Ingabe nawe uyahluleka ebuthongweni bakho? Ingabe uyamemeza? Ake sifunde nge-REM Sleep Behavior Disorder (RBD)!

Ingabe umlingani wakho noma othile ekhaya lakho wake wakutshela ukuthi uyamemeza, ushaya umoya, futhi ngezinye izikhathi uze uhlasele othile ebuthongweni bakho? Kungenzeka ukuthi uvukile unenxeba emzimbeni wakho wazibuza, "Kwenzekeni kimi?" Lokhu kungase kungabi yiphupho elibi nje kuphela. Namuhla, sizokhuluma ngalokhu kuziphatha okungavamile kokulala, okubizwa ngokuthi i-REM Sleep Behavior Disorder, noma i-RBD.

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

Kalula nje, i-`REM Sleep Behavior Disorder (RBD)` yilapho usesigabeni sokulala se-`REM (Rapid Eye Movement)`, futhi empeleni ulingisa amaphupho akho, okungukuthi, ukwenza izinto ozenzayo emaphusheni akho ngokomzimba, ukhuluma emaphusheni akho. Awuqapheli uma wenza lezi zinto. Lesi simo se-`RBD` siwela ngaphansi kwesigaba se-`parasomnia`. I-`Parasomnia` isifo sokulala esibonakala ngezenzakalo zomzimba ezingavamile nezingafuneki noma okuhlangenwe nakho okuphazamisa ubuthongo.

Uma silala, kunezigaba ezahlukene zokulala. Esinye salezi zigaba sibizwa ngokuthi 'ukulala kwe-REM' . I-'REM' imele 'ukunyakaza kwamehlo okusheshayo'. Yilapho amehlo ehamba khona ngokushesha. Yilapho sivame ukuba namaphupho acacile nacacile. Sidlula kule mijikelezo ye-'REM' izikhathi eziningana ebusuku. Umjikelezo wokuqala we-'REM' uqala cishe imizuzu engama-90 ngemva kokulala, futhi uhlala cishe imizuzu eyi-10. Umjikelezo ngamunye we-'REM' olandelayo uba mude.

Kunezinhlobo ezimbili eziyinhloko ze-`RBD`:

1. `I-RBD Ehlukanisiwe (idiopathic): Lokhu kusho ukuthi lesi simo senzeka ngaphandle kwesizathu esithile. Ngeshwa, abantu abaningi abane-`RBD ehlukanisiwe` bangagcina sebenesifo 'se-neurodegenerative' (isimo esenza kancane kancane isimiso sezinzwa sibe buthaka). Ikakhulukazi, izifo ezifana 'ne-Parkinson' (isifo sikaParkinson), 'i-Lewy body dementia' (i-Lewy body dementia) noma 'i-multiple system atrophy (MSA)' (i-multiple system atrophy). Lezi zifo zivame ukubizwa ngokuthi 'i-alpha-synucleinopathies'.

2. I-RBD enezimpawu (yesibili): Lokhu kubangelwa esinye isimo esiyisisekelo. Isibonelo, kungenzeka kubantu abanenkinga yokulala ebizwa ngokuthi i-Type 1 narcolepsy . Uma umuntu enayo yomibili i-alpha-synucleinopathy kanye ne-RBD eshiwo ngenhla, nayo ibhekwa njenge-RBD yesibili.

Futhi, abantu abathatha imithi ethile yokucindezeleka bangaba ne-RBD. Lokhu kubizwa ngokuthi i-RBD ebangelwa izidakamizwa .

Ngenxa yokuthi le `RBD` ingadala umonakalo ongahlosiwe kuwe noma kumuntu olala naye, kubaluleke kakhulu ukuqaphela lokhu futhi ufune ukwelashwa uma kudingeka.

Ubani onamathuba amaningi okuthola i-RBD?

Isifo Sokuziphatha Kokulala Se-REM (RBD) sivame ukuhlasela abantu abangaphezu kweminyaka engu-50.Isilinganiso seminyaka yokuqala kwalesi sifo sicishe sibe yiminyaka engama-61. Kodwa-ke, akuvamile kakhulu, lesi simo singavela nasezinganeni ezincane nakubantu abadala abasebasha.

