Ngaba nawe uyasokola ebuthongweni bakho? Ngaba uyakhwaza? Masifunde nge-REM Sleep Behavior Disorder (RBD)!

Ngaba iqabane lakho okanye umntu ohlala nawe ekhaya wakha wakuxelela ukuba uyakhwaza, uphefumla, kwaye ngamanye amaxesha ude uhlasele umntu ebuthongweni bakho? Usenokuba uvukile unenxeba emzimbeni wakho waza wazibuza, "Kwenzeke ntoni kum?" Oku kusenokungabi liphupha elibi nje kuphela. Namhlanje, siza kuthetha ngale ndlela ingaqhelekanga yokulala, ebizwa ngokuba yi-REM Sleep Behavior Disorder, okanye i-RBD.

Yintoni i-'REM Sleep Behavior Disorder (RBD)'?

Ngamafutshane, i-`REM Sleep Behavior Disorder (RBD)` kuxa ukwinqanaba lokulala le-`REM (Rapid Eye Movement)`, kwaye ngokwenene wenza amaphupha akho, oko kukuthi, ukwenza izinto ozenzayo emaphupheni akho, uthetha emaphupheni akho. Awuqapheli xa usenza ezi zinto. Le meko ye-`RBD` iphantsi kodidi lwe-`parasomnia`. I-`Parasomnia` sisifo sokulala esibonakaliswa ziziganeko zomzimba ezingaqhelekanga nezingafunekiyo okanye amava aphazamisa ubuthongo.

Xa silele, kukho amanqanaba ahlukeneyo okulala. Elinye lala manqanaba libizwa ngokuba yi -'REM sleep' . I-'REM' imele i-'Rapid Eye Movement'. Kulapho amehlo ahamba khona ngokukhawuleza. Kulapho sihlala siphupha amaphupha acacileyo nacacileyo. Sidlula kule mijikelo ye-'REM' izihlandlo ezininzi ebusuku. Umjikelo wokuqala we-'REM' uqala malunga nemizuzu engama-90 emva kokuba silele, kwaye uhlala malunga nemizuzu eli-10. Umjikelo ngamnye we-'REM' olandelayo uba mide.

Kukho iintlobo ezimbini eziphambili ze-`RBD`:

1. `I-RBD eyodwa (idiopathic): Oku kuthetha ukuba le meko yenzeka ngaphandle kwesizathu esithile. Ngelishwa, abantu abaninzi abane-`i-RBD eyodwa` ekugqibeleni banokufumana 'imeko ye-neurodegenerative' (imeko eyenza buthathaka kancinci inkqubo yemithambo-luvo). Ngokukodwa, izifo ezifana 'ne-Parkinson's disease' (isifo sikaParkinson), 'i-Lewy body dementia ' (i-Lewy body dementia) okanye 'i-multiple system atrophy (MSA)' (multiple system atrophy). Ezi zifo zikwabizwa ngokuba yi-'alpha-synucleinopathies'.

2. I-RBD eneempawu (ezimbini): Oku kubangelwa yenye imeko engaphantsi. Umzekelo, inokwenzeka kubantu abanengxaki yokulala ebizwa ngokuba yi-Type 1 narcolepsy . Ukuba umntu une-alpha-synucleinopathy kunye ne-RBD ekhankanyiweyo apha ngasentla, ikwathathwa njenge-RBD yesibini.

Kwakhona, abantu abasebenzisa amayeza athile okudakumba banokuba ne-RBD. Oku kubizwa ngokuba yi-Drug-induced RBD .

Ngenxa yokuba le `RBD` inokubangela ingozi engalindelekanga kuwe okanye kumntu olala naye, kubaluleke kakhulu ukuqaphela oku kwaye ufune unyango ukuba kuyimfuneko.

Ngubani onokuba nethuba elikhulu lokufumana i-RBD?

Isifo sokuziphatha sokulala se-REM (RBD) sidla ngokuchaphazela abantu abangaphezu kweminyaka engama-50 ubudala.Ubudala obuqhelekileyo bokuqala kwesi sifo bumalunga neminyaka engama-61. Nangona kunjalo, kunqabile kakhulu, le meko inokuvela nakubantwana abancinci nakubantu abadala abancinci.

