Lam the nao de nguoi gia ngu tot
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Mat ngu la tinh trang kho di vao giac ngu hoac khong the duy tri duoc giac ngu qua dem, hay noi don gian hon la khong co duoc giac ngu day du. Cam giac khong co duoc giac ngu thoai mai rat pho bien, gap o 20-50% dan so tai cac quoc gia khac nhau.
Co rat nhieu yeu to co the gay mat ngu o nguoi cao tuoi. Cac yeu to nay bao gom giam hoat dong the luc, it tiep xuc voi anh sang, giam nguong bi danh thuc (de bi thuc giac hon), thay doi nhip sinh hoc, giam kha nang hoi phuc cac chuc nang cua co the khi co the bi lao hoa... Kem theo, nhung benh ly hay gap o nguoi cao tuoi nhu sa sut tri tue, benh ly mach mau nao, suy tim, viem nhiem duong ho hap, dau xuong khop, tram cam... deu lam giam chat luong giac ngu.
Nhin chung, co 4 nhom nguyen nhan chinh gay mat ngu o nguoi cao tuoi:
- Cac benh gay roi loan giac ngu tien phat: Tuoi cao thuong di kem voi tang nguy co mac cac benh gay roi loan giac ngu tien phat, pho bien nhat la hien tuong ngung tho luc ngu (hay gap o nhung nguoi beo phi), hoac cac hien tuong chan tay cu dong mot cach tu dong ve dem lam nguoi cao tuoi bi thuc giac.
- Cac benh ly gay roi loan giac ngu thu phat: Dau la nguyen nhan noi bat gay anh huong den giac ngu. Nguyen nhan gay dau pho bien nhat o nhung nguoi cao tuoi la cac benh co xuong khop nhu thoai hoa khop, loang xuong..., co dac diem la dau tang len ve nua dem gan sang, lam cho benh nhan bi tinh giac va sau do rat kho ngu tiep. Cac benh ly khac bao gom benh thieu mau co tim gay dau nguc, hien tuong hay tieu dem (vi du do u xo tien liet tuyen, do benh dai thao duong), hoac kho tho (do suy tim, viem phe quan, hen phe quan)...
- Cac benh ly tam than kinh: Theo nhieu nghien cuu, benh tram cam duong nhu la yeu to lon nhat co lien quan den cac roi loan giac ngu o nguoi cao tuoi. Cac benh nhan tram cam thuong kho bat dau giac ngu hoac hay bi thuc giac som va co hien tuong ngu ngay, mot so benh nhan lai co luc bi kich dong nen rat kho ngu. Uoc tinh co toi 30% nguoi cao tuoi trong cong dong va 50% nguoi cao tuoi trong cac vien duong lao co trieu chung tram cam. Trong mot nghien cuu rat lon o My, nguoi ta thay co den 14% nhung nguoi mat ngu co bieu hien bi tram cam so voi chi 1% nhung nguoi co giac ngu binh thuong. Ngoai ra, cac roi loan tam than khac co kha nang gay mat ngu la lo au, sa sut tri tue... Co nhieu ly do khien nguoi cao tuoi thuong lo lang qua muc nhu so mat uy tin, mat su tin nhiem cua gia dinh, cong dong (khi nghi huu), lo lang ve nhung tai nan cua anh chi em, ban be hoac cac van de tien nong, tai chinh...
- Do thuoc: Nhung thuoc hay gay mat ngu o nguoi cao tuoi gom cac loai corticoid, noi tiet to tuyen giap (deu gay kich thich), cac thuoc dieu tri benh than kinh va ngay ca mot so thuoc dung de dieu tri benh tram cam. Ngoai ra con co cac thuoc chen beta giao cam, thuoc ha huyet ap Methyldopa... Mot so chat tuy khong han la thuoc nhung moi nguoi lai hay dung va rat de gay mat ngu nhu ruou, caffeine (co trong che, ca phe), nicotine (co trong thuoc la). Can chu y la co mot so thuoc ma nhieu nguoi van coi la thuoc ngu va duoc dung de dieu tri mat ngu nhu Benzodiazepine (Seduxen)... lai co tac dung phu la gay buon ngu khien ho ngu nhieu hon vao ban ngay, hau qua la nguoi benh cang it ngu hon vao ban dem.
De co giac ngu tot, cac bien phap khong dung thuoc duoc khuyen khich ap dung cho tat ca nhung nguoi bi mat ngu, nhat la nhung truong hop bi mat ngu do cac roi loan tam ly keo dai. Muc dich la xoa bo hoac lam giam cac yeu to gop phan gay mat ngu, bao gom tu viec huong dan ve giac ngu, thuc hien loi khuyen ve "ve sinh giac ngu" cho toi tap cac ky nang thu gian... Thuat ngu "ve sinh giac ngu" khong tot am chi nhung thoi quen, hoat dong hang ngay khong phu hop de tao nen mot giac ngu tot. Mot so loi khuyen giup cai thien ve sinh giac ngu la:
- Tao mot moi truong thu gian va yen tinh khi di ngu, bao gom cac dieu kien toi uu ve anh sang, tieng on, nhiet do...
