Tidur Terganggu Kerja Celaru

Berdengkur adalah sejenis gangguan tidur akibat sekatan pada aliran udara yang melalui saluran di bahagian belakang mulut dan hidung. Sekatan itu menyebabkan seseorang menghasilkan bunyi kuat dan kasar.

Bagi orang yang berdengkur, ketika tidur otot tekak mereka akan mengendur dan jatuh ke dalam tekak. Ini tidak sahaja mewujudkan sekatan di saluran pernafasan, malah aliran udara menjadi sempit.

Dengkuran berlaku apabila otot tekak yang kendur iaitu lidah dan bahagian atas tekak bergesel dengan lelangit lembut dan uvula (anak tekak). Geselan ini menghasilkan getaran dengan bunyi yang kuat ketika proses pernafasan terutama ketika tidur telentang.

Kelainan anatomi dikenal pasti menyumbang kepada faktor gangguan tidur ini berikutan ada segelintir orang mengalami kecacatan pada hidung dan tekak seperti polip hidung, hidung senget (nasal septal deviation), lelangit lembut dan uvula panjang, pembesaran tonsil dan adenoid besar.

Gaya hidup tidak sihat seperti minum alkohol dan merokok juga mendorong otot tekak lama-kelamaan menjadi kendur. Lemak berlebihan di sekeliling leher akibat obesiti juga menghimpit tisu lembut di belakang tekak ke dalam dan meningkatkan tekanan terhadap otot tekak.

Selain pengambilan ubatan tertentu bagi mengendurkan otot, penuaan juga menyebabkan otot tekak mengendur berikutan keanjalan tisu berkurangan akibat peningkatan usia.

Dengkuran boleh menjadi masalah sosial terutama apabila membabitkan pasangan yang terjejas kerana bunyi bising daripada dengkuran itu menyebabkan waktu tidur mereka diganggu sehingga tidak cukup tidur dan mengantuk ketika bekerja.

Daripada sudut perubatan, tidur yang terganggu akibat dengkuran juga menyebabkan seseorang tidak cukup rehat, malah ia sebahagian daripada spektrum penyakit berhenti nafas sewaktu tidur akibat salur pernafasan terhalang (OSA) yang menyebabkan masalah kesihatan lebih buruk dalam jangka panjang.

Kesan kesihatan buruk yang biasa dikaitkan dengan masalah dengkuran dan gangguan pernafasan ketika tidur adalah rutin terjejas pada sebelah siang dan penyakit kardiovaskular. Akibat kurang tidur, seseorang jadi mengantuk sepanjang siang dan tertidur tanpa sengaja ketika melakukan aktiviti rutin seperti memandu, menonton televisyen atau bekerja.

Masalah lain kurang tidur seperti tidak segar sebaik bangun tidur, memori merosot dan kurang penumpuan, sakit kepala pada waktu pagi, mood berubah, sistem imun terjejas, demam dan halusinasi.

Pensyarah, Pakar Bedah Mulut dan Maksilofasial, Fakulti Pergigian, Universiti Teknologi Mara (UiTM), Dr Mohd Shawal Firdaus Mohamad berkata, kebanyakan orang yang tidur berdengkur tidak menyedari masalah mereka dan mengharapkan orang lain untuk mengawasi gangguan tidur dialami.

Jika anda diberitahu selalu berdengkur dengan sangat kuat ketika tidur hingga mengganggu orang lain, segeralah berjumpa doktor atau pakar bagi menjalani pemeriksaan.

Ujian dijalankan akan mengenal pasti masalah sebenar dihadapi sama ada dengkuran itu adalah simptom penyakit terhenti bernafas sewaktu tidur (apnea) yang sederhana atau serius. Ini kerana, tidak semua orang yang berdengkur menghadapi masalah apnea, sebaliknya semua orang yang mengalami apnea akan berdengkur.

