglycemia
• Hyperthyroidism
• Isifo sendlala yesinye
• Angina noma ubuhlungu besifuba
• Ukuqunjelwa yokumelwa yinhliziyo
• Isifo sokuphelelwa yisikhathi esingapheli
• kungakhuphula izinga likashukela ngenxa ye sikashukela
• Isifo se-pulmonary esingamahlalakhona
• I-reflux ye-Acid or i-reflux yesisu isifo
• I-Restless leg syndrome: I-Restless leg syndrome yisifo sesimiso sezinzwa esibonakala ngokuzwa okungemnandi noma okuvuthayo emilenzeni. Kubangela ukuthi umuntu anyakaze imilenze kungenasidingo. Lo muzwa ongajabulisi ungase umenze avuke ebuthongweni.
• I-Apnea yokulala: I-apnea yokulala kuhlotshaniswa nobunzima bokuphefumula ngenkathi ulele. Kubangela ukuphaphama phakathi nobuthongo.
• Imithi: Imithi enjengama-antidepressants, anti-hypertensive, ne-asthmatics ingaphazamisa ukulala futhi ibangele ukuqwasha.
• Ukudla ngokweqile i-caffeine, i-nicotine, notshwala: Caffeine futhi i-nicotine isebenza njengezikhuthazi zesimiso sezinzwa. Ukudla imikhiqizo ecebile nge-caffeine ne-nicotine ebusuku kakhulu kuphazamisa ukulala futhi kubangela ukuqwasha. Utshwala ngokuvamile bubangela ukuphaphama phakathi nobusuku ngokuvimbela izigaba ezijulile zokulala. Nokho, umphumela walezi zinto uyahlukahluka kuye nomuntu.
• Ukuntuleka kokuzivocavoca umzimba: Ukuntuleka kokuzivocavoca umzimba noma ukuzijabulisa kungabangela ukuqwasha.

Izinhlobo Zokuqwasha

• I-Acute Insomnia: Kubonakala ngesiqephu esifushane sobunzima bokulala obubangelwa izenzakalo ezicindezelayo ekuphileni noma ngenxa yokucindezeleka. Ivamise ukuxazulula ngaphandle kwanoma yikuphi ukwelashwa.
• Ukuqwasha Okungapheli: Yisikhathi eside ikhona ukuphazamiseka kokulala ebonakala ngokuba nenkinga yokulala noma ukulala okungenani ubusuku obuthathu ngeviki izinyanga ezintathu noma ngaphezulu. Kungase kubangelwe ngenxa yomlando wesikhathi eside wezinkinga zokulala.
• I-Comorbid Insomnia: Kubangelwa ngenxa yezinye izimo zezokwelapha ezifana nesifo samathambo noma ukuhlungu obusemhlane, okwenza kube nzima ukulala.
• Ukuqala Ukuqwasha: Kubonakala ngobunzima bokulala ekuqaleni kobusuku.
• Ukuqwasha Kwesondlo: Kubonakala ngokungakwazi ukuhlala ulele. Abantu abanenkinga yokuqwasha yesondlo bavuka ebusuku futhi babe nobunzima bokubuyela lapho bezolala.

Ukuqwasha ngokwako kuthathwa njengophawu lwezinye izimo zezokwelapha ezinjengokukhathazeka okungapheli noma ukucindezeleka.

Ezinye zezikhalazo ezijwayelekile ezihambisana nokuqwasha yilezi:

• Ubunzima bokugcina ubuthongo
• Inkinga yokulala ebusuku
• Ethanda ukulala emini
• Ukuzizwa ukhathele futhi ukhathele emini
• Ukuvuka ungazizwa ushajwe kabusha noma uqabulekile
• Ukuzizwa ubuthakathaka noma ukhathele ngisho nangemva kokulala ebusuku
• Ukuvuka ngaphambi kwesikhathi esibekiwe
• Ukuvuka ebusuku noma ukuvuka izikhathi eziningana ebusuku

