Narcolepsy

Ko te narcolepsy he āhuatanga e tino moe ai te tangata i te awatea, ā, e taea ai te moe ohorere. E torutoru ngā tāngata e whai tohu anō, pēnei i te ngoikore o ngā uaua ina rongo i ngā kare-a-roto kaha.

Ka pā kino ngā tohu ki te oranga o ia rā. Ka uaua ki ngā tāngata e whai narcolepsy ana te noho ara mō ngā wā roa. Ina puta he ngaro ohorere o te uaua i te narcolepsy, e kiia ana ko te cataplexy (KAT-uh-plek-see). Ka taea te whakaohooho e te kare-a-roto kaha, ā, tērā pea he mea whakakatakata.

E rua ngā momo o te narcolepsy. Ko te nuinga o ngā tāngata e whai narcolepsy momo 1 ana e whai cataplexy ana. Ko te nuinga o ngā tāngata e whai narcolepsy momo 2 ana kāore e whai cataplexy.

He āhuatanga ora tonu te narcolepsy, ā, kāore he rongoā. Heoi, ka taea e ngā rongoā me ngā huringa noho te awhina i te whakahaere i ngā tohu. Ka taea e te tautoko mai i te whānau, ngā hoa, ngā kaituku mahi me ngā kaiako te awhina i ngā tāngata ki te whakahaere i te āhuatanga.

Ko ngā tohu o te narcolepsy ka pāngia pea i ngā tau tuatahi. Katahi ka haere tonu mō te ora. Kei roto i ngā tohu: Te moe nui i te awatea. Ko te moe nui i te awatea te tohu tuatahi e puta mai ana, ā, ko te moe nui ka uaua ai te aro turuki me te mahi. Ka iti ake te mataara me te aro o te hunga e pangia ana e te narcolepsy i te awatea. Ka moe hoki rātou kahore he whakatūpato. Ka taea te moe i hea, i tehea wā. Ka puta pea i te wā e ngenge ana rātou, i te wā rānei e mahi ana i tētahi mahi. Hei tauira, ka taea e te hunga e pangia ana e te narcolepsy te moe ohorere i te wā e mahi ana, i te kōrero rānei me ngā hoa. Ka tino kino te moe i te wā e taraiwa ana. Ka roa pea te moe i etahi meneti noa iho, tae atu ki te haurua haora. I muri i te ara, ka whakaorangia te hunga e pangia ana e te narcolepsy, engari ka moe ano. Ngā whāinga aunoa. Ka haere tonu etahi o te hunga e pangia ana e te narcolepsy i te mahi i te wā e moe poto ana rātou. Hei tauira, ka moe pea rātou i te wā e tuhituhi ana, e patuki ana, e taraiwa ana rānei. Ka mahi tonu pea rātou i taua mahi i te wā e moe ana. I muri i te ara, kaore e taea e rātou te maumahara ki te mea i mahi rātou, ā, ki te kore pea i mahi pai. Te ngaro ohorere o te uaua o te tinana. Ko te āhuatanga nei te ingoa ko te cataplexy. Ka taea e ia te whakaiti i te kōrero, te ngoikore rānei o te nuinga o ngā uaua tae atu ki etahi meneti. Ka whakaohohia e ngā kare-a-roto kaha—he maha ngā kare-a-roto pai. Ka taea e te kata, te koa rānei te whakaiti i te uaua o te tinana. Engari i etahi wā, ka taea e te wehi, te miharo, te riri rānei te ngaro o te uaua o te tinana. Hei tauira, i te wā e kata ana koe, ka taka pea tō ulu kahore he mana o koe. Ka ngaro pea te kaha o ō turi, ka taka ai koe. Ko etahi o te hunga e pangia ana e te narcolepsy ka pāngia e tetahi, e rua rānei o ngā wāhanga o te cataplexy i te tau. Ko ētahi atu ka maha ngā wāhanga i te rā. Kāore te katoa o te hunga e pangia ana e te narcolepsy e pāngia ana e ēnei tohu. Te parekura moe. Ka pāngia pea te hunga e pangia ana e te narcolepsy e te parekura moe. I te wā o te parekura moe, kaore e taea e te tangata te neke, te kōrero rānei i te wā e moe ana, i te wā e ara ana rānei. Ko te parekura te nuinga o te wā poto—ka roa pea etahi hēkona, etahi meneti rānei. Engari ka wehi pea. Ka mohio pea koe kei te puta mai, ka taea hoki te maumahara i muri mai. Kāore te katoa o te hunga e pangia ana e te parekura moe e pangia ana e te narcolepsy. Ngā whakairoiro. I etahi wā ka kite te hunga i ngā mea kahore i reira i te wā o te parekura moe. Ka puta pea ngā whakairoiro i te moenga kahore he parekura moe. Ko ēnei te ingoa ko ngā whakairoiro hypnagogic mehemea ka puta i te wā e moe ana koe. Ko ēnei te ingoa ko ngā whakairoiro hypnopompic mehemea ka puta i te wā e ara ana koe. Hei tauira, ka whakaaro pea te tangata kei te kite ia i tētahi tangata ke i te ruma moe kahore i reira. Ka tino marama, ka wehi pea ēnei whakairoiro, no te mea pea kāore koe i te moe katoa i te wā e tīmata ana koe te moemoea. Ngā huringa i te moe tere o te kanohi (REM). Ko te moe REM te wā e puta mai ana te nuinga o ngā moemoea. Ko te tikanga, ka tomo te hunga ki te moe REM i te 60 ki te 90 meneti i muri i te moe. Engari ka tere ake te neke o te hunga e pangia ana e te narcolepsy ki te moe REM. Ka tomo pea rātou ki te moe REM i roto i ngā 15 meneti i muri i te moe. Ka taea hoki te puta mai o te moe REM i tehea wā o te rā. Ka pangia pea te hunga e pangia ana e te narcolepsy e ētahi atu āhuatanga moe. Ka pangia pea rātou e te apnea moe aukati, i te wā e tīmata ana, e mutu ana te manawa i te pō. Ka mahi rānei rātou i ō rātou moemoea, e mohiotia ana ko te mate āhuatanga moe REM. Ka uaua rānei te moe, te moe tonu rānei, e kiia ana ko te insomnia. Tirohia tō kaimahi hauora mehemea ka pāngia koe e te moe nui i te awatea e pā ana ki tō oranga whaiaro, ki tō oranga mahi rānei.