Phakathi kwabantu abaneminyaka engaphezu kwengu-50, amadoda anamathuba aphindwe kasishiyagalolunye okuthola i-RBD kunabesifazane .

I-RBD ihlotshaniswa kakhulu nezifo ezithile ze-neurodegenerative. Njengoba kushiwo ngaphambili, kutholakale ukuthi ingxenye enkulu yabantu abane-RBD ehlukanisiwe (idiopathic) (okungukuthi i-RBD eyenzeka ngaphandle kwanoma yisiphi esinye isizathu) iba nesifo sikaParkinson, i-Lewy body dementia, noma i-multiple system atrophy (MSA) zingakapheli iminyaka eyi-14 yokuxilonga .

Cishe abantu abangu-36% abanesifo se-narcolepsy sohlobo 1 bangase babe ne-'RBD' yesibili. Futhi cishe abantu abangu-6% abasebenzisa imithi yokucindezeleka bangase babe ne-'RBD ebangelwa izidakamizwa'.

I-RBD ivame kangakanani?

Isifo Sokuziphatha Kokulala Se-REM (RBD) empeleni siyisifo esingavamile . Sithinta cishe u-1% wabantu bonke. Kubantu abangaphezu kweminyaka engu-50, cishe u-2%.

Kodwa lezi zinombolo zingase zibe ngaphansi kunalokho eziyikho ngempela, ngoba i-RBD ingaba nzima ukuyixilonga, futhi cishe ingxenye yabantu abanalesi simo abazi nokuthi banaso .

Ziyini izimpawu ze-'RBD'?

Izimpawu ze-'RBD' zingahluka kumuntu nomuntu. Abanye abantu bazizwa njalo, kanti abanye bazizwa kancane. Ngesikhathi umuntu elele, kungazwakala sengathi uphupha kabi. Nazi ezinye izinto ezingase zenzeke:

• Inyama emzimbeni wami iyanyakaza kancane kancane, izitho zami ziyanyakaza.
• Kukhulunywa, kuklabalaswa, futhi ngezinye izikhathi kushiwo amazwi amabi.
• Benza sengathi bashaya noma babamba othile, noma bangashaya noma bamkhahlele ngisho nomuntu osembhedeni.
• Ukugxuma embhedeni, ukuwa phansi.

Cabanga nje, umngane wakho, uNilanthi, nomyeni wakhe, uSugat, balele ebusuku bese bememeza ngokuzumayo bethi “Bamba! Bamba!” bese belula izingalo zabo sengathi bafuna ukushaya othile. Ngezinye izikhathi uSugat uyawa embhedeni azilimaze. Lapho bevuka ekuseni, uSugat akakhumbuli lutho, kodwa ukhumbula iphupho aliphuphayo. Lena yindlela 'ye-RBD'.

Kuthiwa abantu abayisishiyagalombili kwabayishumi abane-RBD bahlushwa ukulimala kokulala .

Lezi zenzakalo zingenzeka kanye noma kaningana ngesikhathi sokulala okukodwa. Abanye abantu babhekana nazo njalo ebusuku, kanti abanye bazizwa njalo. Izimpawu zinzima kakhulu lapho umuntu ebhekene nephupho elibi nelinobudlova.

Into ebalulekile ukuthi, awazi ukuthi lezi zinto zenzeka nini. Iningi labantu lithola ngakho kuphela lapho othile embhedeni ebatshela, noma lapho othile ekhaya ebabona, noma lapho bevuka ekuseni benenxeba emzimbeni wabo.

Uma othile ekuvusa ngalesi sikhathi, ungavuka kalula. Uma uvuka, uqaphile futhi ukhumbula amaphupho akho. Lokhu kubizwa ngokuthi 'ukwesaba kwasebusuku'.Kuhlukile 'kuzinto ezesabekayo zasebusuku'. Kunzima ukuvusa umuntu, futhi ngisho nalapho evuka, ubonakala ekhathazekile futhi edidekile.