- Co gang tao thoi quen ve trinh tu gio giac, cac buoc di vao giac ngu.
- Khi tinh day buoi sang, khong nen nam nan lai tren giuong qua lau.
- Khi vao phong ngu, khong nen doc sach hoac xem ti-vi.
- Ban dem, khong nen nhin vao dong ho.
- Nen tranh uong ca phe, ruou hoac hut thuoc la vao buoi chieu toi.
- Khong nen an hoac uong nuoc, dung cac thuoc co chua chat kich thich.
- Khong nen an hoac uong qua nhieu trong vong 3 gio truoc khi di ngu.
- Chi di ngu khi da cam thay buon ngu va san sang cho giac ngu.
- Nen tap the duc deu dan hang ngay nhung khong nen tap nhieu sau 6 gio chieu.
- Khong nen ngu ngay nhieu.
- Truoc khi di ngu nen tam nuoc am vi se lam tang nhiet do co the va co the giup bat dau giac ngu de dang hon.
- Phong ngu chi nen dung de ngu, khong nen dung cho cac cong viec khac.
- Tranh cang thang hoac xuc cam truoc khi di ngu. Vao moi buoi toi nen danh mot khoang thoi gian de suy nghi, tim cach giai quyet nhung van de minh con quan tam, lo lang.
- Khong nen qua lo lang neu bi mat ngu.
- Phai hoc cach thu gian de co cam giac thu thai ca ve the chat lan tinh than.
- Tranh toi da hien tuong moi truong phong ngu khong thoai mai, vi du nhu vo chong cai nhau, goi dien thoai trao doi cong viec, thuyet phuc khach hang...
- Neu ban buon ngu nhieu vao ban ngay, hay tao moi truong co du anh sang va su kich thich trong gio lam viec de tranh cam giac buon ngu.
Mot nguoi bi mat ngu co the phai dung thuoc trong hai tinh huong sau day:
- De dieu tri cac benh la nguyen nhan gay mat ngu: Vi du nhung nguoi bi mat ngu do dau xuong khop duoc cho dung cac thuoc chua thoai hoa khop hoac cac thuoc giam dau. Dieu tri tot se giup benh nhan co lai duoc giac ngu binh thuong. Can phat hien som va dieu tri tich cuc benh tram cam vi no rat hay xay ra o nhung nguoi bi cac benh man tinh. Chu y nhung nguoi cao tuoi la doi tuong phai dung nhieu loai thuoc nhat (tu dung hoac theo chi dinh cua bac si), trong so do nhieu loai co the gay mat ngu, vi du do co chua caffeine.
Nguyen tac chung cua dieu tri cac benh gay mat ngu la phai lam giam toi da cac trieu chung nhung lai han che dung thuoc den muc toi thieu.
- Cac thuoc gay ngu, dung cho nhung benh nhan bi mat ngu keo dai khong ro nguyen nhan.
Trong thuc te, viec dung thuoc dieu tri chung mat ngu qua pho bien, co khi khong can thiet. Nhieu nghien cuu gan day cho thay, tac dung cua cac thuoc dieu tri mat ngu khong hieu qua bang cac bien phap khong dung thuoc nhu da trinh bay o phan tren. Neu ket hop ca hai bien phap nay se mang lai hieu qua cao hon, trong do thuoc dem lai tac dung nhanh chong tuc thi, con cac bien phap khong dung thuoc se dem lai tac dung lau dai va ben vung.
Co kha nhieu loai thuoc dung de dieu tri mat ngu. Cac thuoc thuong dung la nhom Benzodiazepine (Seduxen, Valium), bao gom cac loai co tac dung ngan hoac dai. Thuoc loai nay co tac dung phu la hay gay buon ngu ban ngay, nguoi cao tuoi dung thuoc de bi nga nen lam tang nguy co bi gay co xuong dui. Cac thuoc gay ngu khong phai Benzodiazepine, vi du nhu Zolpidem (Stilnox), co tac dung tot voi cac benh nhan bi mat ngu keo dai va an toan hon cho nguoi cao tuoi. Cac thuoc khang histamine nhu Diphenhydramine (hay co trong mot so thuoc chong di ung hoac cac thuoc dieu tri cam cum) cung doi khi duoc dung de gay ngu, nhung day khong phai la chi dinh dung. Thuoc co mot so tac dung nhu gay lan lon, kich dong, tut huyet ap tu the, loan nhip tim, bi tieu. Da so cac loai thuoc chong tram cam 3 vong (vi du Laroxyl) deu co tac dung an than va thuong duoc dung lieu thap nhu mot loai thuoc ngu, dac biet o nhung benh nhan co tram cam kem theo.
Giong nhu phan lon cac benh o nguoi cao tuoi, mat ngu la mot roi loan thuong gap do rat nhieu nguyen nhan. De tim lai duoc giac ngu ngon, nguoi benh va cac thay thuoc can chu y tim hieu va dieu tri cac nguyen nhan truc tiep gay mat ngu (neu co the duoc), trong do cac bien phap nham tao cho nguoi cao tuoi mot moi truong song cung nhu moi truong de chiu va phu hop cho giac ngu cung dong vai tro rat quan trong.
Theo Suc khoe Doi song