“Ujian Skala Tidur Epworth juga boleh dilakukan sendiri bagi mengenal pasti tahap mengantuk pada waktu siang akibat tidak cukup tidur. Dalam skala ini, markah kosong hingga tiga diberi bagi setiap peluang untuk anda tertidur ketika melakukan aktiviti rutin seperti sedang duduk dan membaca, menonton televisyen, bermesyuarat, memandu kereta dan ketika berhenti di lampu isyarat.

“Jika markah terkumpul kurang daripada 10, bermakna anda mendapat tidur yang cukup dan andainya markah anda lebih daripada 10, perlu berjumpa doktor atau pakar bagi menjalankan diagnosis seterusnya seperti ujian tidur (polysomnography),’ katanya.

Dr Mohd Shawal Firdaus berkata, hasil ujian berkenaan menentukan tahap gangguan tidur dan puncanya serta rawatan yang bersesuaian untuk memulihkan masalah terbabit.

“Pembedahan biasanya dilakukan bagi gangguan tidur yang berpunca daripada kelainan anatomi dengan membuang sekatan yang wujud dalam saluran pernafasan atau memperbaiki struktur dalam tekak atau hidung yang menyebabkan rongga tersumbat.

“Bagi rawatan bukan pembedahan pula, mereka yang mengalami gangguan tidur boleh menggunakan alat Continuous Positive Airway Pressure (CPAP) yang memberi tekanan tinggi tetap dan boleh membuka saluran pernafasan bagi memudahkan penghembusan udara keluar.

“Namun tidak semua penghidap gangguan tidur boleh bertoleransi dengan penggunaan alat CPAP terdiri topeng mulut dan hidung, hos dan mesin tekanan udara yang beroperasi dengan bantuan bekalan elektrik ketika tidur,” katanya.

Beliau berkata, penggunaan alat bantuan oral berbentuk pendakap gigi plastik juga boleh membantu mengatasi masalah dengkuran dan OSA tahap ringan serta sederhana dengan mengelakkan tisu lembut atau otot tekak jatuh ke dalam tekak dan mengganggu corak pernafasan normal.

“Penahan ortodontik ini membantu membetulkan kedudukan rahang bawah, lidah, lelangit lembut dan tulang berbentuk U di leher yang menyokong lidah pada tempat yang sepatutnya.

“Matlamat alat bantuan oral ini adalah untuk menolak rahang bawah ke depan apabila pendakap gigi di bahagian bawah direka mempunyai penyangkut dan disangkut pada pendakap gigi bahagian atas.

“Dengan ini, alat bantuan oral itu akan menahan otot tekak jatuh ke belakang seterusnya mengekalkan laluan udara terbuka dengan kestabilan lidah dan rahang,” katanya.

Alat bantuan oral seperti SomnoDent iaitu teknologi dibangunkan pengeluar alatan bantuan gangguan tidur berkaitan pernafasan, SomnoMed, adalah alternatif bagi penghidap gangguan tidur yang berisiko untuk melakukan pembedahan, selain mereka yang enggan menggunakan alat CPAP.

Pemakaian SomnoDent tidak halang penghidap berbual, malah boleh membuka atau menutup mulut seperti biasa dan teknologi khasnya menjadikan alat bantuan oral ini tidak mudah berbau serta boleh dicuci sendiri.

“Pendakap gigi untuk mengatasi masalah dengkuran dan OSA perlu dibuat mengikut saiz mulut dan gigi penghidap. Cara menghasilkan alat bantuan oral ini juga sama dengan membuat pendakap gigi untuk membetulkan kecacatan gigi atau maloklusi.

“Penghidap gangguan tidur juga dinasihatkan mengubah gaya hidup mereka kepada amalan

yang lebih sihat seperti kurangkan berat badan, berhenti merokok dan mengambil minuman alkohol serta mengubah kedudukan tidur yang menyumbang faktor pernafasan terganggu,” katanya.

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