Tena tirohia tō kaimahi hauora mena ka pāngia koe e te hiamoe i te awatea e pā ana ki tō oranga whaiaro, ā, ki tō mahi.

E kore e mohiotia te take tino o te narcolepsy. He iti te taumata o te hypocretin (hi-poe-KREE-tin), e kiia ana hoki ko te orexin, i roto i te hunga e pangia ana e te narcolepsy momo 1. He matū te hypocretin kei roto i te roro e āwhina ana ki te whakahaere i te noho ara me te tomo ki te moe REM.

He iti te taumata o te hypocretin i roto i te hunga e pangia ana e te cataplexy. E kore e mohiotia te take tino o te ngaro o ngā pūtau whakaputa hypocretin i roto i te roro. Engari e whakaaro ana ngā tohunga he hua nā te āhuatanga autoimmune. He āhuatanga autoimmune te whakangaro e te pūnaha ārai mate o te tinana ōna ake pūtau.

He mea pea ano te whakaaro o te ira tangata ki te narcolepsy. Engari he iti rawa te tūponotanga o te tuku mai e te mātua o tēnei āhuatanga moe ki te tamaiti—ko te 1% ki te 2% noa iho.

Ka hono pea te narcolepsy ki te whakaū ki te mate huaketo H1N1, e kiia ana ko te mate huaketo poaka. Ka hono pea ano ki tētahi momo rongoā H1N1 i hoatu ki Ūropi.

Ko te tukanga noa o te moe ka tīmata me te wāhanga e kiia nei ko te moe kore-tere tere o te kanohi (NREM). I roto i tēnei wāhanga, ka ngāwhawha ngā ngaru o te roro. I muri i te haora neke atu rānei o te moe NREM, ka huri te mahi o te roro ka tīmata te moe REM. Ko te nuinga o te moemoea ka puta i te moe REM.

I roto i te narcolepsy, ka tomo pea koe ki te moe REM i te wa poto i muri i te haere i roto i te moe NREM iti. Ka taea e tēnei te puta i te pō me te rā. Ko te cataplexy, te parekura moe me ngā whakairoiro he rite ki ngā huringa e puta ana i te moe REM. Engari i roto i te narcolepsy, ka puta ēnei tohu i te wa e ara ana koe, i te wa e moe ana rānei.

Ko etahi noa te take morearea e mohiotia ana mo te narcolepsy, tae atu ki:

• Te Tau. Ko te tikanga ka tīmata te narcolepsy i waenga i te 10 me te 30 tau.
• Te hītori whānau. He 20 ki te 40 wā teitei ake tō morearea o te narcolepsy ki te pēnei tetahi mema whānau tata ki a koe.

