Sleep apnea - symptoms, causes and treatment. Sleep apnea: treatment, causes of sleep apnea in children and adults Sleep apnea

Approximately every fifth inhabitant of our planet is faced with the problem of temporary pauses in breathing during sleep. Because of this problem, oxygen starvation occurs, as air stops flowing into the bronchi and lungs, as a result of which sleep becomes inferior and human health suffers. In addition, this pathology leads to discomfort and irritability of relatives and friends, because respiratory arrest or sleep apnea in adults is often accompanied by snoring. Experts report that this problem can appear at any age, both in men and women.

If sleep apnea syndrome is left unattended and effective treatment will be absent, then this pathology will acquire a chronic form, due to which very serious and dangerous complications can begin to develop, which not only pose a threat to health, but even to the life of the patient.

Since this problem is quite common and serious, everyone should know what are the main signs of sleep apnea in an adult. Thanks to knowledge about this disease, you can go to the hospital in a timely manner and prevent many negative consequences.

Fiction or reality?

Some people think that sleep apnea is nothing more than a myth, but this is far from the case. Experts and doctors consider this syndrome a disease that really threatens people. With the development of pathology, the amount of oxygen that enters the respiratory system is significantly reduced. Numerous respiratory pauses are observed, lasting from 5-10 seconds to 2-3 minutes.

Since a person temporarily stops breathing at night during sleep, some do not even realize the existence of this problem. Sleep apnea occurs during the deep phase of sleep, only when a man or woman snores. It is snoring that is the reason why this syndrome develops. During deep sleep soft tissues the nasopharynx and palate, as well as the muscles of the larynx, relax as much as possible, due to which the respiratory passages overlap, and therefore there is a syndrome of respiratory arrest, in the existence of which some do not believe.

Forms of the syndrome

Doctors have divided this pathology into 3 main forms or types:

central apnea. It occurs due to the missing impulses that normally go to the respiratory muscles. As a result, the lungs receive less oxygen;
obstructive sleep apnea. This form is characterized by temporary obstruction of the airway, which can overlap or narrow for various reasons;
mixed form. This type is a mixture of signs of obstructive and central syndrome.

central shape

Experts consider this type of apnea in adults to be extremely dangerous, because it is characterized by a complete cessation of inhalations and exhalations. There are no obstructions in the central syndrome respiratory tract. The problem lies in the disrupted work of the respiratory center of the brain, this center sends insufficiently active signals or impulses, due to which the oronasal flow and contraction of the muscles of the nasopharynx are not observed.

obstructive appearance

This form of sleep apnea has the following symptoms: During inhalation, the airways are blocked, however, at this point, the oronasal airflow is maintained, there is a contraction of the muscles of the pharynx and respiratory efforts.
Obstructive sleep apnea syndrome is characterized by the following features:

a man or woman sleeps very badly at night;
there are frequent awakenings;
in the daytime all the time pulls to sleep;
performance is impaired;
concentration of attention decreases;
often suffer from headaches;
a person often yawns, feels lethargic and weak.

This syndrome is in many cases accompanied by an increase in blood pressure, in the absence of medical therapy impotence develops.

mixed form

This sleep apnea syndrome is a mixture of symptoms of obstructive and central type of pathology. If this disease often manifests itself at night during sleep, then respiratory hypoxemia begins to develop, during which the oxygen content in the blood decreases significantly and accumulates carbon dioxide. This type of disease usually results in sudden and frequent fluctuations in blood pressure and damage to the heart muscle. The heart rate and heart rate can change very quickly, which leads to the development of serious cardiovascular diseases.

Attention! This form of impaired breathing causes the gradual development of very dangerous complications, which will later be quite difficult to get rid of, their treatment will take a long time. A person should understand that very frequent, regular attacks and respiratory pauses are very dangerous for both health and life, so you should immediately schedule a visit to the doctor.

The main signs that are a danger signal

Experts divide all the symptoms of sleep apnea in adults into two categories: manifested during the day and at night. Daily signs are:

deterioration in concentration, it is difficult to concentrate on any business or things;
apathy, lethargy and drowsiness;
dry mouth, often thirsty;
headaches, migraine;
decreased sexual desire, no desire for intimacy;
soreness in the region of the heart;
frequent drops in blood pressure;
development of impotence;
emotional disorders, manifested by sudden changes in mood;

Nighttime symptoms include:

various sleep disorders;
the appearance of ronchopathy or snoring;
sudden awakenings at night due to the inability to breathe;
the appearance of realistic, often terrible dreams;
the development of enuresis - urinary incontinence at night;
the occurrence of causeless and sudden attacks of panic fear;
the appearance of insomnia;
grinding of teeth and increased salivation;
hyperhidrosis - excessive sweating during sleep.

