What does the term obstructive sleep apnea mean? What is central and night apnea?
Central sleep apnea is very different from obstructive sleep apnea (OSA). The main difference is that respiratory arrest with CAS occurs when the airways are completely passable, under the influence of changes in the level of carbon dioxide in the body or the pH of liquid media. Obstructive sleep apnea syndrome appears due to the fact that the lumen of the respiratory tract is blocked by any factors, among which are excess weight, decreased soft tissue tone, congenital and acquired anomalies in the structure of the pharynx.
The danger of CAC is that the causes of respiratory arrest lie at a deeper level, and there is also a risk of longer apnea, which adversely affects the condition of the whole organism.
It is worth noting the fact that central sleep apnea is almost asymptomatic. That is, for OSAS, the appearance of snoring or noisy breathing is characteristic, while with CAS, there are simply pauses in breathing that another person can notice. After these pauses, reflex breathing, sweat, or awakening are possible.
One of the main signs of respiratory failure during sleep is drowsiness and increased fatigue in the daytime with a sufficient duration of sleep. The appearance of these symptoms requires polysomnography.
It is customary to distinguish three main varieties of CAC. Their classification is based on the clinical picture and the level of carbon dioxide. So, among them there are:
- Patients with hypercapnia. These patients are characterized by rare or shallow breathing before apnea, which leads to an increase in carbon dioxide levels. Hypercapnia leads to inhibition of the respiratory center, which causes respiratory arrest. This group also includes those patients who have impaired activity of the medulla oblongata, as well as thyroid disease (hypothyroidism).
- Patients with hypocapnia. In this situation, people have rapid breathing, which is periodically replaced by attacks of apnea. That is, the body reflexively stops respiratory activity in order to avoid hyperventilation. At the same time, a decrease in the level of carbon dioxide is noted in the body.
- Cheyne-Stokes breath. This pathological breathing is similar to the second form, but it is customary to separate it, as it appears in patients with severe disorders in the body, such as a diabetic coma, severe head injuries, accompanied by cerebral hemorrhages, hemorrhagic strokes, severe intoxications in infectious diseases. It is worth noting that the appearance of this type of breathing is an alarming sign, which means an aggravation of the condition. Most often, it manifests itself in the terminal stages of diseases, when treatment is already ineffective.
The first two forms are characterized by the fact that they can manifest themselves for a long time without attention, since in addition to breathing pauses during sleep, symptoms from other organs and systems may be completely absent.
It is also necessary to separately highlight such a reason as the constant use of opioids. This is important when prescribing narcotic analgesics for cancer patients. It is necessary to take into account the inhibition of the respiratory center with these drugs.
In addition, the relevance of the above is that drug addiction is very common today. One of the most common hard drugs is methadone, which also belongs to the group of opiates.
The causes of central sleep apnea may be different. Therefore, before starting treatment, it is necessary to conduct a comprehensive comprehensive examination and to identify them. Only after establishing the primary pathology can we begin treatment of CAS.
First of all, treatment should be aimed at eliminating the causes of central sleep apnea. In this situation, drug therapy or surgical treatment may be used.
It is worth noting the fact that in the absence of etiotropic treatment, it is impossible to get rid of CAS. In addition, the primary disease can be life threatening. Particular attention should be given to those patients who have Cheyne-Stokes respiration.
In order to stop the respiratory arrest in a dream, the following treatment methods can be applied:
- Oxygen therapy. Oxygen therapy is shown to all patients with central sleep apnea to avoid hypoxia of brain tissue, because this can aggravate the situation. In addition, a lack of oxygen in the body increases the risk of developing myocardial infarction, and also adversely affects the work of other organs.
- CPAP therapy. With the help of a special apparatus, a positive constant pressure in the airways is maintained. Moisturized oxygen is supplied through the mask during sleep. The method is also used to treat obstructive sleep apnea syndrome.
- Electrical stimulation of the phrenic nerves. This method can be used over the age of 2 years. Using electrical stimulation, you can ensure the correct rhythm and respiratory rate. Most often it is used in congenital form of hypoventilation.
- Exclusion of opiates. If CAC is caused by the use of these drugs, then their use should be limited or excluded.
The choice of treatment methods depends solely on the specific situation and should be chosen by the attending physician. Central sleep apnea can not be ignored, as this is most often a sign of disorders and disorders in the body. It is worthwhile to carefully approach the examination so as not to miss the true reason for the appearance of this pathology.
Obstructive sleep apnea syndrome - what is it?
Another case is snoring with complications, in particular apnea.
So, you can observe abrupt breathing, the man stops lung ventilation, and this lasts about 10 seconds.