Ngezinye izikhathi abantu abane -'Obstructive sleep apnea (OSA)' (ukuvimbela ukuphefumula ngesikhathi sokulala) bangabonisa lezi zimpawu. Lokhu kubizwa ngokuthi 'i-pseudo RBD' . Kubantu abanjalo, lapho i-'OSA' yelashwa, ukuziphatha kuyanyamalala.

Yiziphi izimbangela ze-'RBD'?

Ngokuvamile, uma sisebuthongweni be-'REM', uma siphupha, imisipha yethu eminingi (ikakhulukazi imisipha yamathambo) ilahlekelwa ukusebenza kwayo okwesikhashana. Lokhu kubizwa ngokuthi 'imisipha ye-atonia' . Lokhu kwenzeka ukuze sikwazi ukuphupha ngokuphepha ngaphandle kokwenza izinto esizenzayo emaphusheni ethu. Cabanga ukuthi bekuzokwenzekani ukube besingenalo lokho! Uma besigijima emaphusheni ethu futhi sigxume emaphusheni ethu, singangena engozini, akunjalo?

Kodwa abantu abane-RBD abakuboni lokhu kulahlekelwa okwesikhashana komsebenzi wemisipha okubizwa ngokuthi i-muscle atonia. Yingakho benza izinto ngokungazi futhi bakhulume ngezinto abazenzayo emaphusheni abo. Abacwaningi abakaqondi ngokugcwele ukuthi kungani lokhu kwenzeka. Kunezindlela eziningi eziyinkimbinkimbi zemizwa ezihilelekile ekulaleni kwe-REM.

Izimbangela ze-'Isolated (idiopathic) RBD`

Enye inkolelo-mbono enkulu ukuthi i-RBD ehlukanisiwe (idiopathic) ibangelwa inkinga kuma-pons, ingxenye ye-brainstem, ebangela i-muscle atonia ngesikhathi sokulala kwe-REM. Amanye amangqamuzana kuma-pons alawula ukufinyela kwemisipha ngesikhathi sokulala kwe-REM. Izilonda kuma-pons nazo zihlotshaniswa nesifo sikaParkinson, i-Lewy body dementia, kanye ne-MSA. Ngenxa yobudlelwano obuqinile phakathi kwe-RBD ehlukanisiwe nalezi zifo, abacwaningi bakholelwa ukuthi inkinga kuma-pons ingaba yimbangela.

Ucwaningo olulodwa lubonise ukuthi abantu abangu-97% abane-'RBD' ehlukanisiwe bathola esinye salezi zifo zezinzwa zingakapheli iminyaka eyi-14 bexilongwe 'nge-RBD', kanti 'isifo sikaParkinson' yisona esivame kakhulu.

Izimbangela ze-'RBD Yesibili (ebonisa izimpawu)'

Abantu abane-narcolepsy banamazinga aphansi ekhemikhali yobuchopho ebizwa ngokuthi i-orexin noma i-hypocretin . Le khemikhali ilawula ukulala, ukuphaphama, kanye nesifiso sokudla. Uma le khemikhali iphansi, ingaphazamisa ukulala kwe-REM, okuholela ku-RBD.

Izimbangela ze-'RBD ebangelwa yimithi'

Abacwaningi bakholelwa ukuthi i-RBD ebangelwa eminye imithi yokucindezeleka ingase ibangelwe ukungalingani kwe -neurotransmitters i-dopamine ne-serotonin , ezihilelekile ekulaleni kwe-REM.

Ungayithola kanjani i-'RBD'? (Ukuxilongwa)

Uma unezimpawu ze-'RBD', kufanele nakanjani ubone udokotela.Udokotela uzokubuza ngezimpawu zakho kanye nomlando wakho wezokwelapha. Uma unomuntu olala naye noma amalungu omndeni wakho, udokotela angase futhi akubuze ngemikhuba yakho yokulala.

Udokotela uzokuxilonga ngokomzimba futhi akwenze ukuhlolwa kwezinzwa. Ungathunyelwa futhi kuchwepheshe wezokulala.