Kubantu abangaphezu kweminyaka engama-50 ubudala, amadoda anamathuba aphindwe kasithoba okuba ne-RBD kunabafazi .

I-RBD inxulunyaniswa kakhulu neengxaki ezithile ze-neurodegenerative. Njengoko bekutshiwo ngaphambili, kufunyenwe ukuba inani elikhulu labantu abane-RBD (idiopathic) (oko kukuthi i-RBD eyenzeka ngaphandle kwesinye isizathu) banesifo sikaParkinson, i-Lewy body dementia, okanye i-multiple system atrophy (MSA) kwiminyaka eli-14 emva kokufunyaniswa kwesifo .

Malunga nama-36% abantu abane-"Type 1 narcolepsy" banokuba ne-"RBD" yesibini. Kwaye malunga nama-6% abantu abasebenzisa amayeza okudakumba basenokuba ne-"RBD" ebangelwa ngamayeza.

Ixhaphake kangakanani i-RBD?

Isifo sokuziphatha sobuthongo se-REM (RBD) sisifo esingaqhelekanga . Sichaphazela malunga ne-1% yabantu ngokubanzi. Kubantu abangaphezu kweminyaka engama-50, simalunga ne-2%.

Kodwa la manani asenokuba ngaphantsi kunokuba enjalo ngokwenene, kuba i-RBD inokuba nzima ukuyifumanisa, kwaye malunga nesiqingatha sabantu abanale meko abazi nokuba banayo .

Zithini iimpawu ze-`RBD`?

Iimpawu ze-'RBD' zingahluka kumntu nomntu. Abanye abantu bazifumana rhoqo, ngelixa abanye bezifumana kancinci. Xa umntu elele, unokuziva ngathi uphupha kakubi. Nazi ezinye zezinto ezinokwenzeka:

• Inyama emzimbeni wam ihamba kancinci kancinci, amalungu am ayaqhaqhazela.
• Kuthethwa, kukhwazwa, kwaye ngamanye amaxesha kuthethwe amazwi amabi.
• Benza ngathi bayabetha okanye babamba umntu, okanye banokumbetha okanye bamkhabe umntu ebhedini.
• Ukutsiba ebhedini, ukuwa phantsi.

Khawuthelekelele, umhlobo wakho, uNilanthi, nomyeni wakhe, uSugat, belele ebusuku baze ngequbuliso bakhwaze bathi “Bamba! Bamba!” baze bolule iingalo zabo ngokungathi bafuna ukubetha umntu. Ngamanye amaxesha uSugat uyawa ebhedini aze azilimaze. Xa bevuka kusasa, uSugat akakhumbuli nto, kodwa ukhumbula iphupha awayenalo. Olu luhlobo lwe-‘RBDs’.

Kuthiwa abantu abasibhozo kwabalishumi abane-RBD banengxaki yokulala .

Ezi ziganeko zinokwenzeka kube kanye okanye izihlandlo ezininzi ngexesha lokulala kube kanye. Abanye abantu bazifumana rhoqo ebusuku, ngelixa abanye bezifumana rhoqo. Iimpawu ziba nzima kakhulu xa umntu ephupha kakubi kakhulu.

Eyona nto ibalulekileyo kukuba, awazi ukuba ezi zinto zenzeka nini. Uninzi lwabantu lufumanisa kuphela xa umntu elele ebhedini ebaxelela, okanye xa umntu osekhaya ebabona, okanye xa bevuka kusasa benenxeba emzimbeni wabo.

Ukuba umntu ukuvusa ngeli xesha, ungavuka lula. Xa uvuka, uphaphile kwaye ukhumbula amaphupha akho. Oku kubizwa ngokuba 'zizinto ezoyikisayo zasebusuku'.Kwahlukile 'kwizinto ezoyikisayo zasebusuku'. Kunzima ukuvusa umntu, kwaye nokuba uvuka, ubonakala ephazamisekile kwaye edidekile.