The most common are 20-30 seconds of apnea, but sometimes the breath breaks for 2-3 minutes.
Then a man with heavy snoring inhales, sometimes tossing and turning. Severe obstructive sleep apnea syndrome can occur up to 30-40 times per night.
Stopping lung ventilation leads to severe anxiety of everyone around, as the syndrome looks very depressing, while the person himself does not notice the manifestations.
In the waking state, the problem may not manifest itself at all and the man’s breathing is normal, but there is a strong decrease in labor efficiency and distracted attention.
The disease stems from malfunctioning of the upper respiratory tract. In general, the ventilation process depends on the diameter of the internal cavity, muscle tone and the level of pressure created during inhalation.
The problem is observed precisely when a man swallows air, since at this moment the pressure has the opposite meaning and the muscles in the dream are very relaxed.
Thanks to such factors, the airway is completely blocked and apnea is created.. Due to muscle weakness and increased pressure, usually caused by snoring, the pharyngeal muscles are not able to perform their direct function.
A decrease in respiratory activity is characteristic of the syndrome of obstructive sleep apnea.
Corking lasts different times, depending on the physiological characteristics of the person, then, when there is a danger of suffocation, the brain wakes up. It is the impulse from the central nervous system that should wake the muscles of the pharynx and restore normal patency.
What are the symptoms and manifestations of obstructive sleep apnea syndrome?
Naturally, when a man disrupts the proper functioning of the respiratory system, blood lacks oxygen.
A decrease in blood saturation negatively affects the entire body.
The largest consumers of oxygen in a person are the heart and brain, respectively, and they suffer in the first place.
Due to inhibition of heart rhythm and a decrease in oxygen levels, apnea may increase.
The presence of a serious problem with obstructive sleep apnea syndrome, such symptoms will be known in the morning:
- headaches, usually chronic, irritation. Over time, usually by lunchtime, irritation may subside, sometimes continuing throughout the day,
- increased drowsiness. It’s worth considering that the brain is not able to fully rest, as you have to constantly wake up to regulate breathing,
- increased irritability. The lack of normal sleep and headaches naturally cause irritability and a decrease in determination, a man’s gaze switches from the goal in favor of the oppression of the body,
- decreased potency. The general depression of the body affects sexual life, attraction may remain the same, but the potency is significantly impaired.
All of these symptoms become prerequisites for the development of more serious diseases, which makes the syndrome very dangerous in advanced stages.
If a number of the described manifestations are found, you should consult a specialist to heal the man and restore healthy sleep again.
Preliminary diagnosis of the syndrome of obstructive sleep apnea can be based on such indicators:
- intermittent snoring, with loud snoring,
- frequent nightly urination,
- severe daytime sleepiness,
- accompanied by arterial hypertension,
- prolonged deterioration of sleep, usually it is worth the alarm after 3-6 months.
The easiest way to determine night apnea is to an outsider, as one can immediately see strong snoring and abrupt breathing, while respiratory reflexes are obvious, that is, a person tries to breathe, but he does not succeed.
The disease can be aggravated with a certain position of the body, usually on the back, or at some stages of sleep.
What other classifications of apnea are possible. What are the differences and features?
Obstructive sleep apnea syndrome is a disease of varying severity and degree of development, each stage is characterized by approximately the same symptoms, but in a more aggravated stage.
To determine the severity of the disease, a special apnea / hypopnea index (YAG) is used for one hour.
It is recommended to check the YAG before going to the doctor and go to a specialist with this information..
Not always a malfunction of the upper respiratory tract is accompanied by apnea, that is, a complete cessation of air circulation.
More often hypopnea is observed - this is a deterioration in air flow due to a decrease in muscle tone. The difference between hypopnea and apnea is that with the first illness, breathing only worsens, and does not completely overlap.
It is worth worrying if the air circulation drops by more than 30% for a duration of 10s.
Central sleep apnea is a man’s respiratory arrest, especially in sleep, due to respiratory depression.
The main visual difference between both forms of the disease is that with normal apnea, a person tries to breathe, but the patency of the paths does not allow, that is, the chest is working normally.
With central apnea, the entire respiratory center stops working, so the person does not even try to breathe, usually while the throat is free. Then, in both cases, the brain wakes up and starts breathing again.
What are the options for the development of obstructive sleep apnea?
Naturally, each stop of the respiratory cycle causes severe stress for the whole organism. Subsequently, to resolve the problem, you have to use the brain.
Due to the lack of treatment or the application of several symptoms of various diseases, a severe degree of illness can occur.
At the time of respiratory arrest, blood pressure rises significantly, as a result not only the heart, but also other organs suffer, so the pressure reaches a value of 200-250 mm Hg. Art.
