Obstructive sleep apnea syndrome (OSAS) is a pathology in which repeated temporary pauses in breathing occur during a night’s rest. Such “gaps” in the respiratory process can be up to ten seconds. Some concomitant symptoms poison the life of not only the patient, but also the people around him.

Features of the pathology

The cause of obstructive sleep apnea is the collapse of soft tissues in the back of the larynx, due to which the airways are completely blocked. All processes stop suddenly, and after 10 or more seconds they resume again. When the supply of oxygen to the lungs stops, the sleeping person begins to inhale the air deeper than during a restful sleep, loud, pronounced snoring can accompany breathing. During the night, such attacks are repeated repeatedly, disrupting the patient’s sleep.

It is impossible to control the pathology: during sleep, all muscles relax as much as possible. With such attacks, a person often wakes up.

In pathology, tissues may not completely block the airways, provoking obstructive hypopnea . This phenomenon poses a lesser threat to human life, but in the absence of proper treatment, the clinical picture will gradually worsen.

The severity of OSAS is classified based on data on the frequency of seizures. For this, the apnea index has been developed, which reflects the number of pauses in breathing during sleep for one hour. The course of pathology can be of three types:

• mild sleep apnea (5-14 attacks);
• moderate sleep apnea (15–29);
• severe sleep apnea (more than 30).

The number of attacks in severe form can reach 400-500 times per night, the total duration of stops takes about three hours.

How often do you have seizures?

Form start

• A couple of times a month, but it’s very scary
• Not every night
• 1 – 2 times per night
• 3 – 5 times per night
• More than 6 times per night
• 1 time in several months
• For the first time in my life

Prolonged obstructive sleep apnea is fraught with the development of hypoxia. The amount of oxygen in the blood, necessary for the normal functioning of vital organs and nutrition of the brain, is significantly reduced. The whole organism suffers from this, and against the background of this deficiency, the development of numerous concomitant pathologies is possible.

Causes of Obstructive Sleep Apnea

Sleep apnea often develops in men: this is due to a larger weight and a voluminous neck. In women, the pathology occurs after menopause. Also risk factors include:

• obesity;
• genetics;
• bad habits;
• endocrine diseases;
• respiratory tract anomalies;
• nasopharyngeal defects;
• decreased muscle tone;
• chronic lung diseases.

In children, obstructive sleep apnea is quite rare, the causes in most cases are congenital. So, craniofacial anomalies and neuromuscular disorders can provoke pathology. Temporary sleep apnea appears due to enlarged tonsils or adenoids.

Main symptoms of sleep apnea

One of the obvious signs of sleep apnea is constant sudden awakenings, which the patient himself is often unable to explain. When entering a risk group, you should immediately consult a doctor for additional diagnostics. The sooner the disease is detected, the easier it will be to get rid of it.

Sleep apnea symptoms resemble neurological diseases. Relate to them:

• constant daytime sleepiness;
• chronic fatigue;
• memory impairment;
• reduced attention;
• irritability;
• constant depression;
• violation of potency or libido;
• morning cephalgia (headache).

In children, the symptoms are somewhat different, but also resemble neurological pathologies. Such a disease provokes hyperactivity, urinary incontinence, headache in the morning, constant drowsiness. Underweight and stunted growth are also possible.

Possible complications of sleep apnea

Sleep apnea requires immediate medical attention. The further the disease progresses, the higher the risk of serious complications. With severe sleep apnea and chronic hypoxia, heart failure develops: the rhythm goes astray, pressure rises, the heart receives a double load with malnutrition.

In the body, which is trying to independently restore oxygen deficiency, a compensatory reflex awakens. At the same time, blood circulation increases, the result is an increase in blood pressure, which negatively affects the state of the heart and brain.

If blood pressure becomes spasmodic, the vascular function of the heart is gradually impaired. This increases the likelihood of myocardial infarction. And if severe hypoxia ends with a rupture of the vessel, the patient will have a cerebral hemorrhage and a stroke.

Necessary diagnostics for sleep apnea

In case of problems with sleep and suspicion of apnea, it is necessary to contact a general practitioner, who can later redirect the patient to a neurologist or a somnologist. The specialist needs to be told about the general psychological state, bad habits, chronic diseases. During a physical examination, the size of the neck and tonsils are evaluated.