Ka taea e te narcolepsy te whakaeke i ngā raruraru, pēnei i:

• Ngā whakaaro he mō te āhuatanga. Ka pā te narcolepsy ki te mahi, ki te kura, ki tō oranga whaiaro rānei. Ka taea e ētahi atu te titiro ki te hunga e pangia ana e te narcolepsy he mangere, he torutoru rānei.
• Ngā pānga ki ngā whānau tata. Ka taea e ngā āhuatanga kaha, pēnei i te riri, te harikoa rānei, te whakaoho i te cataplexy. Ka taea e tēnei te whakaiti i te whakauru ki ngā hononga wairua mō te hunga e pangia ana e te narcolepsy.
• Te kino tinana. Ka taea e te moe tere te puta mai i te whara. Kei te nui ake te tūpono o te aituā waka mēnā ka moe koe i te wā e taraiwa ana. Kei te nui ake tō tūpono ki te motu me te tahuna mēnā ka moe koe i te wā e tunu kai ana.
• Te momona. Kei te tūpono ake te hunga e pangia ana e te narcolepsy ki te taumaha. I etahi wā ka tere te piki o te taumaha ina tīmata ngā tohu.

Kaore he uauatanga

Ka taea e tō kaiāwhina hauora te whakaaro he narcolepsy koe i runga i ō tohu o te moe i te awatea me te ngaro ohorere o te uaua o te tinana, e kiia nei ko te cataplexy. He tino pea ka tukuna koe e tō kaiāwhina hauora ki te tohunga moe. Ko te tikanga, me noho koe i te po i te pokapū moe mō te tātaritanga moe hohonu kia taea ai te whakamārama tika.

Ka tino whakamārama te tohunga moe i te narcolepsy me te whakatau i tōna kino i runga i:

• Tō hītori moe. Ka āwhina te hītori moe taipitopito ki te whakamārama. He tino pea ka whakakiia e koe te Pae Moe o Epworth. Ka whakamahia e te pae ngā pātai poto hei ine i tō taumata moe. Ka whakautu koe ki te āhei o te moe i ētahi wā, pēnei i te noho iho i muri i te tina.
• Ngā rēkōta moe. Ka tono pea rātou kia tuhi koe i tō tauira moe mō te wiki, rua rānei. Ka taea ai e tō kaiāwhina hauora te whakarite ki te hono o tō tauira moe ki te ātaahua o tō ngākau. Ka mau pea koe i te taputapu i tō ringa, e kiia nei ko te actigraph. Ka ine i ngā wā mahi me te okioki, me te āhua me te wā e moe ai koe.
• Te rangahau moe, e kiia nei ko te polysomnography. Ka ine tenei whakamātautau i ngā tohu i te moe mā te whakamahi i ngā tīkitiki rino papatahi e kiia nei ko ngā electrodes i runga i tō pane. Mō tēnei whakamātautau, me noho koe i te po i te whare hauora. Ka ine te whakamātautau i ō ngā ngākau roro, te tere o te ngakau me te manawa. Ka tuhihia hoki ngā nekehanga o ō waewae me ō kanohi.
• Te whakamātautau moe maha. Ka ine tenei whakamātautau i te roa o te moe i te awatea. Ka tonoa koe ki te moe wha, rima rānei i te pokapū moe. Me wehewehe ngā moe katoa i te rua haora. Ka tirotiro ngā tohunga i ō tauira moe. Ka moe ngā tāngata he narcolepsy ngāwari ka tomo ki te moe tere o te kanohi (REM) tere.
• Ngā whakamātautau ira me te whākōkī lumbar, e kiia nei ko te whākōkī o te tuaiwi. I etahi wā, ka mahia pea te whakamātautau ira ki te kite mena kei te tūpono koe ki te narcolepsy momo 1. Mena koia, ka tūtohu pea tō tohunga moe i te whākōkī lumbar hei tirotiro i te taumata o te hypocretin i roto i tō wai tuaiwi. Ka mahia tēnei whakamātautau i ngā pokapū motuhake anake.

Ka taea hoki e ēnei whakamātautau te awhina i te whakakore i ētahi atu take pea o ō tohu. Ka taea hoki te whakaeke i te moe i te awatea e te kore moe, ngā rongoā e moe ai koe me te moe apnea.

Kāore he rongoā mō te narcolepsy, engari ko te maimoatanga hei awhina i te whakahaere i ngā tohu e whakauru ana i ngā rongoā me ngā huringa oranga.

Ngā rongoā mō te narcolepsy e whakauru ana:

• Ngā whakaohooho. Ko ngā rongoā e whakaohooho ana i te pūnaha io o te pūtau te maimoatanga matua hei awhina i te hunga e mate narcolepsy ana kia noho ara i te awatea. Ka taea e tō kaimahi hauora te tūtohutia te modafinil (Provigil) te armodafinil rānei (Nuvigil). Kāore ēnei rongoā e rite te whakaongaonga ki ngā whakaohooho tawhito. Kāore hoki rātou e whakaputa i ngā teitei me ngā iti e pā ana ki ngā whakaohooho tawhito. Kāore ngā pānga taha e noa ana, engari ka uru pea te mamae o te mahunga, te ruaki, te manukanuka rānei.