Over time, apnea can develop into arterial hypertension, which often provokes strokes.. If coronary disease is additionally present, then you should be wary of arrhythmias, diabetes can also worsen.
Lack of healthy sleep negatively affects the production of growth hormone. In an adult, he is responsible for the regulation of fat in the system, that is, fat is deposited for further processing, and then used.
Growth hormone is responsible for removing fat and converting it into energy. With a failure in this system, obesity is observed, and accumulating in the neck area, night apnea is even more aggravated.
Which specialist should I contact and how soon should I do this to confirm the diagnosis?
For consultation and treatment of night apnea should consult an ENT doctor. He will be able to conduct an examination and determine the severity of the disease, then prescribe treatment.
To help a specialist in the diagnosis, you can independently determine the YAG by contacting the information received, it is easy to identify the stage of development of the disease.
Short-term manifestations of apnea can occur due to stress, but you need to worry about the obstructive form of the disease after 6 months, if nothing has changed, then you need to go to the ENT.
Obstructive sleep apnea syndrome is a serious problem that can greatly ruin a man’s life. Thus, if apnea is observed for a long time, then it is impossible to debug the disease in a distant case, you should contact an ENT specialist as soon as possible.
The condition when breathing stops in a dream and ventilation stops, although attempts to breathe continue, is called sleep apnea in medicine.
The duration of this condition is 10 seconds or more.
The disease usually affects those who prefer to sleep on their backs, and in a sleepy state they snore.
Fun and jokes about snoring are inappropriate: experiencing apnea, a person can completely stop breathing and not return to a normal state - a lethal outcome is possible (in rare cases).
Snoring is not a disease, but you should try to get rid of it in order to avoid further problems with the heart, pancreas, stroke and other unpleasant consequences.
Characteristics of types of night apnea
Occasional respiratory arrest during sleep is observed in people of any age. If they are single - up to 5 manifestations per hour, and short-term - less than 10 seconds, this indicates the norm. Pathological signs of night apnea syndrome are the frequent cases of lack of breathing and uncontrolled closure of the muscle tissue of the larynx for a long time.
Classification for developmental reasons divides nighttime respiratory function into 3 types:
- Obstructive sleep apnea syndrome manifests itself with a pathological change in the organs of the nasopharynx. It is characterized by loud snoring, periodic short-term subsidence of the laryngeal muscles of the respiratory tract. Pulmonary ventilation at this point stops, while respiratory efforts persist. As a result, a decrease in oxygen concentration, then interruption of sleep due to the physiological need for immediate inspiration.
- Syndrome of the central form of sleep apnea is much less common. It develops due to disturbances in neural and muscle signaling due to respiratory failure (impaired gas exchange) or organic damage to brain cells (hemorrhage, neoplasm).Episodes of respiratory arrest are caused by a temporary partial or complete absence of nerve impulses coming from the respiratory center of the central nervous system to the muscles. Motor efforts are not carried out (in contrast to the obstructive form of apnea), therefore, in the process of sleep, the development of severe hypoxemia is possible, as a result - sudden death.
- The mixed-type sleep apnea syndrome is characterized by a combination of complexes of simultaneous manifestations of obstructive and central forms of pathological breath-holding attacks. Such a disease is the most dangerous.
Daytime drowsiness and snoring, as a rule, are pronounced in each case of the development of the syndrome.
The severity of the pathology (form of OSAS) is determined only by specialists, depending on the frequency of repeated episodes of respiratory arrest (per hour) according to the apnea and hypopnea index. The table below.
The sooner you turn to the doctors to diagnose the initial degree of pathology, the more successful the treatment will be.
Symptoms that indicate the development of the syndrome
Symptoms that indicate the development of the syndrome What is apnea, and how to notice it in time? A person cannot independently determine the presence of the syndrome, because he forgets that he woke up and also does not hear how he snores loudly. Men suffer more often from the development of apnea syndrome than women. At risk for the rapid progression of the disease are people with metabolic disorders, obesity, diabetes, neurological, respiratory and cardiac pathologies, as well as bad habits (drink, smoke). Therefore, it is precisely to these categories of relatives and friends that special attention should be paid.
Signs of OSAS in adults
The main symptoms that indicate the development of sleep apnea syndrome are as follows:
- loud rolling snoring, interrupted by seconds (minutes) of complete silence, then renewed with renewed vigor,
- superficial sleep, with periodic sharp movements of the limbs,
- during the night sudden awakenings, arrhythmia, tachycardia,
- coughing fits, difficulty breathing,
- there is an increase in episodes of nightly urination,
- upon awakening, suffocation occurs, a feeling of lack of air,
- in the early morning haunting headaches accompanied by increased pressure,
- disturbed by a feeling of physical impotence and excruciating sleepiness during the day,
- there is a decrease in concentration, a deterioration in the ability to remember,
- manifested depression, irritability,
- sugar level increases
- heartburn, nausea,
- a decrease in libido and potency develops.