Izinkinga Zokuqwasha

• Isifo senhliziyo
• Ukukhanda ikhanda
• Amazinga aphansi wamandla
• Ukuncipha kwesikhathi sokunaka
• Inkumbulo emibi futhi khumbula
• Ukugxila okungalungile nokugxila
• Ukuntuleka kokuxhumana namaphutha
• Ukungabi nesisusa esifanele
• Ukungenzi kahle emsebenzini noma esikoleni
• Ukungakwazi ukwenza imisebenzi elula yansuku zonke
• Ubunzima bokuxhumana nabantu nabanye
• Imisebenzi ephansi yokuzivikela komzimba
• Ukukhathazeka njalo nokuphatheka kabi
• Izimpawu zezinkinga zesisu
• Ukukhathazeka kanye ukucindezeleka
• Imizwa yokuguquguquka nokucasuka

• Ubudala: Abantu abadala basengozini enkulu yokuqwasha ngenxa yoshintsho lwendlela yokuphila njengokungawuvivinyi umzimba, ukwanda kwezinkinga zempilo, nokwanda kokusetshenziswa kwemithi. Amawashi omzimba wabantu abadala ayaphazamiseka futhi lokhu kungase kuphazamise isikhathi sabo sokulala abasifisayo. Ngokuvamile, abantu asebekhulile banokulala okujulile, ukuhlukana okuningi kokulala, futhi basebenzisa inani elikhulu lemithi, konke okwandisa ingozi yokuqwasha.
• Ubulili: Abesifazane basengozini enkulu yokuqwasha kunabesilisa ngenxa yoshintsho lwamahomoni olwenzeka ngesikhathi sokuthomba, ukukhulelwa, isikhathi sangemva kokubeletha, noma ngesikhathi sokuya esikhathini nangemva kokunqamuka kokuya esikhathini.
• Izinguquko zokuphila: Impilo engeyinhle njengokwenza amashifu, ukubhema noma ukusebenzisa eminye imikhiqizo kagwayi, ukuphuza utshwala noma ukuphuza iziphuzo ezine-caffeine ntambama noma kusihlwa, nokuzivocavoca umzimba sekusondele isikhathi sokulala kulimaza imikhuba yokulala futhi kwandisa ingozi yokuqwasha.
• Imithi: Imithi efana ne-steroids, i-theophylline, i-phenytoin, i-levodopa, kanye ne-serotonin reuptake inhibitors ekhethiwe yandisa ingozi yokuqwasha.
• Izimo Zempilo Yengqondo: Iziguli ezinokucindezeleka, ekusebenziseni kabi izidakamizwa notshwala, ukukhathazeka, nezinye izimo zezokwelapha ezifana nesifo senhliziyo, ukuphazamiseka kwemisipha, izimo zesisu, ukuphazamiseka kwe-endocrine, ukwehluleka kwezinso okungapheli, nesifo sezinzwa kunengozi yokuqwasha.

Ukuqwasha ngokuyinhloko kutholwa umlando wesiguli. Okunye ukuhlola nophenyo udokotela angase alwenze ukuze axilonge ukuqwasha kuxoxwa ngezansi:

