sleep apnea syndrome ( sleep apnea ) - Causes, Symptoms and Treatment .MF .
Sleep apnea - episodes of pauses in breathing that occur during sleep.They are isolated, which normally occurs if their frequency does not exceed five per hour.With dozens and even hundreds of stops breathing per night talking about a syndrome of obstructive or central sleep apnea.The differences between the two syndromes are to types of apnea.
breathing stops during sleep obstructive nature associated with airways changes to the level of the larynx.Apnea during sleep central type due to the work of other organs and systems, including the lungs.
Possible causes apnea
dream Possible causes of obstructive sleep apnea similar to those of snoring.They can be divided into two large groups.
1. crux of the airway passage of air. This is possible if there are:
• diseases of the nose (polyps kistaTornvalda);
• frequent sore throats or adenoids;
• pharyngeal tumors;
• congenital narrowing of the airway lumen;
• small and shifted back lower jaw;
• acromegaly or Down's syndrome, in which the
• obesity with the deposition of fat cells around the pharyngeal lumen.
2. Reduced muscle tone pharynx:
• the intake of alcohol or medicines that relax muscles (tranquilizers, some sleeping pills, drugs, muscle relaxants).This is possible, and in operations that require a person to relax, use mechanical ventilation or to relieve severe pain.This is the risk of apnea before coming to consciousness;
• at lower thyroid function, in which all the tissues become more loose and flabby muscles;
• in violation of nerve impulses from the brain receipt responsible for muscle tone (muscular dystrophy, myasthenia gravis and other neuromuscular disorders);
• if damaged peripheral nerves during surgery or trauma;
• the oppression of consciousness, which can be observed in diseases of the brain, or the defeat of the cranial nerves.If this happens, you should immediately seek medical attention!
Possible causes of central sleep apnea in sleep can also be divided into several groups.
1. Reduced aktivnostidyhatelnogo center in the brain.This center controls the rate and depth of breathing, sending pulses of respiratory muscles.If such signals are not received or served rare breathing during sleep may be interrupted.This happens under the following conditions:
Ondine syndrome • brain stem injury (trauma, tumor or hemorrhage, cyst)
• pharyngeal collapse (throw acidic stomach contents into the airway)
2. Violation of the blood supply or gas exchange organs and systems .Normally, if the oxygen a lot, then the respiratory center "turned off" at a time when the concentration is reduced - actively supplies pulses for breathing.With cardiovascular disease or malfunction of the lungs is disturbed during the transmission of the content of oxygen in the blood.As a result, the respiratory center "processes" is too inhibiting respiration, when there are stops that too disperses when hyperventilation developed.This is possible if there is:
lung disease • hypoxemia (oxygen reduction in the blood)
disease • heart failure
3. Changes data respiratory research.Central sleep apnea can be detected during a sleep study (when falling asleep, in a deep sleep, overweight, when the sensors are moving relative to each other is not enough).In this case, it is a mistake to talk about central sleep apnea syndrome.But at the neuro-muscular diseases and respiratory muscle weakness is a pathology.The boundary of the norm will be the frequency of pauses in breathing and accompanying diagnosis.
Possible symptoms of sleep apnea
Sleep apnea - stopping breathing, which can not be heard (especially the main character) and difficult to recognize when a person is sleeping alone.The only sign of obstructive sleep apnea in the early stages can be snoring that occurs when you restore breathing, and fluctuations in airway walls.
appearance of other symptoms suggests progression of sleep apnea and the need for urgent referral to a doctor, a sleep that has been impaired breathing during sleep.The most common manifestations are sleep apnea:
• Daytime sleepiness
awakening • Surface and restless sleep
• Morning headache
• The morning rise in blood pressure that goes by without receiving
medicines • Lack of blood pressure lowering
night • Night arrhythmiaand blockade
• night sweats
• night belching or heartburn
• Standing Up to the toilet to urinate more than 2 times per
night • Impotence
• weight gain
• Inability to lose weight permanently
• Increased sugar levels and develop diabetes
• heart attacks in the early morning
• morning strokes
All of these symptoms are associated with a lack of oxygen in the background pauses in breathing during sleep, increasing the load on the cardiovascular system and the development of hormonal disorders.
Diagnosing sleep apnea
main method for diagnosing sleep apnea - study breathing during the night, when measured airflow, snoring and oxygen content in the blood.To do this, use a respiratory monitor, cardio-respiratory monitoring and polysomnography.
To assess lung function will need chest X-ray (if needed computer tomography or magnetic resonance imaging), functional tests and determination of vital capacity, peak expiratory flow rate and blood gases.
to assess the overall condition of the body, cardiovascular risk and to identify possible causes of sleep apnea requires the following tests:
• 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
Possible complications of apnea
Every fifth of accidents associated with sleepiness.In marked sleep apnea, when reduced memory and concentration, industrial injuries increased significantly.About 33% of all arrhythmias leading to cardiac arrest caused by sleep apnea.It is no coincidence most of the heart attacks and ischemic strokes occur between 3 and 4 o'clock in the morning.All this - the result of undiagnosed and untreated sleep apnea.Such people are 5.2 times more likely to die than those who do not have sleep apnea, or it is treated effectively.