Ngamanye amaxesha abantu abane -'Obstructive sleep apnea (OSA)' (ukuthintela ukuphefumla ngexesha lokulala) banokubonisa ezi mpawu. Oku kubizwa ngokuba yi -'pseudo RBD' . Kubantu abanjalo, xa i-'OSA' inyangwa, iimpawu zokuziphatha ziyanyamalala.

Zithini izizathu ze-`RBD`?

Ngokwesiqhelo, xa silele ubuthongo be-'REM', xa siphupha, uninzi lwezihlunu zethu (ingakumbi izihlunu zamathambo) ziphelelwa ngumsebenzi wazo okwethutyana. Oku kubizwa ngokuba yi -'muscle atonia' . Oku kwenzeka ukuze sikwazi ukuphupha ngokukhuselekileyo ngaphandle kokwenza izinto esizenzayo emaphupheni ethu. Khawucinge ngento ebenokwenzeka ukuba besingenalo olo hlobo! Ukuba besibaleka emaphupheni ethu size sitsibe emaphupheni ethu, sinokufumana ingozi, akunjalo?

Kodwa abantu abane-RBD abafumani lo monakalo wesikhashana wokusebenza kwemisipha obizwa ngokuba yi-muscle atonia. Yiyo loo nto besenza izinto bengaqondanga baze bathethe ngezinto abazenzayo emaphupheni abo. Abaphandi abakaqondi ngokupheleleyo ukuba kutheni oku kusenzeka. Kukho iindlela ezininzi ezintsonkothileyo zemithambo-luvo ezibandakanyekayo ekulaleni kwe-REM.

Izizathu ze-'Isolated (idiopathic) RBD`

Enye ingcamango ephambili kukuba i-RBD eyodwa (idiopathic) ibangelwa yingxaki kwi-pons, inxalenye ye-brainstem, ebangela i-muscle atonia ngexesha lokulala kwe-REM. Ezinye iiseli kwi-pons zilawula ukuxinana kwemisipha ngexesha lokulala kwe-REM. Izilonda kwi-pons nazo zidibene nesifo sikaParkinson, i-Lewy body dementia, kunye ne-MSA. Ngenxa yobudlelwane obuqinileyo phakathi kwe-RBD eyodwa kunye nezi zifo, abaphandi bakholelwa ukuba ingxaki kwi-pons isenokuba yimbangela.

Olunye uphando lubonise ukuba ama-97% abantu abane-'RBD' eyodwa banesifo semithambo-luvo kwiminyaka eli-14 emva kokufunyaniswa kwabo 'njenge-RBD', apho 'isifo sikaParkinson' sixhaphakileyo.

Izizathu ze-'Regional RBD'

Abantu abane-narcolepsy banezinga eliphantsi lekhemikhali yobuchopho ebizwa ngokuba yi-orexin okanye i-hypocretin . Le khemikhali ilawula ubuthongo, ukuvuka, kunye nomdla wokutya. Xa le khemikhali iphantsi, inokuphazamisa ubuthongo be-REM, nto leyo ekhokelela kwi-RBD.

Izizathu ze-'RBD ebangelwa ngamayeza'

Abaphandi bakholelwa ukuba i-RBD ebangelwa zezinye izidambisi-ntlungu inokubangelwa kukungalingani kwe -neurotransmitters i-dopamine kunye ne-serotonin , ezibandakanyeka kwi-REM sleep.

Ungayixilonga njani i-'RBD'? (Ukuxilongwa)

Ukuba uneempawu ze-'RBD', ngokuqinisekileyo kuya kufuneka ubone ugqirha.Ugqirha uza kukubuza ngeempawu zakho kunye nembali yakho yezonyango. Ukuba unomntu olala naye okanye amalungu osapho lwakho, ugqirha angakubuza nangemikhwa yakho yokulala.

Ugqirha uza kukuxilonga ngokwasemzimbeni aze akuxilonge ngemithambo-luvo. Ungathunyelwa kwingcali yokulala.

