Unonetsekawo here muhope dzako? Unoridza mhere here? Ngatidzidzei nezveREM Sleep Behavior Disorder (RBD)!

Mudiwa wako kana mumwe munhu mumba mako akambokuudza here kuti unoridza mhere, unorova muromo, uye dzimwe nguva unotorwisa mumwe munhu uri kurara? Ungangove wakamukawo uine mavanga pamuviri wako uchizvibvunza kuti, "Chii chakaitika kwandiri?" Izvi zvingasava kurota kwakaipa chete. Nhasi, tichataura nezvemaitiro aya asingawanzoitika ekurara, anonzi REM Sleep Behavior Disorder, kana kuti RBD.

Chii chinonzi `REM Sleep Behavior Disorder (RBD)`?

Zvichitaurwa zviri nyore, `REM Sleep Behavior Disorder (RBD)` zvinoreva kana uri muchikamu chekurara che`REM (Rapid Eye Movement)`, uye unonyatsoita zviroto zvako, kureva kuti, kuita zvinhu zvaunoita muzviroto zvako, uchitaura muzviroto zvako. Hauzvizivi paunenge uchiita zvinhu izvi. Chirwere ichi che`RBD` chinowira muchikamu che`parasomnia`. `Parasomnia` chirwere chekurara chinoratidzwa nezviitiko zvisingawanzoitiki uye zvisingadiwe kana zviitiko zvinokanganisa kurara.

Patinorara, pane matanho akasiyana ekurara. Rimwe rematanho aya rinonzi `REM sleep` . `REM` inomiririra `Rapid Eye Movement`. Apa ndipo patinofamba-famba maziso nekukurumidza. Apa ndipo patinowanzova nehope dzakajeka uye dzakajeka. Tinopfuura nepakati pematanho aya e`REM` kakawanda husiku. Kutenderera kwekutanga kwe`REM` kunotanga maminetsi angangoita makumi mapfumbamwe mushure mekunge tarara, uye kunotora maminetsi angangoita gumi. Kutenderera kwega kwega kwe`REM` kunotevera kunotora nguva yakareba.

Kune mhando mbiri huru dze `RBD`:

1. `Isolated (idiopathic) RBD`: Izvi zvinoreva kuti chirwere ichi chinoitika pasina chikonzero chaicho. Zvinosuwisa kuti vanhu vazhinji vane `isolated RBD` vanogona kuzopedzisira vava ne`neurodegenerative condition` (chirwere chinopedza simba tsinga zvishoma nezvishoma). Zvikuru sei, zvirwere zvakaita se`Parkinson's disease` (Parkinson's disease), `Lewy body dementia` (Lewy body dementia) kana `multiple system atrophy (MSA)` (multiple system atrophy). Zvirwere izvi zvinowanzonziwo `alpha-synucleinopathies`.

2. Zviratidzo zveRBD (zvechipiri): Izvi zvinokonzerwa nechimwe chirwere chiripo. Semuenzaniso, zvinogona kuitika kuvanhu vane chirwere chekurara chinonzi Type 1 narcolepsy . Kana munhu aine alpha-synucleinopathy neRBD zvataurwa pamusoro apa, zvinoonekwawo sechirwere chechipiri cheRBD.

Uyewo, vanhu vanotora mimwe mishonga yekudzora kushungurudzika vanogona kuwana RBD. Izvi zvinonzi drug-induced RBD .

Nekuti `RBD` iyi inogona kukonzera kukuvara kusingatarisirwi kwauri kana kumunhu wauri kurara naye, zvakakosha kuti uzive izvi uye utsvage kurapwa kana zvichidikanwa.

Ndiani ane mukana mukuru wekuwana RBD?

Dambudziko reREM Sleep Behavior Disorder (RBD) rinowanzo bata vanhu vane makore anopfuura makumi mashanu.Avhareji yezera rekutanga kwechirwere ichi inosvika makore makumi matanhatu nerimwe. Zvisinei, kashoma, chirwere ichi chinogonawo kuitika kuvana vadiki nevechidiki.

Pakati pevanhu vane makore anopfuura makumi mashanu, varume vane mukana wekuwana RBD wakapetwa kapfumbamwe kupfuura vakadzi .

RBD inobatanidzwa zvakanyanya nemamwe matambudziko etsinga. Sezvambotaurwa, zvakaonekwa kuti vanhu vazhinji vane RBD yakazvimiririra (idiopathic) (kureva RBD inoitika pasina chimwe chikonzero) vanowana chirwere cheParkinson, Lewy body dementia, kana multiple system atrophy (MSA) mukati memakore gumi nemana ekuongororwa .