Ukuze uthole ukuthi unesiqiniseko sokuthi une-RBD, udinga ukwenza isifundo sokulala ngevidiyo elabhorethri, esaziwa nangokuthi i-polysomnogram (PSG) . Lokhu kuvame ukwenziwa esibhedlela noma esikhungweni sokulala, lapho uchitha khona ubusuku bonke uqashwe yikhamera. Lokhu kuhlolwa kuqopha izinto ezilandelayo ngomzimba wakho ngenkathi ulele:

• Isilinganiso senhliziyo.
• Isivinini sokuphefumula kanye nokugeleza komoya.
• Umsebenzi wamagagasi obuchopho.
• Ukunyakaza kwamehlo.
• Ukunyakaza kwemisipha yesilevu sakho kanye nemilenze engenhla.

Ngokusho kwe-International Classification of Sleep Disorders, uhlelo lwesithathu (ICSD-3), konke okulandelayo kumele kube khona ukuze kutholakale ukuthi une-RBD:

• Uhlala uneziqephu lapho ukhuluma khona ulele futhi/noma wenze ukunyakaza okuyinkimbinkimbi.
• Lezi zenzo kumele ziqinisekiswe ngokuhlolwa kwe-polysomnography (PSG) futhi kumele zenzeke ngesikhathi sokulala kwe-REM. Noma, ngokusekelwe emlandweni wakho wezokwelapha, kumele zisikisele ukulala kwe-REM.
• Ukuhlolwa kwe-`PSG` kufanele kubonise ukuthi une-`muscle atonia` (ukulahlekelwa impilo yemisipha) ngesikhathi sokulala kwe-`REM`. (`REM sleep without atonia` - RWA).
• Umsebenzi ohlobene nokuquleka kufanele uphele ngesikhathi sokulala kwe-REM.
• Lezi zinkinga zokulala akufanele zichazwe kahle ngesinye isifo sokulala, esinye isifo, isifo sengqondo, imiphumela emibi yemithi, noma isifo sokusebenzisa izidakamizwa.

Iphathwa kanjani i-RBD?

Umgomo oyinhloko lapho welapha le-'RBD' ukukunikeza wena nomlingani wakho ubuthongo obuphephile . Kunezindlela ezahlukene futhi ngezinye izikhathi imithi yalokhu.

Izinyathelo okufanele uzithathe ukuze uphephe

Nazi ezinye izinto ongazenza ukuze udale indawo yokulala ephephile:

• Susa izinto ezibukhali, ingilazi, kanye nezinto ezisindayo ezizungeze umbhede.
• Beka into ethambile, njengomcamelo, phakathi kwakho ne-headboard noma i-nightstand.
• Beka umatrasi phansi eduze kombhede uma kwenzeka uwe embhedeni, noma ufake izinsimbi zombhede ezimbozwe ngendwangu ezinhlangothini zombili zombhede.
• Kwabanye abantu, ukulala ebhegini lokulala nakho kungasiza.

Uma izimpawu zakho zinzima kakhulu, kungaba ngcono ukuthi ulale wedwa ekamelweni elihlukile ukuze umlingani wakho olele aphephe.

Futhi, kufanele ugweme ukuphuza utshwala ngangokunokwenzeka , njengoba utshwala bungandisa ukwanda kwe-'RBD' futhi kwenze isimo sibe sibi kakhulu.

Imithi ye-'RBD'

Uma izimpawu zakho zinzima, futhi izinyathelo zokuphepha zodwa zingenakukuvimbela ukulimala, udokotela wakho angase akunike imithi yokulawula izimpawu zakho. Nakuba kungekho mithi evunyelwe yi-FDA eqondene ngqo ne-RBD, izifundo zibonise ukuthi i-melatonin, i-clonazepam, ne-pramipexole ngezinye izikhathi inganciphisa izimpawu.

