Sleep apnea is a temporary stoppage of breathing that occurs periodically during sleep. Pathology is accompanied by general fatigue, apathy and decreased performance, which causes a lot of discomfort and interferes with a productive lifestyle.

Apnea – what is it?

What is sleep apnea and how does it manifest itself? Apnea is a pathological disease and requires complex treatment depending on the form and severity.

Classification of apnea according to the mechanism of respiratory arrest:

1. Central type. Caused by disruption of the central nervous system. Breathing movements stop after exhalation, and the rib cage no longer rises. The cause in this case may be: intracranial pressure, traumatic brain injury, viral infections, brain tumor and CNS disorders.
2. Obstructive type – mechanical overlap of the airways.
3. Mixed type – a combination of central and obstructive type. It is characterized by strong snoring.

The following types of stops are distinguished by the duration:

• Hypopnea – oxygen deficiency is up to 50%, the paths are partially blocked (only part of the diaphragm moves, breathing is rapid);
• Sleep apnea, which is characterized by complete relaxation of the larynx. The delay lasts more than 10 seconds.

To determine the severity, pay attention to the duration and frequency of the phenomenon:

• Mild form – 5-20 attacks per night.
• The average form is 20-40 attacks.
• Severe form – more than 40 stops.

Less than five episodes per night is considered safe for a person.

Apnea severity is calculated using a formula that takes into account these indicators and the duration of stops in seconds that occur during the hour of rest.

Symptoms

The main symptom of sleep apnea is a sudden interruption of breathing during sleep, frequent awakenings, restless sleep and heavy snoring (stops abruptly before breathing stops). The patient often does not remember the night episodes, so others can point out deviations – children, parents or a soulmate. Accompanying signs should alert:

• frequent urge to go to the toilet at night;
• drowsiness and weakness during the day;
• morning headaches;
• dry mouth;
• deterioration of reaction and memory;
• emotional instability (depression, irritability or stress);
• constant anxiety and paranoia.

These signs are temporary. They are mainly observed at night and in the morning, and disappear in the evening. If treatment is not started on time, the general condition of the person worsens and other deviations develop:

• sexual dysfunction and prostatitis (in men);
• a sharp set of body weight;
• arrhythmia;
• cardiovascular diseases.

In 50% of patients, comorbidities are diagnosed that significantly worsen the course of apnea. Treatment in this case is aimed at eliminating arterial hypertension, bronchial asthma, coronary heart disease, and other lung diseases.

It is also very important to supervise children during the day and at night. Breathing through the mouth, urinary incontinence, increased sweating, slow reaction, a sharp change in temperament and unusual postures during sleep can give out pathology.

The reasons

The main cause of sleep apnea is a violation of the motor function of the muscles and tissues of the larynx. Relaxation of this part of the body leads to interruptions in the supply of oxygen to the lungs, from which the person begins to suffocate and wakes up.

In most cases, anoe is a congenital pathology that is inherited from parents.

In addition to genetics, there are a number of body features and bad habits that lead to the development and aggravation of the condition:

1. Floor. Men are affected twice as often as women.
2. Age changes. At risk are people over 50 years of age. This is due to the weakening of the muscles, especially if a person leads a sedentary lifestyle.
3. Anatomy features: an enlarged tongue, narrow airways, excessive mucosal folds, enlarged tonsils and a sunken lower jaw block the normal supply of oxygen.
4. Alcoholism and smoking are bad habits that are abused by every third patient with sleep apnea.
5. Diabetes mellitus increases the risk by 2-3 times.
6. polyps and adenoids.
7. Nasal fractures and congestion.
8. Taking sleeping pills.
9. Hormonal changes in women – pregnancy, menopause.

Being overweight is the most common cause, especially if a person has fatty tissue in the neck, chin, and abdomen. Accumulations of fat put pressure on the muscles in these areas, preventing the diaphragm and larynx from working properly. Excess weight tends to be deposited in these places in men, so they suffer from sleep apnea more often.

Damage to peripheral nerves and hypofunction of the thyroid gland also lead to a decrease in muscle tone.

Prevention

Compliance with the rules below will help reduce the manifestations, and in some cases even completely cure sleep apnea:

• Control over body weight. Losing weight by 5–10% improves oxygen permeability by 50–60%.
• Sleep on your stomach or side. When a person lies on his back, his tongue falls inward, thereby blocking the airways.
• Elevated position of the head prevents snoring and falling of the tongue inside. Raising the pillow too high is not recommended, as this will lead to the opposite effect.
• Taking hormonal drugs will help women suffering from age-related changes.
• Exclusion of the use of sedative drugs and relaxing tinctures on medicinal herbs.
• Exclusion of bad habits.
• The use of special suction cups against snoring.
• Ensuring easy nasal breathing. Chronic nasal congestion requires immediate treatment by an ENT doctor.

In addition, it is important to provide the most comfortable conditions and peace: exclude all unnecessary sounds, give up the TV and computer before going to bed, use a dark blindfold.

Treatment

The method of therapy directly depends on what type of apnea is diagnosed. First of all, the treatment of apnea should be aimed at eliminating the causes, therefore, therapy for the central nervous system, obesity, diabetes mellitus, etc. is needed.

With mild obstructive sleep apnea, the cause of which is anatomical features, surgical intervention is prescribed. The attending physician prescribes a method of therapy after a complete diagnosis.

In the moderate and severe form, surgery is ineffective, since a mechanical obstruction is not the main hazard. How to treat? In this case, CPAP, BiPAP and TRIPAP devices are used.

Surgery

It is prescribed for enlarged tonsils, curvature of the lower jaw and nose. Includes the following types of operations:

• The application of the Pillar system is the introduction of synthetic plates into the soft palate, which make it stiffer and support it like a framework. Effectively eliminates snoring.
• Adenomectomy is the removal of hypertrophied lymphoid tissue. Polyps are removed on the upper part of the nasopharynx under local anesthesia.
• Tracheostomy – opening the trachea and inserting a special tube that provides constant access to air, even when the path to breathing is completely blocked.
• Bariatrics . It is carried out with severe obesity and is a surgical reduction in the size of the stomach. A person begins to consume less food and loses weight.
• Uvulopalatopharyngoplasty is the removal of part of the soft palate.
• Tonsillectomy – removal of hypertrophied tonsils.

CPAP

This is one of the best and safest ways, which consists in connecting a special mask that covers the nose and mouth before going to bed.

Through a special tube under pressure, air enters, providing a constant supply of oxygen to the body. Modern devices have special settings for humidity and air temperature, which allows you to create the most comfortable conditions for the patient.

An effective treatment for sleep apnea caused by tongue-throwing is the placement of rubber mandibular splints on the teeth to help hold the jaw and tongue in a secure position.

When diagnosing the central form, along with the main treatment, the diuretic Acetazolamide is used , which relieves swelling and improves blood supply to the brain cells.

Complications

In the absence of treatment, a person goes into a state that threatens his life. Lack of coordination and fatigue can lead to dangerous situations such as getting into an accident.

Constant oxygen starvation increases the risk of heart attack and stroke by 30-40%. In severe forms, sleep apnea enters a daytime phase, and carbon dioxide metabolism is disrupted 24 hours a day. In such cases, the diagnosis of ” Pickwick syndrome” is established, when, due to drowsiness and general fatigue, a person can fall asleep at any time and in any place, which is fraught with physical and industrial injuries.

The rapid increase in clinical manifestations can lead to disability and even death.