Vanhu vanosvika 36% vane chirwere che "Type 1 narcolepsy" vanogona kunge vaine chirwere chechipiri chinonzi "RBD". Uye vanhu vanosvika 6% vanotora mishonga yekudzora kushungurudzika vanogona kunge vaine chirwere chinonzi "RBD" chinokonzerwa nemishonga.

RBD yakajairika zvakadii?

Dambudziko reREM Sleep Behavior Disorder (RBD) chirwere chisingawanzoitiki . Chinobata vanhu vanosvika 1% chete. Muvanhu vane makore anopfuura 50, chinenge 2%.

Asi nhamba idzi dzinogona kunge dziri pasi pane dzadziri chaizvo, nekuti RBD inogona kuoma kuona, uye inenge hafu yevanhu vane chirwere ichi havatombozivi kuti vanacho .

Ndezvipi zviratidzo zve `RBD`?

Zviratidzo zve `RBD` zvinogona kusiyana kubva pamunhu kusvika pamunhu. Vamwe vanhu vanozviona kakawanda, nepo vamwe vasingazvioni kakawanda. Munhu paanenge akarara, anogona kunzwa sekunge ari kurota hope dzakaipa. Heano zvimwe zvinhu zvinogona kuitika:

• Nyama iri pamuviri wangu inofamba zvishoma nezvishoma, makumbo angu anogwinha.
• Kutaura, kupopota, uye dzimwe nguva mashoko akaipa anotaurwa.
• Vanonyepedzera kurova kana kubata mumwe munhu, kana kuti vanogona kutorova kana kukava munhu ari pamubhedha.
• Kusvetuka kubva pamubhedha, kuwira pasi.

Fungidzira, shamwari yako, Nilanthi, nemurume wake, Sugat, vakarara husiku uye kamwe kamwe vanodanidzira vachiti "Bata! Bata!" votambanudza maoko avo sekunge vari kuda kurova mumwe munhu. Dzimwe nguva Sugat anodonha pamubhedha ozvikuvadza. Pavanomuka mangwanani, Sugat haayeuki chero chinhu, asi anoyeuka hope dzaakarota. Aya ndiwo maitiro e 'RBDs'.

Zvinonzi vanhu vasere pavanhu gumi vane RBD vanotambura nekukuvara kwehope .

Zviitiko izvi zvinogona kuitika kamwe chete kana kakawanda panguva yekurara kamwe chete. Vamwe vanhu vanozviona husiku hwese, asi vamwe havazvioni kakawanda. Zviratidzo zvinonyanya kuipa kana munhu achirota hope dzakakomba.

Chinhu chakakosha ndechekuti, hauzive kuti zvinhu izvi zvinoitika riini. Vanhu vazhinji vanongozviziva chete kana mumwe munhu ari pamubhedha akavaudza, kana kana mumwe munhu ari kumba akavaona, kana pavanomuka mangwanani vaine ronda pamuviri wavo.

Kana mumwe munhu akakumutsa panguva ino, unogona kumuka zviri nyore. Paunomuka, unenge wakangwarira uye uchiyeuka zviroto zvako. Izvi zvinonzi 'zvinotyisa zvehusiku'.Zvakasiyana ne "kutya kwehusiku". Zvakaoma kumutsa munhu, uye kunyangwe paanomuka, anoita seanetseka uye avhiringidzika.

Dzimwe nguva vanhu vane `Obstructive sleep apnea (OSA)` (kuvharirwa kwekufema panguva yekurara) vanogonawo kuratidza zviratidzo izvi. Izvi zvinonzi `pseudo RBD` . Muvanhu vakadaro, kana `OSA` yakarapwa, maitiro acho anonyangarika.

Ndezvipi zvikonzero zve `RBD`?

Kazhinji, patinenge tiri muhope dze'REM', patinorota, tsandanyama dzedu zhinji (kunyanya tsandanyama dzemapfupa) dzinorasikirwa nebasa radzo kwenguva pfupi. Izvi zvinonzi 'muscle atonia' . Izvi zvinoitika kuti tigone kurota takachengeteka tisina kuita zvinhu zvatiri kuita muzviroto zvedu. Fungidzira zvaizoitika dai tisina izvozvo! Kana tikamhanya muzviroto zvedu tosvetuka muzviroto zvedu, tinogona kupinda mutsaona, handiti?

Asi vanhu vane RBD havasangani nekurasikirwa kwenguva pfupi kwebasa retsandanyama kunonzi muscle atonia. Ndosaka vachiita zvinhu vasingazive uye vachitaura nezvezvinhu zvavanoita muzviroto zvavo. Vaongorori vachiri kusanzwisisa zvizere kuti sei izvi zvichiitika. Kune nzira dzakawanda dzakaoma dzetsinga dzinobatanidzwa mukurara kweREM.