• I-Melatonin: Lena yi-hormone ekhiqizwa ngokwemvelo yi-pineal gland ebuchosheni bethu. Kubalulekile ekulawuleni umjikelezo wethu wokulala nokuvuka. I-melatonin yokwenziwa iyatholakala njengomuthi. Lokhu kubhekwa njengokwelashwa kokuqala kwe-RBD ngoba inemiphumela emibi embalwa kakhulu. Udokotela uzoqala ngomthamo ophansi bese ekhulisa kancane kancane umthamo kuze kube yilapho izimpawu ziphela.
• I-Clonazepam: Lena umuthi wokudambisa. Abacwaningi abakaqiniseki ukuthi usiza kanjani nge-RBD. Kodwa-ke, abantu abaningi abane-RBD bathola ukuthi ukuthatha umthamo ophansi we-clonazepam ngaphambi kokulala kunciphisa noma kuqeda amaphupho amabi, ukuklabalasa, nokuhamba ulele. Kodwa-ke, i-clonazepam ingaba nemiphumela emibi engathandeki. Yingakho udokotela wakho engase ayinike uma i-melatonin inganikezi impumuzo eyanele.
• I-Pramipexole: Lona umuthi we-dopamine agonist. Odokotela bawunikeza kakhulu isifo sikaParkinson kanye ne-restless leg syndrome. Kodwa ucwaningo lwamuva lukhombisile ukuthi unganciphisa nezimpawu ze-RBD. Abacwaningi bakholelwa ukuthi lo muthi uyasebenza ngoba i-RBD yisimo esibangelwa ukuntuleka kwe-dopamine (i-dopaminergic deficiency disorder).

Ingabe i-RBD ingavinjelwa?

Ezimweni eziningi, akukho esingakwenza ukuvimbela i-RBD. Lokhu kungenxa yokuthi kunezici eziyingozi esingenakuzivimbela noma esizishintshayo. Isibonelo, iminyaka yakho, noma ukuthi une-narcolepsy noma isimo sokuwohloka kwemizwa.

Kodwa uma i-RBD ibangelwa izinto ezifana notshwala, futhi uma izimpawu zanda, i-RBD ingase iphele uma uyeka ukusebenzisa lezo zinto.

Iyini i-prognosis ye-RBD?

Inkambo yesikhathi esizayo ye-RBD, okungukuthi, lapho lesi sifo sizoya khona, incike ezintweni eziningana:

• Kungakhathaliseki ukuthi kukhona imbangela eyisisekelo. Okusho ukuthi, kungakhathaliseki ukuthi kungenxa ye-'narcolepsy' ('i-RBD' yesibili), umuthi wokucindezeleka ('i-RBD ebangelwa izidakamizwa'), noma ngabe kumane kwenzeka (ngokuzenzakalelayo - `i-RBD ehlukanisiwe`).
• Ukuthi izimpawu zakho zimbi kangakanani nokuthi ziyakubangela yini umonakalo.
• Ukuthi uzofuna ukwelashwa noma cha.
• Ukuthi unesifo sezinzwa kanye ne-RBD.

Isici esibaluleke kakhulu nesingathi sína se-RBD ukuhlangana kwayo nezifo zezinzwa, ikakhulukazi isifo sikaParkinson, ukuwohloka kwesistimu eminingi, kanye ne-Lewy body dementia. Ubufakazi obandayo busikisela ukuthi i-RBD ingaba uphawu oluyisixwayiso sakuqala lwalezi zifo. Lokhu kuyiqiniso ikakhulukazi uma i-RBD yenzeka ngokuzenzakalelayo, ngaphandle kwanoma yisiphi esinye isizathu, futhi ayibangelwa yi-narcolepsy noma umuthi.

I-RBD ingadala umonakalo omkhulu kuwe kanye/noma kumlingani wakho olele, ngakho-ke kubaluleke kakhulu ukufuna ukwelashwa.

Isibikezelo kubantu abane-RBD kanye nesimo sezinzwa ngokuvamile asisihle. Isibonelo, kutholakale ukuthi abantu abanesifo sikaParkinson kanye ne-RBD esiteji sokuqala banezinga eliphansi lokuphila kunabantu abanesifo sikaParkinson esiteji sokuqala kodwa abanaso i-RBD.