Main reasons

Exist various reasons apnea in adults. Quite often, this problem appears in those people who are overweight and obese, have a body mass index of more than 35 units. With the accumulation of fatty deposits in the neck, nasopharynx and larynx, the pharyngeal lumen decreases, the airways partially overlap, which causes short-term respiratory arrest. In addition, the causes of sleep apnea can be the following:

too much frequent use alcoholic beverages;
smoking. Cigarette smoke adversely affects the condition of the tissues of the nasopharynx;
poor heredity, due to which a person has congenital anomalies;
various pathologies and abnormal structure of the facial bones, nasal septum;
serious congenital diseases;
pickwick's syndrome;
hormonal and metabolic disorders that occur along with obesity, their medical name is metabolic syndrome;
high blood pressure, which is about 170 over 110, and higher;
bradyarrhythmia, which is an abnormal heart rhythm, especially its periodic significant decrease;
heart failure;
chronic obstructive pulmonary disease, especially severe;
respiratory failure of the second and third degree;
thyroid pathology.

In addition to all of the above, there are other factors that cause respiratory pauses, for example, enlarged, inflamed tonsils, nasal congestion, allergic manifestations accompanied by a severe runny nose.

Often, impaired breathing is observed in premature and newborn babies. If there is no treatment, then the problem becomes chronic.

Which specialist to contact

Many are interested in which doctor to go to if a person has respiratory disorders? If a man or woman systematically stops breathing at night, and this problem is accompanied by snoring, then the first thing to do is to contact a therapist. It is this doctor who must diagnose, interview and examine the patient, in some cases the therapist determines the cause of the pathology. In addition, this doctor may recommend any lifestyle or nutritional adjustments, and may prescribe medical preparations to get rid of the problem.

If there are diseases of the nasopharynx, manifested in acute or chronic form if the patient has soreness in the throat area, then he needs to go to an appointment with an otolaryngologist or ENT specialist. This doctor will examine the patient and prescribe either special procedures or effective medicines and in some cases surgery is indicated.

When the patient has violations in the structure of the upper or lower jaw, and they provoke respiratory obstruction, then it is necessary to consult a dentist. It is this doctor who will analyze the situation, if necessary, perform jaw plastic surgery, and make an intraoral applicator.

In some cases, a sleep doctor listens to the patient's complaints and suggests how to treat sleep apnea in an adult. Consultation with a somnologist is necessary if insomnia and other sleep disorders are present.

Diagnostics

First of all, relatives and close people diagnose respiratory pathology. However, in order to fully verify their words, a special diagnostic procedure- polysomnography. It is carried out in a medical institution, in a sleep laboratory. The patient falls asleep, and at this time, for 7-8 hours, special sensors connected to the body record information and transmit it to the screen. The device determines the level of oxygen in the blood, the number of breaths and exhalations, the duration of pauses in breathing, the indicator of brain activity, the state of the heart, eye activity during sleep.

Based on the data obtained, the specialist makes a diagnosis and establishes the severity of the pathology. After that, the doctor often prescribes a suitable treatment method.

Surgical intervention

In many cases, the treatment of respiratory disorders that have arisen due to an abnormal structure of the nasopharynx or sagging soft tissues is performed using surgical operation. Whether an operation is needed or not, only the attending physician decides after he analyzes all the results of the patient's tests and examines the structure of the oropharynx. The operation is a last resort, it is resorted to in cases where medical methods have not brought positive result. The most common types of surgery are:

tonsillectomy - this treatment is the removal of the tonsils, due to which the inflammatory process began;
conchotomy - removal or reduction of nasal turbinates;
polyectomy is the removal of polyps located in the nasal cavity;
alignment of the nasal septum;
installation of implants in the soft palate, which are necessary to strengthen and support soft, sagging tissues that have lost their elasticity and tone;
uvulopalatopharyngoplasty is the removal of excess tissue of the oropharynx, uvula and tonsils;
somnoplasty is an operation on the soft palate;
myotomy is an operation on the genioglossal muscle;
osteotomy is an operation on the lower and upper jaw;
tracheostomy is the elimination of anatomical anomalies located in the region of the trachea and nasopharynx.

Medications

Medications are used in the treatment of respiratory disorders as aids. The medicine should be prescribed by a qualified doctor after examining the patient. Usually prescribed such nasal drops and sprays: Dr. Khrap, Asonor and Silence. These drugs soften the mucous membranes of the oropharynx, tone and strengthen soft tissues, thanks to natural essential oils and other natural ingredients.

CPAP therapy

This therapy is used to treat the advanced stages of the disease. It is the creation of the necessary pressure in the respiratory organs with the help of an apparatus. For therapy, a special device is used, consisting of a compressor, a tube and a mask. The compressor pumps the necessary air pressure, which is fed through a tube into a mask worn on the patient's face. With the help of this device, a sufficient volume of air enters the lungs, the root of the tongue, the palatine uvula and the soft tissues of the oropharynx acquire the desired position, so respiratory pathologies are eliminated.