Zvikonzero zve 'Isolated (idiopathic) RBD'

Imwe dzidziso huru ndeyekuti RBD yakatsaurwa (idiopathic) inokonzerwa nedambudziko riri mupons, chikamu cheuropi, chinokonzera tsandanyama atonia panguva yekurara kweREM. Mamwe masero ari mupons anodzora kusimba kwetsandanyama panguva yekurara kweREM. Maronda ari mupons akabatanidzwawo nechirwere cheParkinson, Lewy body dementia, uye MSA. Nekuda kwehukama hwakasimba huripo pakati peRBD yakatsaurwa nezvirwere izvi, vaongorori vanotenda kuti dambudziko riri mupons rinogona kunge riri iro rinokonzera.

Imwe ongororo yakaratidza kuti 97% yevanhu vane `RBD yakaparadzaniswa` vanowana chimwe chezvirwere izvi zvetsinga mukati memakore gumi nemana ekuonekwa kwavo se`RBD`, uye `Parkinson's disease` ndiyo inonyanya kuwanikwa.

Zvinokonzera `Secondary (zviratidzo) RBD`

Vanhu vane chirwere chenarcolepsy vane huwandu hushoma hwekemikari yeuropi inonzi orexin kana hypocretin . Kemikari iyi inodzora kurara, kumuka, uye kuda kudya. Kana kemikari iyi yakaderera, inogona kukanganisa kurara kweREM, zvichikonzera RBD.

Zvinokonzera 'RBD Inokonzerwa Nemishonga'

Vaongorori vanotenda kuti RBD inokonzerwa nemimwe mishonga yekuora mwoyo inogona kunge iri nekuda kwekusaenzana kwema neurotransmitters dopamine ne serotonin , ayo anobatanidzwa mukurara kweREM.

Nzira yekuongorora `RBD` sei? (Kuongororwa)

Kana uine zviratidzo zve `RBD`, unofanira kuona chiremba.Chiremba achakubvunza nezvezviratidzo zvako uye nhoroondo yako yehutano. Kana uine mumwe munhu waunorara naye kana nhengo dzemhuri, chiremba anogonawo kumubvunza nezvemaitiro ako ekurara.

Chiremba achakuongorora muviri wako uye achakuongororwa netsinga. Unogonawo kutumirwa kuna chiremba wehope.

Kuti uzive kana uine RBD, unofanirwa kuita vhidhiyo yekudzidza nezvekurara murabhoritari, inozivikanwawo se polysomnogram (PSG) . Izvi zvinowanzoitirwa muchipatara kana nzvimbo yekurara, kwaunopedza husiku hwese uchitariswa nekamera. Bvunzo iyi inonyora zvinhu zvinotevera nezvemuviri wako paunenge wakarara:

• Kurova kwemoyo.
• Kufamba kwemhepo uye kufamba kwemhepo.
• Kushanda kwemafungu europi.
• Kufamba kwemaziso.
• Kufamba-famba kwetsandanyama dzechirebvu chako nedzemakumbo ekumusoro.

Zvichienderana neInternational Classification of Sleep Disorders, Third Edition (ICSD-3), zvese zvinotevera zvinofanirwa kunge zviripo kuti munhu aonekwe aine RBD:

• Unoramba uchiita zviitiko apo unotaura wakarara uye/kana kuita mafambiro akaomarara.
• Maitiro aya anofanira kusimbiswa nebvunzo yepolysomnography (PSG) uye anofanira kuitika panguva yekurara kweREM. Kana, zvichibva pane zvakaitika kwauri, anofanira kunge achiratidza kurara kweREM.
• Bvunzo ye `PSG` inofanira kuratidza kuti une `muscle atonia` (kurasikirwa nehupenyu hwetsandanyama) panguva yekurara kwe `REM`. (`REM sleep isina atonia` - RWA).
• Zviitiko zvine chekuita nepfari zvinofanira kupera panguva yekurara kweREM.
• Matambudziko aya ekurara haafanirwe kutsanangurwa zvakanaka nedambudziko rekurara, rimwe chirwere, chirwere chepfungwa, mhedzisiro yemishonga, kana dambudziko rekushandisa zvinodhaka.

RBD inorapwa sei?

Chinangwa chikuru pakurapa chirwere ichi ndechekupa iwe nemumwe wako hope dzakachengeteka . Kune nzira dzakasiyana siyana uye dzimwe nguva mishonga yekurapa chirwere ichi.