• Umlando Wokulala: Ekuqaleni udokotela uqoqa umlando wokulala wesiguli ukuze ahlole ukuqwasha okuyisisekelo. Kuyasiza udokotela ukuthi alandele indlela ehlelekile yokuxilonga ukuqwasha. Umlando wokulala uqukethe incazelo evamile yalesi sifo njengobude baso, ubunzima, ukuhluka, namaphethini okulala emini ngokusekelwe kulokho isiguli esihlangabezane nakho kanye nolwazi olunikezwa isiguli.
• Umlando Wemithi: Imithi ehlukahlukene efana ne-phenytoin ne-lamotrigine, i-beta-blockers, i-antipsychotics, i-serotonin reuptake inhibitors (SSRIs) ekhethiwe noma i-monoamine oxidase inhibitors (MAOIs), kanye nezidakamizwa ezingezona ukuvuvukala (ama-NSAID) njenge-indomethacin, i-diclofenac, ne-naproxe I-sulindac ibangela ukuqwasha. Ngakho, udokotela uzohlola ukuthi isiguli sithatha noma yimiphi yale mithi.
• Idayari Yokulala noma Irekhodi Lokulala: Idayari yokulala isiza ukuhlonza imikhuba yokulala engalungile yesiguli njengokuthatha isihlwathi noma ukuchitha isikhathi esiningi embhedeni (ngaphezu kwamahora angu-8). Isiguli siyalwa ukuba sibhale okuhlangenwe nakho kwaso kwansuku zonke kanye nephethini yokulala edayari. Kuyasiza ukulandela umkhondo wokuthobela ukungenelela kokuziphatha kanye nokusabela ekwelashweni.
• Isilinganiso Sokulala Nengqondo: I-Epworth Sleepiness Scale (ESS) ilinganisela ithuba lokozela ngesikhathi umuntu enza noma yimiphi imisebenzi elandelayo:
  • Ukuhlala nokufunda
  • Ukubuka umabonakude
  • Ukuhlala ngokungenzi lutho endaweni yomphakathi
  • Ukuhamba ihora ngaphandle kokuphumula
  • Ngesikhathi elele ukuze aphumule ntambama
  • Ukuhlala nokukhuluma nomuntu isikhathi eside
  • Ukuhlala ngokuthula ngemva kwesidlo sasemini ngaphandle kokuphuza utshwala
  • Ngenkathi ulinde uphawu lomgwaqo emotweni

Into ngayinye kwezingenhla ilinganiselwe esikalini samaphuzu angu-4 ngale ndlela elandelayo:

• 0 - awekho amathuba okuthi ukozela;
• 1 - amathuba amancane okozela;
• 2 - amathuba amaphakathi okozela; futhi
• 3 - amathuba aphezulu okozela.

Uma umuntu ethola amaphuzu angaphezu kuka-16, lokho kubonisa ukulala kwasemini.

• Ukuhlolwa ngokomzimba kanye Nomlando Wezokwelapha: Kuzokwenziwa ukuhlolwa okujwayelekile komzimba, futhi umlando wezempilo wesiguli uzobuyekezwa ukuze kwaziwe ukuthi umuntu unazo yini izimo ezifana nalezi. izifo ezingama-pulmonary ezingapheli (COPD), isifuba somoya, noma i-restless leg syndrome engase iphazamise ukulala.
• Izivivinyo zegazi: Ukuhlolwa kwegazi kuyenziwa ukuze kwaziwe ukuthi isiguli sinaso yini ukuphazamiseka kwamahomoni njenge izifo ze-thyroid, ukuntuleka kwe-iron anemia, noma ukushoda kukavithamini B12 okubangela ukuqwasha.
• I-Polysomnography: Kubhekwa njengezinga eligolide lokulinganisa ukulala ezigulini ezinokuqwasha okungapheli. I-Electroencephalogram (EEG), i-electrooculography (EOG), i-electromyography (EMG), i-electrocardiography (ECG), i-pulse oximetry, kanye nokugeleza komoya kusetshenziswa ukuze kutholakale izimo ezihlukahlukene ezifana nokuphazamiseka kokuhamba kwezitho ngezikhathi ezithile, i-apnea yokulala, kanye i-narcolepsy. Lokhu kuhlola futhi kusiza ukuqapha nokuqopha iphethini yamaza obuchopho, ukuphefumula, ukushaya kwenhliziyo, nokunyakaza kwamehlo kumuntu ngamunye.
• I-Actigraphy: Kuyasiza ukukala umsebenzi womzimba womuntu. Kuwumshini ophathwayo, umuntu okufanele awugqoke esihlakaleni. Idatha erekhodiwe ingagcinwa amasonto ambalwa bese ilandwa ikhompuyutha. Isikhathi sokulala nokuvuka singahlaziywa ngokuhlaziya idatha yokunyakaza. Ukuncipha kokulala nesikhathi sokuvuka kubhalwe ezigulini ezinokuqwasha.