  Ko te Solriamfetol (Sunosi) me te pitolisant (Wakix) he whakaohooho hou e whakamahia ana mō te narcolepsy. Ka āhei pea te pitolisant hei awhina mō te cataplexy.

  Ko ētahi tāngata e hiahia ana ki te maimoatanga me te methylphenidate (Ritalin, Concerta, ētahi atu). Ā, ka taea e rātou te tango i ngā amphetamines (Adderall XR 10, Desoxyn, ētahi atu). He whai hua ēnei rongoā, engari ka taea te whakaongaonga. Ka puta pea ngā pānga taha pēnei i te manukanuka me te tere o te ngākau.

• Sodium oxybate (Xyrem, Lumryz) me ngā tote oxybate (Xywav). He pai te mahi o ēnei rongoā ki te whakaora i te cataplexy. Ka āwhina rātou ki te whakapai ake i te moe o te pō, he iti tonu i te narcolepsy. Ka āhei pea hoki te āwhina i te whakahaere i te moe o te awatea.

  He whakatōpūtanga hou te Xywav me te iti o te konutai.

  Ka taea e ēnei rongoā te whai pānga taha, pēnei i te ruaki, te mimi i te moenga me te hikoi i te moe. Ko te tango tahi me ētahi atu papa moe, ngā whakaora mamae narcotic, te waiū rānei ka āhei te arahi ki te raruraru o te manawa, te coma me te mate.

Ngā whakaohooho. Ko ngā rongoā e whakaohooho ana i te pūnaha io o te pūtau te maimoatanga matua hei awhina i te hunga e mate narcolepsy ana kia noho ara i te awatea. Ka taea e tō kaimahi hauora te tūtohutia te modafinil (Provigil) te armodafinil rānei (Nuvigil). Kāore ēnei rongoā e rite te whakaongaonga ki ngā whakaohooho tawhito. Kāore hoki rātou e whakaputa i ngā teitei me ngā iti e pā ana ki ngā whakaohooho tawhito. Kāore ngā pānga taha e noa ana, engari ka uru pea te mamae o te mahunga, te ruaki, te manukanuka rānei.

Ko te Solriamfetol (Sunosi) me te pitolisant (Wakix) he whakaohooho hou e whakamahia ana mō te narcolepsy. Ka āhei pea te pitolisant hei awhina mō te cataplexy.

Ko ētahi tāngata e hiahia ana ki te maimoatanga me te methylphenidate (Ritalin, Concerta, ētahi atu). Ā, ka taea e rātou te tango i ngā amphetamines (Adderall XR 10, Desoxyn, ētahi atu). He whai hua ēnei rongoā, engari ka taea te whakaongaonga. Ka puta pea ngā pānga taha pēnei i te manukanuka me te tere o te ngākau.

E whakauru ana i te venlafaxine (Effexor XR), te fluoxetine (Prozac), te duloxetine (Cymbalta, Drizalma Sprinkle) me te sertraline (Zoloft). Ka taea e ngā pānga taha te whakauru i te taumaha, te moe kore me ngā raruraru o te pūnaha kai.

Sodium oxybate (Xyrem, Lumryz) me ngā tote oxybate (Xywav). He pai te mahi o ēnei rongoā ki te whakaora i te cataplexy. Ka āwhina rātou ki te whakapai ake i te moe o te pō, he iti tonu i te narcolepsy. Ka āhei pea hoki te āwhina i te whakahaere i te moe o te awatea.

He whakatōpūtanga hou te Xywav me te iti o te konutai.

Ka taea e ēnei rongoā te whai pānga taha, pēnei i te ruaki, te mimi i te moenga me te hikoi i te moe. Ko te tango tahi me ētahi atu papa moe, ngā whakaora mamake narcotic, te waiū rānei ka āhei te arahi ki te raruraru o te manawa, te coma me te mate.

Ki te tango koe i ngā rongoā mō ētahi atu āhuatanga hauora, ui atu ki tō kaimahi hauora me pēhea te mahi tahi me ngā rongoā narcolepsy.

He rongoā ātaahua e taea te hoko e kore ai he whakahau ka taea te whakaputa i te ngenge. E whakauru ana i ngā rongoā mate pāwera me te makariri. Ki te mate koe i te narcolepsy, ka taea e tō kaimahi hauora te tūtohutia kia kaua e tango i ēnei rongoā.

Kei te ako ngā kairangahau i ētahi atu maimoatanga pea mō te narcolepsy. Ko ngā rongoā kei te akohia e whakauru ana i ngā mea e whai take ana i te pūnaha matū hypocretin. Kei te ako hoki ngā kairangahau i te immunotherapy. Me mahi atu te rangahau i mua i te wā e wātea ai ēnei rongoā.

Kaore he uauatanga