Matanho ekutora kuti uchengetedzeke

Heano zvimwe zvinhu zvaunogona kuita kuti ugadzire nzvimbo yakachengeteka yekurara:

• Bvisa zvinhu zvakapinza, magirazi, uye zvinorema kubva pamubhedha.
• Isa chimwe chinhu chakapfava, senge piro, pakati pako neheadboard kana nightstand.
• Isa matiresi pasi pedyo nemubhedha kana ukadonha kubva pamubhedha, kana kuisa simbi dzakagadzirwa padivi pemubhedha kumativi ese emubhedha.
• Kune vamwe vanhu, kurara mubhegi rekurara kunogonawo kubatsira.

Kana zviratidzo zvako zvakanyanya, zvingava zvakanaka kuti urare wega muimba yakasiyana kuti mumwe wako agare akachengeteka.

Uyewo, unofanira kurega kunwa doro zvakanyanya sezvinobvira , sezvo doro rinogona kuwedzera kuwanda kwe `RBD` uye kuita kuti mamiriro acho awedzere kuipa.

Mishonga ye `RBD`

Kana zviratidzo zvako zvakanyanya, uye matanho ekuchengetedza chete asingakwanise kudzivirira kukuvara, chiremba wako anogona kukupa mishonga yekudzora zviratidzo zvako. Kunyangwe pasina mishonga inotenderwa neFDA yakanangana neRBD, zvidzidzo zvakaratidza kuti melatonin, clonazepam, uye pramipexole dzimwe nguva zvinogona kuderedza zviratidzo.

• Melatonin: Iyi ihormone inogadzirwa nepineal gland iri muuropi hwedu. Yakakosha pakugadzirisa kurara kwedu nekumuka. Melatonin yakagadzirwa inowanikwa semushonga. Iyi inoonekwa semushonga wekutanga wekurapa RBD nekuti haina migumisiro yakawanda. Chiremba anotanga nedosi shoma uye anowedzera dosi zvishoma nezvishoma kusvika zviratidzo zvadzikira.
• Clonazepam: Uyu mushonga wekunyaradza. Vaongorori havasati vava nechokwadi chekuti unobatsira sei neRBD. Zvisinei, vanhu vazhinji vane RBD vanoona kuti kutora clonazepam musati marara kunoderedza kana kubvisa hope dzakaipa, kuridza mhere, uye kufamba-famba wakarara. Zvisinei, clonazepam inogona kuva nemigumisiro isingafadzi. Ndokusaka chiremba wako angakunyorera kana melatonin isingape zororo rakakwana.
• Pramipexole: Uyu mushonga wedopamine agonist. Vanachiremba ndivo vanonyanya kuupa mushonga weParkinson's disease uye restless leg syndrome. Asi tsvakiridzo yazvino yakaratidza kuti inogonawo kuderedza zviratidzo zveRBD. Vaongorori vanotenda kuti mushonga uyu unoshanda nekuti RBD chirwere chinokonzerwa nekushaikwa kwedopamine (dopaminergic deficiency disorder).

Ko RBD inogona kudzivirirwa here?

Kazhinji, hapana chatingaita kudzivirira RBD. Izvi zvinokonzerwa nekuti pane zvinhu zvine njodzi zvatisingakwanise kudzivirira kana kuchinja. Semuenzaniso, zera rako, kana kuti une chirwere chepfungwa kana kuti une dambudziko repfungwa.

Asi kana RBD ichikonzerwa nezvinhu zvakaita sedoro, uye kana zviratidzo zvikawedzera, RBD inogona kupera kana warega kushandisa zvinhu izvozvo.

Chii chinonzi fungidziro yeRBD?

Nzira yeramangwana yeRBD, ndiko kuti, uko chirwere chichaenda, inoenderana nezvinhu zvakati wandei:

• Kana paine chikonzero chiripo. Kureva kuti, ingave iri nekuda kwe `narcolepsy` (`RBD` yechipiri), mushonga wekudzora marwadzo (`RBD inokonzerwa nemishonga`), kana kuti yakangoerekana yaitika (zvisingatarisirwi - `RBD yakaparadzaniswa`).
• Zviratidzo zvako zvakakomba sei uye kana zviri kukukuvadza.
• Kutsvaga kurapwa here kana kuti kwete.
• Kana uine chirwere chetsinga pamwe chete neRBD.

Chinhu chakakosha uye chakakomba cheRBD ndechekubatana kwayo nezvirwere zvetsinga, kunyanya chirwere cheParkinson, multiple system atrophy, uye Lewy body dementia. Humbowo huri kuramba huchikwira hunoratidza kuti RBD inogona kunge iri chiratidzo chekutanga chezvirwere izvi. Izvi zvinonyanya kuitika kana RBD ikaitika yega, pasina chimwe chikonzero, uye isiri nekuda kwenarcolepsy kana mushonga.

