Ukuwohloka komqondo nokulala

-Delile

• Ukufundwa Kwe-Dementia Okubalulekile
• Kungani Ukuzithiba Kwehluleka ku-Dementia

Kungenzeka ukuthi uqaphele, njengoba ngibonile, imibiko yakamuva emithonjeni yezindaba mayelana nokwanda okuphawulekayo kwezinga lokuzibulala kusukela ekupheleni kweminyaka yama-1990. Izinga lenyuke ngaphezu kuka-25% phakathi kuka-1999 no-2016 ngokunyuka kwezifundazwe ezingama-49 kwezingama-50. Ngikholwa ukuthi ezinye zezinto ezibangela lokhu kwanda zihlobene nokwanda kwezinto ezibonakalayo nokushoda kwencazelo abaningi ababhekana nayo emphakathini wethu. Noma ngabe yini imbangela, ukuzibulala kungaba nzima kakhulu ukubikezela kochwepheshe bezempilo yengqondo futhi kuyadabukisa ukusondelana nomndeni nabangane abalahlekelwa othandekayo ngokuzibulala. Kube yisipiliyoni sami ukuthi ukwelashwa kwengqondo okuhlose ukusiza la malungu omndeni nabangane kungaba omunye wemisebenzi eyinselele kakhulu owelaphi owake wayenza. Ngenkathi ngicabanga ngalokhu, ngakhumbula ukuzibulala okubuhlungu kukaRobin Williams. Wayekade enenkinga yokudangala futhi ngokusobala efunda ukuthi wayenezigaba zokuqala zomqondo wokuduka kwengqondo okwakumkhulu kangangokuba wakhetha ukuzibulala. Emndenini wakhe nakubalandeli abaningi lesi bekuyisigameko esibuhlungu.

Ukuthola ukuxilongwa kokukhubazeka okuncane kwengqondo noma ukuwohloka komqondo kungalimaza iziguli namalungu emindeni yazo. Ukukhubazeka okuncane kokuqonda kutholakala lapho abantu bekhula futhi benenkinga yokuqonda kaningi kunaleyo etholwa abantu bobudala obufanayo. Kubandakanya izinkinga ezinjengokukhohlwa kaningi ukwaziswa okusanda kufundwa, ukukhohlwa izehlakalo ezibalulekile njengokuqokwa kodokotela, ukuzizwa ukhungathekile ngokwenza izinqumo, kanye nokuthola izinqumo ezingezinhle ngokwengeziwe. Lezi zinguquko zibaluleke ngokwanele ukuthi abangane nomndeni bazibheke. Ukukhubazeka okuncane kwengqondo kungaba yisandulela sesifo i-Alzheimer's futhi mhlawumbe kuvame ukwenzeka ngenxa yohlobo olufanayo lwezinguquko olwenzeka ebuchosheni ngesikhathi sokukhula komqondo.

Ukukhubazeka okuphakathi kwengqondo kuyisimo esiphakathi sokungasebenzi kahle kwengqondo phakathi kwalokhu okubonakala ekugugeni okujwayelekile kanye nokuwohloka komqondo kwangempela (UPeteren, R. C., 2011). Imvamisa, inkumbulo iyancipha ngobudala, kepha hhayi ezingeni lokuthi ithikameza ikhono elijwayelekile lokusebenza. Inani elincane kakhulu labantu, elizungeze oyedwa kwabayikhulu, angakwazi ukudlula empilweni ngaphandle kokuncipha kokuqonda noma yini. Abanye bethu abanamathuba amancane. Ukukhubazeka okuphakathi kwengqondo kutholakala lapho ukwehla kokusebenza kokuqonda kukhulu kunalokho obekulindelekile ngesisekelo sokuguga kuphela. Phakathi kwabantu abaneminyaka engaphezu kwengama-65 ubudala phakathi kuka-10% no-20% bahlangabezana nenqubo yokukhubazeka okuncane kwengqondo. Ngeshwa, ucwaningo luye lwabonisa ukuthi abantu abaningi abanokukhubazeka okuncane kokuqonda basengozini enkulu yokuthola ukuwohloka komqondo. Kulabo abanokukhubazeka okuncane kwengqondo, imisebenzi enjengokukhokha izikweletu nokuya ezitolo iba nzima ngokwengeziwe. Ngiye ngaphawula kaningi ukukhathazeka okukhulu ukuthi lokhu kuphazamiseka kwengqondo kubangela iziguli.