Pass inspection on time and keep your life for yourself and loved ones!
In cases where the apnea is already developed, and there were daily or symptoms characteristic of the disease, require full and immediate assistance, a sleep physician.
the treatment of apnea active tactics applied, aimed at eliminating the causes of the disease.
First of all, you need to change your lifestyle :
- Refusal of bad habits.
- Dieting (low-carbohydrate high-protein).
- Regular aerobic exercise.
- Weight reduction by at least 10% of the original, if there is excess weight.
- Positional treatment (sleep on your side, if sleep apnea is observed only on the back).
These measures may be applied independently with mild sleep apnea, or combined with other treatments, if breathing stops are more pronounced.
Drug treatment of sleep apnea.
approach to receiving medication depends on the type of sleep apnea.When central stops breathing focuses on the correct function of the lungs and heart.Accordingly, the drugs will be prescribed by the doctor on the basis of health status.Directly to central apnea affects diakarba reception, which is also prescribed by doctors.
Treatment of obstructive sleep apnea drugs ineffective.Magic pills do not have, and those that are available will not be able to heal you from breathing stops.Even many folk remedies that strengthen the mucous membrane, reduce swelling, or deprive you of sleep, do not give the proper result.Firstly, the situation is serious during apnea associated with airway wall sticking, which persists medication.Secondly, many drugs and folk remedies may even worsen the picture, triggering allergies and throat swelling.Pay attention to the (doctor Snoring, Silence, SnorStop).Typically, a combination of several plant components, which can cause unpredictable reactions.It is worth remembering, especially given the fact that allergic rhinitis occurs in one-third of people with sleep apnea.In this case it is possible to use only local corticosteroid (mometasone), which reduce inflammation and swelling of the airway mucosa during exacerbation of allergies.There is evidence that in 17% of cases is reduced and the volume of the tonsils, pharynx extending lumen.
Surgical treatment of sleep apnea.
Applies only when obstructive , with central sleep apnea stops breathing impractical because no object impact.
The goal of surgery - to increase the lumen of the respiratory tract and eliminate the obstacles in the path of air flow.This may be the removal of enlarged tonsils, adenoids, polyps and other tumors and malformations.Surgery is very effective and can eliminate the cause of apnea, but only if no other conditions affecting respiration during sleep and there are no contraindications for surgery, for example, obesity. fundamental error in the surgical treatment of sleep apnea - surgery on the soft palate (the removal of the tongue), especially with a laser.They can not be carried out! This is due to the low efficiency and high risk of complications, including death immediately after surgery.
Intraoral devices (capacitor).
is a good alternative to surgery and PAP therapy in obstructive sleep apnea .breathing is not applied when the central disturbance.
Capa push the lower jaw forward during sleep, thereby increasing airway clearance, do not let the walls come into contact with each other.The effectiveness of this method is quite high, and the inconvenience of wearing a mouth guard during sleep are minor and go away over time.
Capa for the treatment of snoring and sleep apnea
Unfortunately, this method will yield results only in mild to moderate obstructive sleep apnea.More severe breathing disorders during sleep require PAP therapy.
PAP-therapy for the treatment of sleep apnea.
This method of treatment stops breathing like obstructive and central type .The basic principle of the method - the air supply pressure to the airways, so as not to make the walls of the pharynx to stick together.The device can operate in different modes, depending on the severity and nature of the violations (CPAP mode BIPAP, TriLevel, servoventilyatsiya).This method is safe and has no absolute contraindications.The result is visible in the first days of use: disappearing stop breathing, snoring, daytime sleepiness and other symptoms of sleep apnea.The efficiency can reach 100% even at the combination of several causes of apnea, which eliminates the other methods, including operations at the throat.PAP therapy is prescribed a sleep physician and performed at home.
PAP therapy for apnea
Effective treatment of sleep apnea without harm to health possible.A proper timely preventive maintenance will prolong your life.
sleep to prevent sleep apnea, you need to remember about the main factors of its appearance, and did not allow them to develop:
1. Timely examination and treatment of somatic diseases (in particular, brain, thyroid, upper respiratory tract, heart and lungs).Controlling the level of thyroid hormones, sugar and blood pressure.
2. Weight control and reduction in the recruitment of more than 10% of the original.
3. Refusal of bad habits: smoking, alcohol, night work, stress.
4. Regular aerobic exercise (walking, swimming, biking, playing sports).
These simple rules will not only protect you from sleep apnea, but also save your life and health.
Elena Tsareva, a sleep physician,