Ukuze uqiniseke ukuba une-RBD, kufuneka wenze uphando lwevidiyo lokulala elabhoratri, olukwaziwa ngokuba yi-polysomnogram (PSG) . Oku kudla ngokwenziwa esibhedlele okanye kwiziko lokulala, apho uchitha ubusuku bonke ujongwa yikhamera. Olu vavanyo lurekhoda ezi zinto zilandelayo malunga nomzimba wakho ngelixa ulele:

• Inqanaba lentliziyo.
• Isantya sokuphefumla kunye nokuhamba komoya.
• Umsebenzi wamaza obuchopho.
• Iintshukumo zamehlo.
• Iintshukumo zemisipha yesilevu sakho kunye nemilenze engasentla.

Ngokwe-International Classification of Sleep Disorders, Third Edition (ICSD-3), zonke ezi zinto zilandelayo kufuneka zibe khona ukuze kufunyaniswe ukuba une-RBD:

• Uhlala uneziqendu apho uthetha ulele kwaye/okanye wenze iintshukumo ezinzima.
• Ezi ndlela zokuziphatha kufuneka ziqinisekiswe ngovavanyo lwe-polysomnography (PSG) kwaye kufuneka zenzeke ngexesha lokulala kwe-REM. Okanye, ngokusekelwe kwimbali yakho yeklinikhi, kufuneka ukuba zibonisa ukulala kwe-REM.
• Uvavanyo lwe-`PSG` lufanele lubonise ukuba une-`muscle atonia` (ukulahlekelwa bubomi bemisipha) ngexesha lokulala kwe-`REM`. (`REM sleep ngaphandle kwe-atonia` - RWA).
• Umsebenzi onxulumene nokuxhuzula kufuneka uphele ngexesha lokulala kwe-REM.
• Ezi ngxaki zokulala akufuneki zichazwe kakuhle sisifo sokulala esinye, esinye isifo, isifo sengqondo, isiphumo esibi samayeza, okanye isifo sokusebenzisa iziyobisi.

Iphathwa njani i-RBD?

Eyona njongo iphambili xa unyanga le `RBD` kukubonelela wena neqabane lakho ngokulala okukhuselekileyo . Kukho amaqhinga ahlukeneyo kwaye ngamanye amaxesha amayeza okwenza oku.

Amanyathelo ekufuneka uwathathe ukuze ukhuseleke

Nazi ezinye izinto onokuzenza ukuze ulale kwindawo ekhuselekileyo:

• Susa izinto ezibukhali, iglasi, kunye nezinto ezinzima ezijikeleze ibhedi.
• Beka into ethambileyo, njengomqamelo, phakathi kwakho nebhodi yentloko okanye itafile yokulala.
• Beka umatrasi phantsi ecaleni kwebhedi xa unokuthi uphume ebhedini, okanye ufake iireyile ezifakwe uphahla kumacala omabini ebhedi.
• Kwabanye abantu, ukulala ngebhegi yokulala kunokunceda.

Ukuba iimpawu zakho zinzima kakhulu, kungcono ukuba ulale wedwa kwigumbi elahlukileyo ukuze iqabane lakho likhuseleke.

Kwakhona, kufuneka uphephe ukusela utywala kangangoko unako , kuba utywala bunokunyusa ukwanda kwe-'RBD' kwaye buyenze imeko ibe mandundu.

Amayeza e-'RBD'

Ukuba iimpawu zakho zinzima, kwaye amanyathelo okhuseleko ewodwa awanakukuthintela ukwenzakala, ugqirha wakho unokukunika amayeza okulawula iimpawu zakho. Nangona kungekho mayeza avunyiweyo yi-FDA ngokukodwa e-RBD, izifundo zibonise ukuba i-melatonin, i-clonazepam, kunye ne-pramipexole ngamanye amaxesha zinokunciphisa iimpawu.