Ukubuyekezwa kwezincwadi okwenziwe nguDa Silva (2015) kutholakale ukuthi ukuphazamiseka kokulala kwenzeka kaningi ekuwohlokeni komqondo futhi kubikezela ukwehla kokuqonda kwabantu asebekhulile abanokuwohloka komqondo. Kungenzeka ukuthi ukukhomba nokwelapha ukuphazamiseka kokulala kubantu abanokukhubazeka okuncane kwengqondo nokuwohloka komqondo kungasiza ekulondolozeni ukuqonda, futhi ukuqapha ukuphazamiseka kokulala ezigulini ezinokukhubazeka okuncane kwengqondo kungasiza ekuboneni izimpawu zokuqala zokuwohloka komqondo. I-Cassidy-Eagle & Siebern (2017) inothi ukuthi cishe abantu abangama-40% abaneminyaka engaphezu kwengama-65 ubudala babika uhlobo oluthile lokuphazamiseka kokulala kanti ama-70% alabo abaneminyaka engaphezu kwengama-65 ubudala banezifo ezihlukumezayo ezine noma ngaphezulu. Njengoba abantu bekhula, ubuthongo buyahlukana futhi ubuthongo obukhulu buyancipha. Njengoba bekhula, abantu bavame ukungasebenzi kangako futhi babe nempilo encane, okwenza lokho kube nomthelela ekwandeni kwezinkinga ezifana nokuqwasha. Lezi zinguquko zenzeka kaningi futhi kanzima kubantu abanokukhubazeka okuncane kwengqondo. Ukuchitha isikhathi esiningi embhedeni uphapheme futhi kuthatha isikhathi eside ukulala kuhlotshaniswa nengozi eyengeziwe yokukhubazeka okuncane kwengqondo noma komqondo wabantu asebekhulile.

Ngenhlanhla, ukwelashwa kokuziphatha kwengqondo kutholakale kusebenza ngempumelelo ekwelapheni ukulala kubantu asebekhulile njengoba kunjalo nakwabancane. Abantu abaningi asebekhulile bathola ukuthi ukwelashwa kokuziphatha kwengqondo kwamukeleka kakhulu kunokwelashwa kwemithi, ngokwengxenye, ngoba ayinayo imiphumela emibi ehambisana nokuphathwa kwemithi yokuqwasha. UCassidy-Eagle noSiebern (2017) basebenzise ukungenelela kokuziphatha okunengqondo okuhlinzekwe ngudokotela wezengqondo kubantu abadala abangama-28 abaneminyaka yobudala engama-89.36, abahlangabezana nezindlela zombili zokuqwasha nokukhubazeka okuncane kwengqondo. Lokhu kungenelela kokwelashwa kuholele ekwenzeni ngcono ukulala nezinyathelo ezithuthukisiwe zokusebenza okuphezulu njengokuhlela nokukhumbula. Lokhu kukhombisa ukuthi ukwelashwa kokuziphatha kwengqondo kungaba ukungenelela okuwusizo kweziguli ezinokukhubazeka okuncane kwengqondo. Olunye ucwaningo luzodingeka ukuhlola ngokugcwele izinzuzo ezingaba khona zokwelashwa kwengqondo kokuqwasha kulezi ziguli.