Gradually, an increase in body weight and subcutaneous adipose tissue occurs, which leads to an even greater development of the disease.
Symptoms of childhood apnea
In babies, sleep apnea syndrome is expressed by the following characteristic signs:
- loud snoring with silent pauses
- gnashing of teeth, drowsiness, fatigue during the day,
- predominantly oral breathing
- bouts of coughing, shortness of breath,
- restless sleep with twitching of arms, legs
- increased sweating
- blueness (or developing pallor) of the skin of the nasolabial region and oral mucosa during an attack during sleep,
All of the listed symptoms of the syndrome are similar to signs of neurological diseases, therefore, for the correct treatment, it is very important to determine the conditions and prerequisites for the occurrence of the pathology.
Prerequisites for Obstructive Apnea
The syndrome develops due to the absence (or decrease) of airway patency along the branches of the respiratory tract due to the following pathologies:
- diseases and neoplasms of the nose, larynx (adenoids, cysts, polyps, inflamed tonsils narrow the passages),
- infectious and allergic diseases of the nasopharynx cavities (swelling occurs),
- congenital pathologies of the development of organs of the upper respiratory tract (thinness of the lumens, displacement of the jaws, an increase in the volume of the tongue),
- consequences of muscle obesity (narrowing of the larynx).
Almost always, senile obstructive changes in organ tissues (friability, loss of elasticity, sagging) lead to the appearance of nocturnal respiratory arrest.
Causes of obstructive and mixed apnea syndrome
Pathologies arise due to a decrease in muscle tone of the larynx and are caused by such factors:
- medicines, drugs or alcoholic beverages that help relax the muscles of the larynx,
- untimely transmission of nerve impulses from the center of respiration to the muscles due to neuromuscular pathologies,
- due to softening and lethargy of the muscles of the larynx with thyroid dysfunction.
In some cases, mixed and obstructive types of respiratory disorders occur due to inhibition of consciousness after operations to remove brain tumors.
The conditions for the appearance of apnea syndrome in the central type
Prerequisites for the destruction of the chain of neural and muscle connections:
- in the tissues of the brain neoplasms, injuries, hemorrhages,
- respiratory failure due to undina syndrome,
- the formation of pharyngeal collapse.
Inhibition of respiratory functions occurs due to insufficient activity of the nervous system of the central part of the brain, which coordinates the frequency and depth of breathing.
Factors for the emergence of central and mixed types of apnea syndrome
Respiratory system dysfunction is formed due to disturbances in gas exchange processes and blood circulation.
The following pathologies are to blame:
- respiratory failure due to disease of the bronchi and lungs (fibrosis, pleurisy, pneumonia),
- cardiovascular disorders
- alpine disease.
In such cases, hypoxemia quickly develops (a very low concentration of oxygen in the blood), in which a fatal outcome is possible.
Why nighttime breath syndromes occur in infants
Causes of sleep apnea in infancy:
- difficult birth
- pathology of the development of the respiratory system,
- diseases of the ears and nasopharynx,
- low birth weight (not more than 2.5 kg),
- heart and respiratory failure,
- congenital pathologies of the skull,
- neurological abnormalities
- allergic reactions to medicines,
- gastrointestinal reflux.
It is impossible to visually determine all the factors that cause respiratory arrest in sleep with sleep apnea syndrome. It is necessary to undergo a comprehensive study in a medical institution.
Features of human breathing in a dream
Saturation of blood with oxygen and excretion of excess carbon dioxide from the body is considered a vital function. Therefore, breathing does not stop for a minute. During a night's rest, all muscle tissue relaxes. As a result, the air passing through the upper respiratory tract causes the walls to vibrate. So the sounds of snoring.
At times, the walls of the pharynx can become so closed that even with respiratory movements, air does not enter the lungs. There is a respiratory arrest, as a result of which the whole organism will suffer.
Obstructive Sleep Apnea Syndrome
Apnea, according to ICD-10, belongs to the class of diseases of the nervous system. Patients wake up due to suffocation, as there is a blockage of the respiratory tract, and the activity of their muscles remains. This type of pathology is called obstructive. The amount of oxygen and carbon dioxide in the blood changes. Due to hypoxia, the body takes another breath to get the missing air, but such attempts remain unsuccessful and only cause a person’s micro-awakening.