Most likely, the patient will be assigned the following tests:

• general blood analysis;
• blood for sugar;
• assessment of glycated hemoglobin;
• biochemical analysis;
• thyroid hormones;
• lipid spectrum of blood;
• urinalysis – general and albumin.

The main diagnostic method for sleep apnea is polysomnography , a procedure in which body functions are recorded after deep sleep occurs. It is recommended to periodically undergo the procedure for people who are at risk. You will have to visit a special sleep center.

Additionally, the following may be assigned:

• sleep video endoscopy ;
• respiratory monitoring during sleep;
• pulse oximetry ;
• ECG.

How is sleep apnea treated?

Treatment tactics depend primarily on the severity of apnea and the reasons that provoked it. Correction is also carried out in two directions at once – you need to get rid of breathing problems and their provocateur. It is almost impossible to choose therapy on your own.

You also need to be prepared to change your habits. For example, you may need to change your sleeping position, start following a strict diet, and take medication for the underlying cause of sleep apnea. In some cases, dental or ENT manipulations or surgery will be needed.

Medical therapy for sleep apnea

It is impossible to treat sleep apnea with medications alone: individual drugs are used as part of complex therapy. One of the most common mistakes is that patients often self-prescribe sleeping pills or sedatives. This only aggravates the situation – tranquilizers contribute to the maximum relaxation of the muscles, which increases the frequency of attacks.

Intranasal corticosteroids are used with caution , and they are not suitable for every patient: the drugs can provoke additional sagging of the soft tissues that block the respiratory passage. Together with other therapeutic methods , Modafinil or Provigil are prescribed, drugs that are effective against narcolepsy.

Hardware breathing

The most effective technique for dealing with sleep apnea is the use of a special device called CPAP. It allows you to keep the airways free and conducts artificial ventilation during sleep. It is recommended to use the device every night.

CPAP is a compressor equipped with a flexible soft tube and a sealed nasal mask. According to patients’ reviews, due to the regular use of the device, sleep is getting better, and the discomfort characteristic of oxygen starvation disappears.

The device can be used at home, without the supervision of a specialist. The main task of the doctor is to tell about the principle of operation of the device and show how to operate it correctly. For maximum efficiency, the mask is adjusted, “fitting” individually to the characteristics of the patient’s body.

For the adaptation period, it is better to start with low atmospheric pressure, it should increase gradually. You will also have to get used to the mask itself: straps and a foreign object on the face can cause negative sensations and interfere with sleep. In addition, some patients may develop ulcers or allergic rashes in the mouth area. With such pathologies, you should consult your doctor.

Sleep Apnea Surgery

In severe forms of sleep apnea, surgery is recommended to get rid of the problem once and for all. The following methods are used:

• tracheostomy ;
• UPFP;
• implantation;
• laser.

Tracheostomy is the most difficult option, which is prescribed only in case of especially dangerous pathologies that pose a threat to life. During surgery, a hole is made in the neck into which a tube is inserted. The method is not the best: after such an intervention, patients experience numerous psychological and physical inconveniences.

During UPPT ( uvulopalatopharyngoplasty ), the airways are widened by removing excess tissue from the throat. Most often this concerns the tonsils, too long “tongue” or adenoids. The same procedure is carried out using a laser beam. The main disadvantage of the procedure is that the pathology can recur, and sleep apnea will return.

No doctor can guarantee that the syndrome will not return after surgery. If this happens, you will have to select other methods of treatment or switch to sleep using a CPAP machine.

Preventive measures

The main preventive measures for sleep apnea are a healthy lifestyle and weight control.

• If obesity is provoked by endocrine or hormonal disorders, it is necessary to choose an effective treatment and follow a diet that will allow you to lose weight.
• It is important to stop smoking, and alcohol can be consumed no later than two hours before bedtime.
• It is necessary to take control of the diet: you will have to reduce carbohydrates and fats, add more vegetables and fruits.
• If necessary, drink vitamin and mineral complexes at least once every six months to strengthen the immune system.