Snoring - Causes, Symptoms and Treatment .MF .
Snoring - a vibrating sound when breathing during sleep, which rarely bothers snoring, but it can lead to insomnia others.
Possible causes snoring
main mechanism of snoring - a change of breathing due to the emergence of obstacles, narrowing its lumen, or the relaxation of the pharynx wall.In this case the air, instead of passing directly into the lungs, twists and causes the soft palate tissue to oscillate and fight each other.This creates a unique timbre and frequency of snoring.In further developments of airway walls developing obstructive sleep apnea syndrome (OSAS, periodic pauses in breathing during sleep due to airway overlap).
emergence of snoring is associated with a number of reasons.
1. Obstruction to air flow can create:
• • nose polyps
• Bag Tornvalda
• swelling of the nasal mucosa in rhinitis (runny nose), including:allergic
• swelling of the tongue or mucous membranes of the mouth and throat during an allergic reaction
• hypertrophic tonsils (including the ade
• pharyngeal tumors
• anatomically narrow lumen
pharynx • displacement of the lower jaw back
• underdevelopment of the upper or lower jaw •
enlarged tongue in acromegaly or illness
Down • deposition of adipose tissue in the lateral walls of the pharynx in obesity
2. Relaxation of the throat muscles can be observed:
• under the influence of alcohol and drugs (muscle relaxants, tranquilizers, sleeping pills, narcotic pain medications);
• hypothyroidism, when all the general tone of muscles is reduced and tissues become looser;
• with neuromuscular diseases in violation of the receipt of nerve impulses from the brain responsible for muscle tone (muscular dystrophy, myasthenia gravis);
• trauma of peripheral nerves (random or during surgery with cutting of the throat nerve);
• when the brain is damaged and cranial nerve (brain edema, hydrocephalus, stroke, compression of the brain stem, bleeding in the trunk of the nucleus, and other diseases, leading to suppression of consciousness and control muscles of the pharynx).As a rule, it is acute conditions that require immediate access to medical care.Snoring in this case only one of the symptoms, which goes by the wayside.
The variety of reasons for snoring and diseases in which he appears, requires a mandatory and comprehensive examination.
surveys and analyzes snoring at why they are needed
When snoring requires full diagnostics to identify the causes of this phenomenon and the complications that can be dangerous. To this end, developed an algorithm of complex diagnostics with snoring.
1. Detailed conversation with a doctor and a sleep-examination to identify risk factors for sleep-disordered breathing and cardiovascular complications.Particular emphasis is placed on the conditions such as the structure of the face, jaw, teeth, throat, curvature of the nasal septum, the presence of tonsillar hypertrophy, obesity and related diseases that can cause snoring.
2. Survey to determine the "sleepy" habits that affect the assessment of snoring and sleepiness, and the presence of other sleep disorders besides snoring.
3. Carrying out functional tests with the assessment of nasal breathing and jaw thrust.
4. sleep study to detect breathing disorders during sleep and to assess their severity.
5. Carrying out complex analyzes to assess risk factors for cardiovascular disease, the presence of hypothyroidism, diabetes or metabolic syndrome.This includes the following analyzes:
• blood test for sugar,
• glycated hemoglobin,
• biochemical blood test for total protein, urea, creatinine,
• blood test for thyroid hormones (TSH, T4 free,TPO);
• lipid profile (total cholesterol, high density lipoproteins (HDL), low density lipoproteins (LDL), triglycerides, atherogenic index);
• urine: Rehberg test, urine test for albumin.
6. Consultations related professionals to clarify the causes of snoring and its complications (otolaryngologist, dentist, orthodontist, endocrinologist, nutritionist, cardiologist, neurologist and a lung specialist).
On the basis of the information on the survey, the most appropriate method for the treatment of snoring.This usually depends on several factors:
• What is the cause or causes of snoring,
• which one is more important in the development of snoring,
• What reasons can be eliminated, and which are not,
• severity of respiratory changes during sleep,
• presence of irreversible complications of snoring,
• what is the state of health in general, if there is comorbidity.
How to get rid of snoring in Obscheprofilakticheskie methods home
aimed at eliminating the factors that lead to snoring and may be eliminated, - addictions, drug action, dry air, allergens action, obesity, weakness, nasal valve body position duringtime to sleep.
• Failure or ogranicheniekureniya for 2-3 hours before bedtime.This will reduce inflammation, mucosal edema, reducing snoring.The same measure applies to alcohol.Abandoning alcohol before going to bed, you can reduce the relaxation of muscles and the likelihood of snoring.
• Replace or discard medications that relax the muscles (hypnotics, muscle relaxants, tranquilizers, sedatives, narcotic analgesics).
• Use a humidifier or air conditioning system.This will improve the condition of the mucous and breathing during sleep.
• Remove from the bedroom all possible allergens (wool items, including carpets, blankets, blooming and strong-smelling plants, pets, old pillows and mattresses).