• IMelatonin: Le yihomoni eveliswa ngokwendalo yi-pineal gland engqondweni yethu. Ibalulekile ekulawuleni umjikelo wethu wokulala nokuvuka. I-melatonin yokwenziwa iyafumaneka njengeyeza. Le ithathwa njengonyango lokuqala lwe-RBD kuba ayinazo iziphumo ebezingalindelekanga ezininzi. Ugqirha uza kuqala ngedosi ephantsi aze kancinci kancinci anyuse idosi de iimpawu ziphele.
• I-Clonazepam: Le yimithi yokuthomalalisa. Abaphandi abakaqiniseki ukuba inceda njani kwi-RBD. Nangona kunjalo, abantu abaninzi abane-RBD bafumanisa ukuba ukuthatha idosi encinci ye-clonazepam ngaphambi kokuba ulale kunciphisa okanye kuphelisa amaphupha amabi, ukukhwaza, kunye nokuhamba ulele. Nangona kunjalo, i-clonazepam inokuba nemiphumo emibi engathandekiyo. Yiyo loo nto ugqirha wakho enokuyinika ukuba i-melatonin ayiniki ncedo lwaneleyo.
• I-Pramipexole: Le yi-dopamine agonist. Oogqirha bayinika ikakhulu isifo sikaParkinson kunye ne-restless leg syndrome. Kodwa uphando lwakutshanje lubonise ukuba inokunciphisa neempawu ze-RBD. Abaphandi bakholelwa ukuba eli yeza liyasebenza kuba i-RBD yimeko ebangelwa kukungabikho kwe-dopamine (i-dopaminergic deficiency disorder).

Ngaba i-RBD ingathintelwa?

Kwiimeko ezininzi, akukho nto sinokuyenza ukuthintela i-RBD. Oku kungenxa yokuba kukho izinto ezinobungozi esingenakuzithintela okanye sizitshintshe. Umzekelo, ubudala bakho, okanye nokuba une-narcolepsy okanye imeko ye-neurodegenerative.

Kodwa ukuba i-RBD ibangelwa zizinto ezifana notywala, kwaye ukuba iimpawu ziyanda, i-RBD inokuphela xa uyeka ukusebenzisa ezo zinto.

Ithini ingqikelelo ye-RBD?

Indlela yekamva ye-RBD, oko kukuthi, apho esi sifo siya khona, ixhomekeke kwizinto ezininzi:

• Nokuba kukho unobangela oyintloko. Oko kukuthi, nokuba kungenxa ye-'narcolepsy' ('i-RBD' yesibini), i-antidepressant ('i-RBD ebangelwa ziziyobisi'), okanye nokuba yenzeke nje (ngokuzenzekelayo - `i-RBD ehlukanisiweyo`).
• Ukuba zinzima kangakanani iimpawu zakho nokuba azikubangela na ingozi.
• Nokuba ufuna unyango okanye hayi.
• Nokuba unesifo senkqubo yemithambo-luvo kunye ne-RBD.

Eyona nto ibalulekileyo nebalulekileyo nge-RBD kukunxulumana kwayo nezifo zemithambo-luvo, ingakumbi isifo sikaParkinson, ukuwohloka kwenkqubo ezininzi, kunye ne-Lewy body dementia. Ubungqina obandayo bubonisa ukuba i-RBD isenokuba luphawu olulumkisayo lwale zifo kwangethuba . Oku kuyinyani ngakumbi ukuba i-RBD yenzeka ngokuzenzekelayo, ngaphandle kwesinye isizathu, kwaye ayibangelwa yi-narcolepsy okanye amayeza.

I-RBD inokubangela ingozi enkulu kuwe nakwiqabane lakho elileleyo, ngoko ke kubaluleke kakhulu ukufuna unyango.

Ingqikelelo yabantu abane-RBD kunye nemeko yemithambo-luvo ayilunganga kangako. Umzekelo, kufunyenwe ukuba abantu abanesifo sikaParkinson kunye ne-RBD abakwinqanaba lokuqala lobomi babo banomgangatho ophantsi wobomi kunabantu abanesifo sikaParkinson abakwinqanaba lokuqala kodwa abangenaso i-RBD.

Ziziphi iingxaki ezinokubakho ze-RBD?