Ukwelashwa kokuqwasha ikakhulukazi ihlose ukwelapha isimo sezempilo esiwumsuka noma izinkinga ezingokwengqondo. Ukuhlonza ukuziphatha okungalungile okwenza ukuqwasha kube kubi kakhulu kusiza iziguli ukuba zithuthukise impilo enempilo futhi ziqede ukuqwasha. Ukwelashwa kuhlanganisa inhlanganisela yokwelashwa kwengqondo-yokuziphatha kanye nemithi.

Funda Futhi: Isimo Sokucindezeleka Esicindezelayo Sokuthunyelwa 

Imithi Yokwelapha Ukuqwasha

Imithi Yokwelapha Ngomqondo-Ngokuziphatha

• I-Stimulus Control Therapy: Ukwelashwa kokulawula isikhuthazi kuphakamisa izenzo ezizovusa ubuthongo. Ezinye zezenzo ezisiza ukuvusa ubuthongo yilezi:
  • Ukulala kuphela lapho uzizwa ulele
  • Sebenzisa ikamelo lokulala kuphela
  • Gcina isikhathi esivamile sokuvuka ekuseni kungakhathaliseki ubude besikhathi sokulala ngobusuku bangaphambilini
  • Gwema ukulala emini
  • Zivocavoce njalo okungenani imizuzu engu-20 ngosuku amahora angu-4-5 ngaphambi kokulala
  • Gwema ukuphuza iziphuzo ezine-caffeine njengetiye, ikhofi, iziphuzo ezibandayo njll., ngemva kwantambama
  • Gwema ukubeka izibani ezinamandla kakhulu, izinga lokushisa, umsindo, njll. ekamelweni lakho

• Ukuvinjelwa Ukulala: Ukwelashwa okukhawulelwe ukulala kuhlanganisa ukukhawulela inani lesikhathi esichithwa embhedeni. Kuyasiza ekuvimbeleni ukulala ngokweqile kwasemini futhi kukhuthaze ukuqala kokulala kusenesikhathi.
• Izindlela Zokwelapha Zokuzilibazisa: Imithi yokuphumula efana nokuphumula kwemisipha okuqhubekayo kanye nezindlela ze-biofeedback zinciphisa ukuvuka. Izinqubo zokunaka ezinjengokuqeqeshwa kwezithombe kunciphisa ukuvuka kwengqondo ngaphambi kokulala. Lezi zindlela zinciphisa ukuphazamiseka kokulala ezigulini ezinokucindezeleka.
• I-Cognitive Therapy: Ukwelapha ngengqondo kuhlose ukushintsha izinkolelo nezimo zengqondo ezingalungile mayelana nokulala kumuntu.
• Imfundo Yenhlanzeko Yokulala: Imfundo yenhlanzeko yokulala isiza ukuthuthukisa indlela yokuphila enempilo ngokuzijwayeza ukudla okunempilo nokuzivocavoca umzimba. Ifundisa izindlela zokunciphisa izici zemvelo ezinjengokukhanya, umsindo, izinga lokushisa, nomatilasi ezingase ziphazamise ukulala.
• Ukungenelela Ekuziphatheni: Isiza iziguli ukuba zithole ukuhlanzeka kokulala kahle futhi zisuse ukuziphatha okungahambelani nokulala, njengokulala embhedeni nokukhathazeka.

Imithi

Imithi kusiza ekwehliseni ukuqwasha ngokulungisa ukungalingani kwamahomoni nokwelapha okucashile ukuphazamiseka kwengqondo.

Eminye yemithi esetshenziswa ekwelapheni ukuqwasha yile:

• Benzodiazepines
• I-Zopiclone
• I-Zolpidem
• Zaleplon
• I-Eszopiclone
• I-Ramelteon
• Ama-anticepressants ama-Tricyclic (TCAs)
• I-Trazodone
• Ama-Antihistamine

Le mithi ivame ukunikezwa isikhathi esifushane (amaviki angu-2 kuya kwangu-3). Ukusetshenziswa isikhathi eside kungase kubangele ukulutheka, kukhinyabeze ukusebenzisana, ibhalansi, noma ukuphaphama kwengqondo.