Izinhlobo ezinkulu zokuwohloka komqondo yisifo i-Alzheimer's, isifo sikaParkinson esinokuwohloka komqondo, ukuwohloka komqondo ngemizimba yeLeyy, ukuwohloka komqondo ngemithambo yegazi, isifo sikaHuntington, isifo seCreutzfeldt-Jakob, nesifo sengqondo esiyingozi sangaphambili.Iningi labantu liyasazi isifo i-Alzheimer's kanye nesifo sikaParkinson nesifo sokuwohloka komqondo. Eqinisweni, isifo i-Alzheimer siyimbangela enkulu yokuwohloka komqondo ekugugeni. Isifo sikaParkinson siyaziwa futhi sivame ukuhlotshaniswa nokuwohloka komqondo. Cishe i-80% yeziguli zikaParkinson zizokhula umqondo othile phakathi neminyaka eyisishiyagalombili. Phakathi kweziguli ezingama-40% nezingama-60% ezinokuwohloka komqondo zithinteka ukuqwasha. Ukuqwasha kungenye yezinkinga eziningi zokulala ezingacindezela izimpilo nokwelashwa kweziguli ezinokuwohloka komqondo. Kuyaziwa futhi ukuthi ukuphazamiseka kokulala okwandayo, kanye nezinguquko ze-EEG ezingabonakala kwi-polysomnography, zivame ukuba zimbi kakhulu kanye nokuqhubeka kokuwohloka komqondo.

Isifo i-Alzheimer yisifo se-neurodegenerative esincipha ngokuqhubekayo kwimemori nokusebenza kwengqondo ngokuhamba kwesikhathi. Kuze kube ngu-25% weziguli ezine-Alzheimer's eziphakathi nendawo nezingama-50% ezinezifo ezilinganayo ukuya kwezinzima ezinezinkinga ezithile zokulala. Lokhu kufaka phakathi ukuqwasha nokulala ngokweqile emini. Mhlawumbe inkinga ebucayi kakhulu kulezi ezihlobene nobuthongo yisimo esixhunyaniswe ne-circadian "sokushona kwelanga", lapho, iziguli emahoreni kusihlwa ziqala ukuba nesimo esifana ne-delirium ngokudideka, ukukhathazeka, ukuyaluza, nokuziphatha okunolaka okungenzeka kube ukuzulazula kude nasekhaya. Ngempela, ubunzima bokulala kulezi ziguli bunomthelela omkhulu ekufakweni kwezikhungo zakuqala, futhi ukuzulazula kaningi kubangela isidingo sokuthi lezi ziguli zihlale kumayunithi akhiyiwe.

Isifo sikaParkinson esinokuwohloka komqondo sihlotshaniswa nezinkinga ezinkulu zokulala kufaka phakathi ukusangana okungenzeka kuhlobene nezici zokulala ze-REM ezivela ngesikhathi sokuvuka, ukugula kokuziphatha kwe-REM lapho abantu benza khona amaphupho, nokwehla kwekhwalithi yokulala. Lezi zinkinga zingaba nzima kakhulu ezigulini, imindeni yazo, nakubanakekeli bazo.

Izinkinga zokulala eziyinhloko iziguli ezinazo zonke izinhlobo zokuwohloka komqondo ukungalali, ukulala ngokweqile emini, ukushintsha isigqi se-circadian, nokunyakaza ngokweqile ebusuku njengokukhahlela umlenze, ukulingisa amaphupho nokuzula. Isinyathelo sokuqala ekusizeni ukuphatha lezi zinkinga ukuthi odokotela babo babone ukulala okungeziwe noma ukuphazamiseka kwezokwelapha ukuze bakwazi ukuphathwa ukuze basize ekulungiseni lobu bunzima. Isibonelo, iziguli zingaba nesifo semilenze esingenakuphumula, i-apnea yokulala, ukucindezeleka, ubuhlungu, noma izinkinga zesinye, konke okungaphazamisa ukulala. Ukwelashwa kwalezi zinkinga kungasiza ekwehliseni ukuqwasha nokulala ngokweqile emini. Izinkinga ezahlukahlukene zezokwelapha nemithi esetshenziselwa ukubelapha ingaba nomthelela ezinkingeni zokulala ezigulini ezinokuwohloka komqondo. Isibonelo kungaba amandla okwanda kokuqwasha okubangelwa ukusebenzisa imishanguzo yokulwa nokucindezelwa ukuphatha ukucindezeleka.

Ukufundwa Kwe-Dementia Okubalulekile

Kungani Ukuzithiba Kwehluleka ku-Dementia