Specialists distinguish two more forms of the disease: central and mixed. Their mechanism of occurrence is different, but the symptoms are similar. If asthma attacks often appear, the quality of rest suffers, as a result of which obstructive sleep apnea syndrome develops.
Why can not refuse qualified treatment
The prognosis of complications of the syndrome of recurring night attacks can become very unfavorable.
- Even with a mild degree of sleeping apnea, the human body does not rest at night, as is required to restore energy.
- People experience physical and emotional overload due to oxygen starvation of brain cells, which leads to decreased attention.
As a result, numerous technological accidents occur on roads, factories, motor ships. In addition, untimely treatment of the severe stage of any disease, which is the main cause of sudden respiratory arrest in a dream, threatens a person with serious pathologies: the development of a heart attack, stroke, cardiac arrest due to arrhythmia, death.
Self-medication for sleep apnea syndrome is useless and dangerous, because there is no magic remedy to prevent respiratory arrest in a dream either by traditional herbalists or commercial agents selling pills, dietary supplements and dubious devices “from all diseases”. And the use of medicines without a doctor’s prescription can aggravate the manifestations of pathology, as well as cause new irreversible processes that are destructive for the body.
Sometimes the disturbances that occur are due to the tightness of the muscles of the pharynx. Breathing stops, as the lumen for the passage of air flow closes for a certain time. Therefore, in this case, the ailment has a name from the word "obstruction" or clogging.
Similar obstacles develop gradually, over the years. When the respiratory lumen narrows, soft tissues vibrate. A person begins to snore, as a result of which the amount of oxygen delivered to the lungs will be much less. In this case, the initial signs of hypoxia appear. In the morning, patients have hypertension and headaches, and drowsiness during the day.
In most cases, the disease affects overweight people. Appeared fat deposits on the outside of the pharynx squeeze it, the muscles lose their tone and the patient stops breathing. In addition to obesity, other reasons can provoke pathology:
- Endocrine disorders.
- Brain injuries.
- Neurological diseases.
- Taking medications (tranquilizers, sleeping pills and sedatives, testosterone).
- The use of tobacco and alcohol.
- Anatomical features (narrow nasal passages, an increase in the soft palate and tonsils).
- Curvature of the septum of the nose, the neoplasms present in it.
- Allergic or chronic rhinitis.
- Heart failure.
The likelihood of an ailment is greater in men. Age-related changes can cause disruptions in the respiratory process. Also at risk include:
- Persons with metabolic disorders (extreme obesity).
- Allergy sufferers.
- Women during pregnancy and menopause.
Some have a hereditary predisposition to this ailment. The abnormal structure of the lower jaw, the anatomical features of the nasopharynx and larynx can affect the development of the syndrome.
The severity of the disease is divided into three degrees. Their determination is based on the total number of respiratory arrests and its disorders within an hour (hypopnea). The following forms of the development of the disease are distinguished:
|The form||Episode frequency per hour||Nature of the disease|
|Easy||5 – 15||Minor deterioration in performance. Daytime sleepiness.|
|Moderate||15 – 30||Severe morning awakening, tired throughout the day. Decreased attention span.|
|Heavy||30 and more||A person involuntarily falls asleep during monotonous exercises, at any time, while an attack of suffocation occurs almost immediately. Other health problems appear.|
This classification is typical for adults. In children under 12 years of age, the indicators differ: with an index of 10 and higher, the development of a severe degree of pathology is determined.
Depending on the severity of respiratory disorders, appropriate treatment methods are selected. To combat a mild disease, a change in lifestyle will be sufficient. Moderate to severe therapy requires a more serious approach.
Some consider such anomalies harmless, so they do nothing. But from the point of view of somnology, this ailment has several dangers, and sometimes the risk of death is increased. According to studies, mortality ends when patients are not involved in the treatment of the disease.
It is impossible to ignore night attacks of suffocation. After all, its consequences are difficult to respond to traditional therapy. The organs that need a lot of oxygen - the heart and the brain - are the first to suffer, so the following complications are observed:
- Heart failure, ischemic heart disease.
- Heart attack, stroke.
- A shift in metabolism.
- Neurotic conditions.
Particularly affected is a good night's rest. A lack of oxygen signals the brain to wake up to prevent suffocation. Such micro awakenings are characterized by a state of drowsiness, which reduces the duration of the deep sleep phase or even leads to their absence. In the morning, fatigue, drowsiness, lethargy are observed. In the fight against these symptoms, the patient tries to restore strength by abusing coffee and food, but this is not always the best solution to the problem.