Le mithi iphikiswa ezigulini ezingezwani nazo, umlando wokusebenzisa kabi izidakamizwa, noma ezine-apnea engelashiwe. Aziphephile kwabesifazane abakhulelwe noma abancelisa.

Ukuqwasha kungavinjelwa ngokuhlakulela imikhuba engcono yokulala. Eminye yemikhuba emihle yokulala ibhalwe ngezansi:

• Lala kuphela lapho uzizwa ukhathele.
• Phuza ingilazi yobisi olufudumele ngaphambi kokulala.
• Qinisekisa ukuthi igumbi lakho lokulala lithulile futhi limnyama.
• Gcina igumbi lakho lokulala lisezingeni lokushisa elinethezeka.
• Ungawuvivinyi amahora ambalwa ngaphambi kokulala.
• Sebenzisa igumbi lokulala kuphela ukulala nokwenza ucansi.
• Gwema ukudla ukudla okukhulu noma ukuphuza amanzi amaningi kusihlwa.
• Gwema ukuphuza iziphuzo ezine-caffeine njengekhofi netiye, noma ugwayi ebusuku kakhulu
• Landela umjikelezo wokulala nokuvuka ngisho nangezimpelaviki. Isiza umzimba ukuba uthuthukise isimiso sokulala.
• Gwema ukufunda, ukubukela i-TV, noma ukukhathazeka embhedeni ngoba lokhu kungabangela ukuphazamiseka kokulala
• Gwema ukuthatha isihlwathi isikhathi esingaphezu kwemizuzu engama-30. Ungalali njalo futhi ungalali ngemva kuka-3:00 ntambama
• Geza ngamanzi afudumele ngaphambi kokuyolala noma ufunde inoveli noma indaba imizuzu eyi-10 njalo ebusuku ngaphambi kokulala.

Isiphetho

Uma futhi uhlushwa yizinkinga zokulala, kungcono ukuxhumana nodokotela ngokushesha ngangokunokwenzeka. Ngoba ukulala kahle ebusuku kubaluleke kakhulu ekuphileni okunempilo. Ngakho-ke qiniseka ukuthi uhlala ungenayo ingcindezi futhi ujabulele ukulala okuzwakalayo njalo ebusuku, njalo ebusuku.

Uhlolojikelele

Izinkinga zokuqwasha

Izimpawu Zokuqwasha

I-Insomnia Risk Factors

I-Insomnia Diagnosis

Ukwelapha Ukuqwasha

Ukuvimbela Ukuqwasha

Imibuzo Evame Ukubuzwa

Ingabe ukuqwasha kungase kubeke ukuphila engozini?

Ukuqwasha kakhulu akusona isimo esisongela ukuphila. Kodwa, ukuqwasha kwesibili okubangelwa yi-obstructive sleep apnea kungasongela ukuphila. Khumbula ukuthi ukuqwasha ngokwako akuyona inkinga, kodwa imbangela yokuqwasha iyingozi futhi ingaba yingozi empilweni.

Kuyini jet lag?

I-Jet lag ukungalingani kwesikhashana kwesigqi esivamile somzimba sokujikeleza, okubangelwa ukuhamba komoya okunesivinini esikhulu ezindaweni ezihlukene zesikhathi. Iphazamisa iwashi lebhayoloji lomzimba lishintsha umumo walo osethiwe ubheke emini nasebusuku. Ngakho-ke, umuntu angase abhekane nokukhathala nokulala ngamahora angajwayelekile, ukucasuka kanye nezinye iziphazamiso ezihlukahlukene zokusebenza.

Ingabe ukuqwasha kuyaziphelela ngaphandle kokwelashwa?

Yebo, ukuqwasha kwesikhashana noma okubabazekayo okubangelwa izenzakalo ezicindezelayo zokuphila kuyaphela ngemva kokuba isigaba sokucindezeleka sesiphelile. Ukuqwasha okungapheli noma okungapheli kudinga ukwelashwa.