CPAP therapy is used during sleep, either in the hospital or at home. If the disease is advanced, then the device for treatment will have to be used every night. This therapy has several advantages over other methods:

the patient quickly gets rid of snoring;
sleep is normalized, night rest becomes full and high-quality;
during the day a person feels much better;
lethargy and drowsiness disappear, working capacity increases;
headaches are eliminated.

CPAP therapy has some disadvantages:

with regular use of the mask, discomfort appears;
irritation and redness occur on the skin of the face;
there are difficulties with inhalation and exhalation, sometimes stuffy nose;
some complain about headache and discomfort in the abdomen.

Additional remedies for treatment

If the disease is not severe, then the following methods can be used:

nose strips that expand the wings of the nose, increasing air permeability;
aerosol agents for softening mucous membranes;
intraoral devices;
folk medicine. You can eat three times a day baked carrots in the oven. You can use a mixture of cabbage leaf and a teaspoon of honey before bed. Effective for healing sea buckthorn oil, which is instilled 1-2 drops in each nostril 3 hours before bedtime.

Before using any remedy, you should consult a qualified doctor.

A person spends half his life in a dream. Resting, he restores his protective functions, the forces expended during the day.

But before falling asleep, we don’t even think about the fact that sometimes terrible problems can arise at night.

These include apnea - a temporary stoppage of breathing, which in rare cases ends in death.

So, he fell asleep and didn't wake up. What is this disease, what are its symptoms and how to treat.

Causes of the violation

Abrupt cessation of breathing during sleep, daytime rest, naps, for more than 10 seconds is called obstructive sleep apnea syndrome (OSAS).

If a snoring person lives next to you, then you must have heard at least once when he, snoring, holds his breath.

And only after a certain interval of time does he again snort strongly and begin to breathe. Throughout the night, these stops are repeated more than once.

In fact, we do not even suspect that he has a serious illness that should be taken very seriously.

If the patient is asked whether he woke up at night, he will not remember. A patient with sleep apnea has increased drowsiness.

Very often a person can fall asleep while negotiating, driving a car. He just turns off for a few hours, and after he wakes up, not understanding what happened.

Important! OSAS is a common sleep disorder in which soft tissue rear wall the larynx relaxes and falls down, blocking the airways.

Normally, a person may accidentally stop breathing, but if this lasts from 10 to 30 seconds, then it is worth sounding the alarm.

As a result of a pathological stop of respiratory functions, the body, as it were, does not fall into full sleep but is in a state of drowsiness and does not receive proper rest.

What can be the causes of OSA?

Such a pathological state of the body can be triggered by a number of physiological abnormalities in the body:

Obesity of the neck. The neck becomes too wide, muscle mass and body fat increase, and when relaxed, occupy a large space in the larynx, blocking the breathing tube.
Irregular shape of the skull.
The lower jaw strongly protrudes relative to the upper.
On the contrary, underdeveloped lower jaw.
The large size of the tongue, which is difficult to fit in the mouth.
Large tonsils and swelling of the palate.
Acquired injuries of the nasal septum or its congenital pathologies.
Extraneous formations in the nasopharynx, which complicate the respiratory process even during wakefulness.
Obstructive pathologies of the respiratory organs.
Present diseases:,.

In addition to physiological causes, there are risk factors that increase the likelihood of a disease. So, for example, gender affects the predisposition of sleep apnea.

This syndrome is more common in men than in women. Their weight is greater, which means that the neck muscles are expanded and enlarged. But the female sex, this problem begins to overcome more often after menopause.

Age indicators - more often apnea affects a category of people aged 40 to 60 years. But young people are also not immune from the disease.

In addition, a harbinger of the onset of the disease can be genetic predisposition and the presence of addictions to addictions.

Symptoms of obstructive sleep apnea

How to understand that a person is sick? main feature, which you need to pay attention to - snoring, and it depends on how a person sleeps, on his back or side.

At the time of snoring, he holds his breath, the color of the lips becomes cyanotic. If you make a count and it was more than 10, then this is nothing but OSAS.

In rare cases, his muscles tense up, I make involuntary movements, the patient may even fall out of bed.

Other indirect signs of the disease are:

nightly shudders and awakenings, not infrequently in a cold sweat, panic fear;
frequent urge to urinate;
sleep disturbance after each awakening;
falling into a state of drowsiness during the day at work;
the appearance of fatigue after a morning urge;
potency decreases;
decreased performance, memory, attention;
changes emotional background: depression, irritability, Bad mood, depression.

If you find yourself with such symptoms, you should consult a doctor for help in order to avoid serious consequences in health.

Apnea types

There are two types of disease.

Central sleep apnea

It is rare and is associated with nervous disorders.