Aba bantu basengozini enkulu yokuzilimaza okanye ukwenzakalisa abanye ebhedini ngenxa yeentshukumo zabo ezidlamkileyo ngamanye amaxesha xa belele. Kwakhona, njengoko ubuthongo buhlala buphazamiseka, oku kunokuchaphazela umgangatho wobuthongo ngokubanzi.

Iintlobo ezinokubakho zokwenzakala:

• Imivumbo.
• Ukunqunyulwa.
• Ukuqhekeka.
• Amathambo aphukileyo.
• Iimeko ezinzulu ezifana nokwenzakala entloko kunye ne-subdural hematomas (ukopha ngaphakathi kwentloko) .

Ngamanye amaxesha ezi ngozi zinokuba yingozi ebomini .

Kubikwa ukuba ama-90% amaqabane abantu abane-RBD aneengxaki zokulala , kwaye ngaphezulu kwama-60% baye benzakala emzimbeni .

Ngoko ke, kubaluleke kakhulu ukufuna unyango lwe-RBD kunye nokudala ubuncinane indawo yokulala ngokukhuselekileyo.

Ufanele uye nini kugqirha malunga ne-'RBD'?

• Ukuba ufunyaniswe une-`isolated RBD` (i-RBD engenasizathu sithile), kuya kufuneka ubone ugqirha rhoqo ukuze 'ujonge iimpawu' zezifo zemithambo-luvo ezinokuba zinxulumene kakhulu nayo (`Parkinson's`, `Lewy body dementia`, `MSA`).
• Ukuba ufumanisa naziphi na iimpawu ezintsha, ezifana neengxaki zokuhamba okanye utshintsho lwengqondo, bona ugqirha ngoko nangoko.
• Ukuba wena okanye umntu olala naye wenzakele ngenxa ye-RBD, funa ingcebiso kagqirha ngokukhawuleza.

Ngaba i-'RBD' sisifo sengqondo?

Hayi, i-`REM Sleep Behavior Disorder (RBD)` ayisiyo 'isifo sengqondo'. Ayifani 'nesifo sengqondo' okanye 'nesifo sokuxhalaba'. I-`RBD` yi 'sleep disorder' - ngakumbi uhlobo lwe-`parasomnia'.

Kunokuba buhlungu kakhulu kwaye kukuphazamise ukwenzakalisa ngengozi wena okanye umntu olala naye. Ukuba iqabane lakho likuxelela ukuba uyasokola okanye ukhala ebuthongweni bakho, musa ukuyithatha lula loo nto. Thetha nogqirha. Banokucebisa ukuba kwenziwe uphando lokulala ukuze babone ukuba banayo na i-RBD, kwaye banokucebisa unyango ukuba kuyimfuneko. Khumbula, eyona nto ibalulekileyo kukudala indawo yokulala ekhuselekileyo ukuthintela ukwenzakala.

Okokugqibela, khumbula oku (Umyalezo Wokuya Ekhaya)

Ngoko ke, ukuba wena okanye umntu omaziyo uziphatha ngendlela engaqhelekanga ebuthongweni bakhe – ekhala, ejika iingalo zakhe, ewa ebhedini, njl.njl. – musa ukuyithatha njengephupha elibi. Isenokuba yi-REM Sleep Behavior Disorder (RBD).

Ingakumbi ukuba ibangela ukwenzakala kuwe okanye kwabanye, qiniseka ukuba ucela ingcebiso kagqirha. Khumbula, oku kungaba luphawu lokuqala lwezifo ezithile ezinzulu zemithambo-luvo. Kungoko ke, kubaluleke kakhulu ukukufumanisa kwangethuba kwaye uthathe amanyathelo afunekayo. Ukulala kwakho, ukulala kweqabane lakho, kunye nokhuseleko lwazo zombini zibaluleke kakhulu. Ngoko ke lukhathalele olu.

Ingxaki yokuziphatha kokulala kwe - REM, i-RBD, iingxaki zokulala, ukuhambahamba ebuthongweni, ukukhwaza ebuthongweni, iingxaki zokulala, iingxaki zemithambo-luvo