• Reduce weight, at least 10% of initial body weight, if there is extra weight.The situation will improve with the breath half.
• Use strips extend over the nose during sleep.So you expand your nostrils, and they will not stick together.
• If snoring occurs when you sleep on your back, lie on your side on the orthopedic pillows with rollers or a mat under the back of the tennis ball.It will not let you sleep on your back.
Intraoral devices (capacitor)
purpose of the method - the displacement of the lower jaw forward during sleep and lock in this position.This extends the anterior-posterior size of the pharynx, preventing contact between the walls themselves.A very convenient method, especially for travel.
Surgical treatment of snoring
most often associated with the removal of obstacles in the path of air during breathing.This may be interference on the nasal septum (nose surgery), the sky (removal of the uvula, soft palate implants, uvulopalatoplasty, expanding the lumen of the pharynx), removal of enlarged tonsils or polyps.Surgical methods differ by type of intervention: classic (using a scalpel), RF, laser, chemical, combined.All of these approaches have advantages and disadvantages.It is worth to highlight the laser operation.They have a greater risk of complications for people with snoring in the background of obstructive sleep apnea.
PAP-therapy for the treatment of snoring
Other names for this method of treatment of snoring: PAP therapy, PAP, PAP, lecheniePAP.This reduction from the first letters of the Latin name PositiveAirwayPressure - positive airway pressure, which reflects the essence of the treatment.At the time of interruption of breathing during sleep unit compressor delivers pressurized air that spreads the throat, not allowing them to come closer.The main indication for this method of treatment - sleep apnea, which is often associated with snoring.However, given the general nature of these disorders, snoring is also eliminated.There are several types of PAP therapy:
• CPAP (iliCPAP) otContinuousPositiveAirwayPressure that means continuous positive airway pressure.The device is always blowing on the same level.
• avtoSIPAP (autoCPAP).The principle of operation is the same, only the device adapts to the patient's breath and exhale.
• BIPAP (BiPAP, or BiLevel) - a two-level PAP-machine mode.At the same time set a fixed air pressure values of the inhalation and exhalation.
• avtoBIPAP (autoBiPAP) - an automatic duplex mode PAP.
• TriLevel - a three-level operation, when autoBiPAPdobavlyaetsya additional support at the end of exhalation.
mode PAP therapy is chosen, a sleep physician, based on research and clinical data.The selection may take several days.
PAP-therapy for the treatment of snoring
choice of treatment takes place, depending on the severity of snoring and sleep apnea, as well as from a combination of causes of the sounds in his sleep.
1. If snoring - it is just a sound, not complicated by sleep apnea, it will suit all of these treatments.
2. In the case of a combination of snoring with obstructive sleep apnea of any severity (with the index pauses in breathing per hour 5) excludes surgery on the soft palate (eg, removal of the uvula).
3. snore and stop breathing easy and moderate severity can be treated by obscheprofilakticheskih events and intraoral devices (cap).
4. Snoring and obstructive sleep apnea syndrome, moderate and severe require PAP therapy for straightening the walls of the airways when they are closing.The combination with end caps.
presence of daytime sleepiness, obesity, hypertension, diabetes, coronary heart disease and hypothyroidism requires a more careful approach to treatment and often a combination of several treatments.Integrated treatment is also necessary for several causes of snoring, as each of them can have independent significance in shaping the sound.For example, a combination of a curved septum and obesity.If you apply only to the plastic nose, excess weight will remain and will cause snoring.It is therefore important to treat snoring under the supervision of a sleep doctor.
How dangerous snoring
snoring itself is not dangerous, it's just a sound, albeit unpleasant.Danger is what he says.This may be an acute situation (as described above) requiring medical intervention (such as stroke).Or, obstructive sleep apnea, which occurs in each of the third and snoring in the next 3-5 years ending strokes, heart attacks, diabetes, arrhythmias or death. Often snoring - the only sign pointing to it.Ignoring the problem could end sadly.
To which the doctor ask for snoring, and when it should be done
The sooner treatment is started snoring, the easier and faster it goes.This will protect you from irreversible complications, life-threatening.
is urgent cases when snoring combined with increased weight, hypertension, elevated levels of insulin and sugar, pain in the heart, night awakenings for urination, morning headaches and daytime sleepiness.These are signs of pronounced respiratory disorders during sleep.Urgent sign up to the doctor.
To cure snoring, you need to see a doctor, a sleep.It is a specialist trained in the field of sleep medicine.Unlike ordinary doctors who are also involved in the treatment of snoring, a sleep sees the whole picture.This allows you to identify the root cause of snoring and deal with it quickly and efficiently without harm to health.
It is this doctor conducts sleep studies that determine further treatment strategy.It is possible that a sleep refer you to an orthodontist, ENT doctor or a dietitian, but you will know that it will help.You do not have to choose a method of treatment, testing each one of them for yourself.
Elena Tsareva, a sleep physician,