RBD inogona kukonzera kukuvara kukuru kwauri kana kune mumwe wako ari kurara, saka zvakakosha kuti utsvage kurapwa.

Kufanotaura kwevanhu vane RBD uye vane chirwere chetsinga kazhinji hakuzi kwakanaka. Semuenzaniso, zvakaonekwa kuti vanhu vane chirwere cheParkinson neRBD vari muchikamu chekutanga chehupenyu hwavo vane hupenyu hwakaderera pane vanhu vane chirwere cheParkinson chiri muchikamu chekutanga chehupenyu asi vasina RBD.

Ndezvipi zvinetso zvinogona kuitika nekuda kweRBD?

Vanhu ava vari panjodzi huru yekuzvikuvadza kana kukuvadza vamwe pamubhedha nekuda kwekufamba kwavo zvine simba panguva yekurara. Uyewo, sezvo kurara kuchiwanzokanganiswa, izvi zvinogona kukanganisa kunaka kwekurara.

Mhando dzekukuvara dzinogona kuitika:

• Maronda.
• Kuchekwa.
• Kutsemuka kwemuviri.
• Mapfupa akatyoka.
• Matambudziko akakomba akadai sekukuvara mumusoro uye hematomas iri pasi peganda (kubuda ropa mukati medehenya) .

Dzimwe nguva kukuvara uku kunogona kuisa hupenyu panjodzi .

Zvinonzi 90% yevanhu vane RBD vane matambudziko ekurara , uye vanopfuura 60% vakakuvara mumuviri .

Saka, zvakakosha zvikuru kutsvaga kurapwa kweRBD uye kugadzira nzvimbo yekurara yakachengeteka.

Unofanira kuona chiremba rini nezve `RBD`?

• Kana wakamboonekwa uine `isolated RBD` (RBD isina chimwe chikonzero), uchafanira kuona chiremba nguva nenguva kuti 'uongorore zviratidzo' zvezvirwere zvetsinga zvingave zvine chekuita nazvo (`Parkinson's`, `Lewy body dementia`, `MSA`).
• Kana ukaona zviratidzo zvitsva, zvakaita sematambudziko ekufamba kana shanduko dzepfungwa, enda kuna chiremba nekukasika.
• Kana iwe kana mumwe munhu waunorara naye akakuvara nekuda kweRBD, tsvaga rubatsiro rwechiremba nekukasika.

`RBD` chirwere chepfungwa here?

Kwete, `REM Sleep Behavior Disorder (RBD)` haisi 'chirwere chepfungwa'. Haina kufanana ne 'mood disorder' kana 'anxiety disorder'. `RBD` i'hope disorder' - kunyanya rudzi rwe 'parasomnia'.

Zvinogona kushungurudza uye kushungurudza zvikuru kuzvikuvadza iwe pachako kana mumwe munhu waunorara naye netsaona. Kana mumwe wako akakuudza kuti uri kunetseka kana kuchema uri kurara, usazvitore sezvisina basa. Taura nachiremba. Vangakurudzira kuti mudzidze nezvekurara kuti vaone kana vaine RBD, uye vangakurudzira kurapwa kana zvichidikanwa. Yeuka, chinhu chakakosha kugadzira nzvimbo yakachengeteka yekurara kudzivirira kukuvara.

Chekupedzisira, yeuka izvi (Mharidzo Yekuenda Kumba)

Saka, kana iwe kana mumwe munhu waunoziva ari kuita zvinhu zvisinganzwisisike muhope dzake - kuchema, kukwenya maoko ake, kudonha kubva pamubhedha, nezvimwewo - usazvitore sehope dzakaipa. Zvingave REM Sleep Behavior Disorder (RBD).

Kunyanya kana zvichikonzera kukuvara kwauri kana kune vamwe, iva nechokwadi chekutsvaga mazano echiremba. Yeuka, izvi zvinogonawo kuva chiratidzo chekutanga chezvirwere zvakakomba zvetsinga. Saka, zvakakosha kuti uzvione nekukurumidza uye utore matanho anodiwa. Kurara kwako, kurara kwemumwe wako, uye kuchengetedzeka kwese zviri zviviri zvakakosha zvikuru. Saka chengetedza izvi.

Dambudziko reREM remaitiro ekurara, RBD, matambudziko ekurara, kufamba-famba muhope, kuchema-chema, matambudziko ekurara, matambudziko etsinga