Oxygen starvation and the absence of a deep stage of sleep disrupt the production of growth hormone. As a result, fat is not converted into the necessary energy, but is deposited. However, even attempts to lose weight remain inconclusive. Fat deposits in the cervical spine contribute to the progression of the disease. Therefore, such cases require special and timely treatment.
Diagnosis of violations
The somnologist is engaged in the identification of this pathology. After an interview with the patient, he appoints a diagnosis. Mandatory procedures in such cases are:
- Clinical blood test and study of its gas composition.
- Respiratory function test.
- X-ray of the lungs.
Thanks to new technological devices, some diagnostic procedures are recommended to be performed at home. In research institutions, specialists in somnology conduct special testing - polysomnography. Its principle is as follows: at night, with the help of a special device, eye movements, brain activity, respiration parameters, the amount of oxygen in the blood are recorded, heart function is evaluated. After the examination, the specialist determines the type of apnea, the severity of the pathology, and selects an acceptable treatment.
For the treatment of the syndrome of drugs, as such, does not exist. But drugs that eliminate concomitant symptoms can be useful. Often they are used in combination with the prescribed standard therapy. These include corticosteroids, drugs used to combat narcolepsy, nasal drops and sprays that moisturize the nasopharynx.
Surgical intervention is carried out in extreme cases, if serious complications are found (adenoids, curvature of the nasal septum). There are several types of operations that improve the quality of life of patients. These include:
- Laser plastics of the soft palate.
- Bariatric surgery.
The use of intraoral devices is effective in mild forms of obstructive sleep apnea. Special mouthguards and applicators provide expansion of the lumen of the pharynx and hold the lower jaw in the correct position. The use of CPAP therapy increases the pressure of the inhaled air, it is recommended even in severe forms of the disease.
An alternative to medical treatment is traditional medicine. Her arsenal includes recipes with herbs, honey and other natural ingredients. Simple procedures such as salt baths, instillation of the nose with a solution of sea salt or sea buckthorn oil, the use of cabbage juice, alleviate the symptoms of the disease.
Additional recommendations for apnea sufferers
Sometimes in solving a problem, you can do without consulting a specialist. Many patients saw positive results following simple guidelines:
- Get rid of bad habits.
- Sleep on your side.
- Do not overeat at night.
- Lie down so that your head is raised.
- Lose weight.
- Ensure free breathing through the nose.
Pose during sleep and the organization of a berth
The position of the body noticeably affects the frequency of night attacks. Usually, people sleeping on their backs suffer, so in this case you need to try to lie on your side. Care must be taken that the bed is raised at the head of the bed. To do this, use special pillows or put something under the mattress. The dormitory should be regularly ventilated, the air should be sufficiently humid.
Since obese people have a chance of apnea, it is necessary to set a goal to lose weight. Experts recommend a healthy diet, increase physical activity. With a decrease in adipose tissue of the walls of the pharynx, the respiratory process is facilitated. The development of concomitant symptoms slows down, the appearance of nighttime episodes becomes less frequent.
Healthy lifestyle as the best way to prevent
The best recommendation for the prevention of the syndrome is to eliminate all conditions for its occurrence. The key role in this is played by the correction of the patient’s lifestyle, suggesting the following measures:
- Stop smoking.
- Do not abuse alcohol, especially at night.
- To do physical exercises.
- Do not take medications that relax smooth muscle without acute need.
The syndrome is considered an urgent medical problem, as it increases the risk of developing cardiovascular disorders. Timely identification of dangerous signs prevents complications and the likelihood of death.
What it is
Sleep apnea syndrome is a deviation accompanied by episodes of awakening in connection with a malfunction of the respiratory organs. During the night, a person can wake up to 60 times. This does not allow you to fully sleep. Sleep disturbance affects well-being and performance. With a long course of the disease, nervous disorders develop. Sleep becomes superficial and short-lived.
Involuntary respiratory arrest in a dream provokes a number of external and internal factors. Most often, the problem lies in the particular structure of the nasal passages. Otolaryngological abnormalities are acquired and congenital. Short stops in respiratory function may occur due to airway obstruction.
The main danger of respiratory breaks is oxygen starvation. With a lack of oxygen, life-threatening diseases develop in brain cells. According to statistics, men are most prone to apnea. In women, this problem occurs in the menopause.
Attacks of confused breathing lasting less than 10 seconds, repeating no more than 5-6 times per night are considered the norm.
Classification of obstructive sleep apnea syndrome is carried out according to the nature of origin. In medicine, the following forms of the disease are presented:
Central apnea is formed due to pathological processes triggered by organic damage to brain cells. In this case, breathing stops due to the absence of nerve impulses to the respiratory system.