Yiziphi izinkinga ezingaba khona ngenxa ye-RBD?

Laba bantu basengozini enkulu yokuzilimaza bona noma abanye embhedeni ngenxa yokunyakaza kwabo okunobudlova ngezinye izikhathi ebuthongweni babo. Futhi, njengoba ubuthongo buvame ukuphazamiseka, lokhu kungathinta ikhwalithi yokulala iyonke.

Izinhlobo ezingaba khona zokulimala:

• Imivimbo.
• Ukusikwa.
• Ukuqhekeka.
• Amathambo aphukile.
• Izimo ezimbi kakhulu njengokulimala ekhanda kanye nama-hematomas angaphansi kwesikhumba (ukopha ngaphakathi kwekhanda) .

Ngezinye izikhathi lokhu kulimala kungaba yingozi empilweni .

Kubikwa ukuthi ama-90% abalingani babantu abane-RBD banezinkinga zokulala , kanti abangaphezu kwama-60% baye balimala ngokomzimba .

Ngakho-ke, kubaluleke kakhulu ukufuna ukwelashwa kwe-RBD futhi okungenani udale indawo yokulala okuphephile.

Kufanele ubonane nini nodokotela mayelana ne-'RBD'?

• Uma utholakale une-'isolated RBD' (i-RBD ngaphandle kwesinye isizathu), kuzodingeka ubonane nodokotela njalo ukuze 'uhlole izimpawu' zezifo zezinzwa ezingase zihlobene kakhulu nayo ('Parkinson's', 'Lewy body dementia', 'MSA').
• Uma uhlangabezana nanoma yiziphi izimpawu ezintsha, njengezinkinga zokunyakaza noma izinguquko zokuqonda, bona udokotela ngokushesha.
• Uma wena noma umuntu olala naye elimele ngenxa ye-RBD, funa iseluleko sezokwelapha ngokushesha.

Ingabe i-'RBD' isifo sengqondo?

Cha, i-`REM Sleep Behavior Disorder (RBD)` ayisona 'isifo sengqondo'. Ayifani 'nesifo sengqondo' noma 'isifo sokukhathazeka'. I-`RBD` iyi-'sleep disorder' - ikakhulukazi uhlobo lwe-'parasomnia'.

Kungaba yinto ekhathazayo kakhulu futhi ecasulayo ukuzilimaza ngengozi noma umuntu olala naye. Uma umlingani wakho ekutshela ukuthi uyalwa noma ukhala ebuthongweni bakho, ungakuthathi kalula. Khuluma nodokotela. Bangase batuse ucwaningo lokulala ukuze babone ukuthi bane-RBD yini, futhi bangase basikisele ukwelashwa uma kudingeka. Khumbula, into ebaluleke kakhulu ukudala indawo yokulala ephephile ukuze kuvinjelwe ukulimala.

Okokugcina, khumbula lokhu (Umyalezo Wokuya Ekhaya)

Ngakho-ke, uma wena noma umuntu omaziyo eziphatha ngendlela exakile ebuthongweni bakhe – ekhala, ephenduphendula izingalo zakhe, ewa embhedeni, njll. – ungamane nje ukukuthathe njengephupho elibi. Kungaba yi-REM Sleep Behavior Disorder (RBD).

Ikakhulukazi uma kubangela ukulimala kuwe noma kwabanye, qiniseka ukuthi ucela iseluleko sezokwelapha. Khumbula, lokhu kungaba uphawu lokuqala lwezifo ezithile ezinkulu zemizwa. Ngakho-ke, kubaluleke kakhulu ukukuthola kusenesikhathi futhi uthathe izinyathelo ezidingekayo. Ukulala kwakho, ukulala komlingani wakho, kanye nokuphepha kwakho kokubili kubaluleke kakhulu. Ngakho-ke nakekela lokhu.

Isifo sokuziphatha kokulala se - REM, i-RBD, izinkinga zokulala, ukuhambahamba ubuthongo, ukuklabalasa ubuthongo, izinkinga zokulala, izinkinga zezinzwa