Obstructive night apnea develops due to the blockage of the respiratory system due to complete muscle relaxation. The activity of the central nervous system in this situation persists. This type of disorder is accompanied by certain respiratory dysfunctions, which include:
- Obesity-hypoventilation syndrome. It develops on the basis of excess weight and is accompanied by oxygen starvation at night.
- Mixed obstruction of the respiratory system. In pathology, blocking of the upper and lower respiratory tract is combined.
- Signs of hypoventilation. Accompanied by perfusion of blood and a decrease in the function of providing the lungs with oxygen.
- Pathological snoring. It is the main reason for the awakening of a person in a dream.
The mixed variety is characterized by airway blockage and the absence of impulses from the brain. A mild form of pathology is accompanied by up to 5 episodes of interruption of the breathing process per hour. This problem does not require a solution. Stopping breathing with a frequency of 5 to 15 times per hour occurs with a simple type of apnea of a mixed form. If the number of attacks reaches 30 per hour, and their duration is more than 10 seconds, we are talking about the moderate severity of the disease. The frequency of seizures greater than 30 indicates a severe degree of pathology.
Causes and Risk Factors
The cause of the appearance of sleep apnea syndrome depends on the form of pathology. Dysfunctions of the central nervous system provoke injuries to the stem of the brain. Such violations often occur with Alzheim-Peak syndrome. In childhood, primary respiratory system disorders are observed. They often occur in infants due to underdeveloped respiratory organs.
The obstructive form of the disease is caused by obesity, frequent stressful situations and abnormalities in the functioning of the endocrine system.
Risk factors include the following phenomena:
- change in the shape of the nasal septum,
- anatomical imperfections in the structure of the respiratory organs (large palatine uvula, too narrow nasal passages, voluminous neck and enlarged tonsils),
- infectious diseases,
- the presence of a foreign object in the airways,
- uncomfortable body position,
- hereditary predisposition
- pathology processes of the nervous system,
- pathology of the lungs.
The occurrence of snoring during sleep is due to a stop in pulmonary ventilation. A stream of air does not enter the lungs. Because of this, vibration occurs, accompanied by characteristic rattling sounds. A person does not hear these sounds during sleep. He wakes up from brain signals about the need to wake up to resume respiratory function. Subsequently, lung pathologies develop on this basis.
Causes and symptoms of CAS
Central sleep apnea (hereinafter - CAC) - a group of diseases, the root cause of which is a malfunction of the respiratory apparatus without obstruction (narrowing) of the respiratory tract.
These diseases are united by the presence of respiratory distress when the airways fall down and the air does not penetrate into the lungs.
All patients are united by an increased content of carbon dioxide in the blood, and depending on the concentration of CO2 in the blood and the degree of impaired lung ventilation, 2 types of the disease are distinguished.
One group is characterized by a high content of CO2 and a decrease in the activity of the respiratory center.
Apnea is a disease that can and should be treated regardless of variety.
There are many reasons for this condition, including:
- carbon dioxide poisoning
- pathology of the thyroid gland with a slowdown in metabolism,
- brain stem infarction,
- Arnold – Chiari disease,
- encephalitis, etc.
In the second group, in the presence of normal or reduced blood saturation with carbon dioxide, excessive activity of the respiratory center is noted, and at the same time there are attacks of apnea or periodic breathing. Perhaps a combination of these respiratory disorders.
Patients of this group in the daytime feel lethargy, drowsiness. In all varieties of the disease, the cessation of oxygen supply to the lungs occurs, which leads to hypoxia.
Frequent relapses of apnea are observed among climbers and those who climb to great heights. CAC has also been seen in drug addicts and in cancer patients taking drugs to relieve pain.
There are congenital forms of CAC, for example, the curse of Ondinewhen gene mutations cause a congenital central hypoventilation syndrome.
In this case, the disease manifests itself already in infancy.
If the body of the newborn does not cope with the attack, then cardiac arrest will occur.
A fatal outcome in a dream is often found in children with this hereditary disease.
CAC is asymptomaticTherefore, only relatives, relatives, or an employee and medical facilities can detect signs of the disease, having the opportunity to observe the sleep of a person whose breathing is stopped or interrupted in a dream.
In order to accurately diagnose this disease, the patient is prescribed a type of examination such as polysomnography.
An exact explanation of the causes of CAS is to visualize the brain and stem.
Nighttime OSAS - definition
Obstructive sleep apnea syndrome (hereinafter - OSAS) consists in constantly recurring attacks due to the closure of the upper respiratory tract or their narrowing at the level of the pharynx (in this case, the person breathes, but intermittently), while there is no violation of the functions of the muscles involved in the breathing process.
A patient with OSAS in case of discomfort during an attack wakes up, not understanding the reason for awakening. The structure of sleep itself is disturbed: the patient can plunge into the stage of only superficial sleep, which does not give a feeling of vigor, full of strength.
The patient who did not sleep well should be constantly lethargic, unhappy with everything and unable to work fully, especially in places requiring mental stress.
From relapses of apnea, such patients develop chronic oxygen deficiency.
Obstructive apnea affects about 10% of the adult male population.
Factors of origin and development
The main risk factors are:
- belonging to the stronger sex,
- respectable age
- hereditary predisposition.
Factors of the second level are more dependent on the lifestyle of men, these include:
- frequent drinking
- increased body weight
- low motor activity leading to low vital capacity of the lungs,
- lethargy, drowsiness during the day.
The cause may also be the specific structure of ENT organs. - an excessively long palatine uvula, enlarged tonsils with compression chronic tonsillitis, an allergic rhinitis or a curved septum in the nose.
Hypopnea episodes and their frequency
Consider episodes of obstructive sleep apnea and hypopnea. If apnea is characterized by a complete decrease in the upper respiratory tract with air obstruction, then with hypopnea it is characterized by a partial airway obstruction, when the passage is closed by 50% or more.
Even a partial decline in the upper respiratory organs harms the body of a patient who does not receive the proper amount of oxygen.
The severity of OSAS is determined by the frequency of episodes of apnea and hypopnea per hour.
Since it is difficult for a person who does not know the intricacies of medicine to distinguish one type of pharyngeal overlap from another, it is necessary to take into account all the attacks during sleep, the result is to divide the duration in hours.
As a result, an indicator of the frequency of episodes is obtained and the severity is derived:
- 5-15 episodes / hour - easy,
- 15-30 - average
- more than 30 is heavy.
Diagnosis and treatment
Diagnosis of apnea includes a comprehensive examination. The state of the cardiovascular and nervous systems, as well as the refinement of the structure of the ENT organs, are important.
It is impossible to do without:
- respiratory monitoring.
In any case, measures must be taken to eliminate snoring. Treatment consists either in surgery for the correction of ENT organs, or in the somnology department using CPAP therapy.
To restore oxygen content, oxygen therapy is prescribed.
But the main directions are measures for the treatment of major diseases, as well as reducing the influence of related factors.
So, with obesity, it is urgently necessary to reduce body weight, smoking patients should gradually get rid of this addiction.
Patients are not recommended to drink alcohol and take sedatives.
Apnea during night sleep, as a disease that entails a lot of health problems, requires attention from both the patient himself and his relatives, who are able to monitor the course of sleep.
Stopping breathing, intermittent, snoring - an occasion to consult a doctor for examination and treatment. If the disease is not treated, then serious complications and even death are possible.
What is SOAGS (Obstructive Sleep Apnea Syndrome)? The doctor answers:
Treatment for obstructive sleep apnea begins with the elimination of frequent awakening and snoring. To this end, use special devices for fixing the jaw bone. One of the most common methods is considered CPAP therapy. It involves the use of a mask for mechanical ventilation. This method of treatment is considered the most effective and safe for health. At first, the device is configured to supply low atmospheric pressure. In order to avoid draining the mucous surface of the nasal passages, a humidifier is used. Subsequently, manipulations are carried out with constant positive pressure.
Drug therapy involves the use of drugs to treat narcolepsy. To ensure artificial ventilation of the pulmonary system, Modafinil and Provigil are prescribed. In some cases, intranasal corticosteroids are prescribed. In the severe stage of the disease, surgical intervention is required. The main methods of the procedure include tracheostomy, uvulopalatopharyngoplasty and laser UPPP.
Obstructive sleep apnea syndrome is fraught with the development of serious consequences related to the patient’s health. These include the following:
- deviations in the work of the kidneys,
- metabolic syndrome
- increased risk of developing atherosclerosis,
- male impotence,
- increased irritability and unbalanced behavior,
- increased likelihood of heart attacks and strokes,
- fatal outcome.
Obstructive apnea can be prevented if preventive measures are taken in time. The main method of prevention is a timely visit to a doctor with the appearance of snoring and symptoms of lack of sleep. Obese people require weight loss.
It is also recommended to exclude other provoking factors of the pathology - bad habits, the use of sleeping pills, a sedentary lifestyle and chronic diseases of the nasopharynx.
According to statistics, in the absence of treatment, the prognosis is poor. In 40% of cases, sleep apnea syndrome leads to serious complications approximately 5 years after the onset of pathology. Timely action helps to reduce the percentage of deaths, increasing the patient's life by at least 15 years.