The disease is caused by the absence of nerve impulses to the brain for the respiratory organs to begin to perform their functions.

It is difficult for a person in a dream to breathe after stopping breathing, from this he wakes up abruptly, he has a lack of oxygen.

The reason for such apnea type is heart disease.

The patient suffers less than with OSAS. Daytime drowsiness appears less frequently, but the night stoppage of the respiratory organs is much longer and more problematic.

Mixed sleep apnea

The species name speaks for itself. This is a mixture of two types: obstructive and central.

In the process of sleep, periodic occurrence of one after the other can be observed.

First, there is a central cessation of breathing, then it alternates with the action of the muscles of the larynx.

A complex disease can cause dysfunction of cardio-vascular system organism.

Consequences for the body

Pathological sleep disorders in OSAS destroy everyday life in the truest sense of the word.

After inadequate sleep, the patient does not recover strength, on the contrary, he feels depressed.

Decreased concentration of thoughts at work physical activity and performance.

A frequent accompaniment of sleep apnea is nervous irritability, leading to conflicts in the family and at work, since a person cannot think about anything other than sleep and rest.

A more serious consequence is an increase in road injuries. If the patient acts as a driver of a car or a sleeping pedestrian.

In addition, a sick person should not be allowed to work in dangerous and harmful production.

A bunch of physiological abnormalities join everyday everyday hardships: increased blood pressure, arrhythmia.

Doctors consider this disease a risk of stroke, heart attack, as well as a complication of bronchitis, asthma and other chronic lung diseases.

Treatment of sleep disorders

You can determine the disease in a close relative already at home, based on the method of Dr. Rovinsky.

To do this, using a stopwatch, it is necessary to measure the duration of respiratory failure and calculate the frequency of such failures per night.

With such indicators, you should consult a doctor who, by comparing body weight and measurements, will determine the severity of sleep apnea.

The program is developed individually for each patient, taking into account individual features patient.

It may include drug and no therapy, as well as surgical intervention to eliminate the causes of the syndrome.

Surgery

At this stage, the following methods are used:

Uvulopalatopharyngoplasty is an operation to cut off excess tissue in the patient's larynx to widen the airways. Excess tissue includes part of the soft tongue or all that hangs from the upper part of the palate, above the tonsils, as well as part of the soft palate at the transition to the throat. Large tonsils and adenoids are usually also excised. Treatment is carried out in a hospital with further monitoring of the patient.
Uvulopalatoplasty with a laser - there is less tissue during the operation, mainly to eliminate snoring. manipulation is carried out under local anesthesia in the doctor's office. Stationary stay is not required.
Palatal implantation pillar - this procedure is used for mild sleep apnea. An implant is implanted into the sky, which reduces the vibration of the sky - snoring. It does not require inpatient treatment, it is performed under local anesthesia.
Tracheostomy is a complex operation that is used in rare cases to treat life-threatening sleep apnea. A hole is made in the neck, passing into the trachea, a special tube is inserted into it for breathing during sleep.
Other surgical manipulations associated with the plasticity of congenital external deviations of the structure of the skull, lower jaw, the size of the tongue, tonsils, etc.

Third-party surgical procedures to change congenital or acquired changes in the body in some cases do not give success, but in combination with basic operations they bring positive results.

Medicines

The following can be prescribed as medicines by a doctor:

Provigil;
Modafinil;
intranasal corticosteroids;
Theophylline etc.

Important! Sedative drugs should not be used, as they provoke sagging of soft tissues, which worsen the respiratory process during sleep.

Folk methods

These methods involve the implementation of simple activities at home.

These include:

Weight tracking. If present excess weight, you need to get rid of it by applying diets.
Eliminate late eating, it is advisable to do this three hours before bedtime.
Quit smoking and drinking alcohol.
Train yourself to sleep on your side. To do this, you can buy a special anatomical pillow that will save you from snoring. If you are used to sleeping on your back, then you should readjust.
Eliminate nasal congestion before bedtime using drops, patches, sprays with menthol, eucalyptus, mint. Can be applied essential oils that promote the expansion of the airways.

Such manipulations will help eliminate a mild degree of the disease or alleviate the condition after a previously performed operation.

In addition to prevention, you can use washing and rinsing the larynx brine at night, this therapy will moisturize the nasopharynx and facilitate breathing.
A glass of cabbage juice with honey will improve your daytime condition.
Drink milk with honey at night. The composition perfectly envelops the walls of the larynx and facilitates breathing.
Eat a few fresh carrots in the evening, rich in vitamin D, which improves sleep.

You can use butter, sea buckthorn, vegetable and other oils in combination with drug therapy. They are able to soften the tissues of the throat and upper respiratory tract, reduce asthma attacks.

Important! All procedures should be carried out under the supervision of a doctor.

Conclusion

Obstructive sleep apnea is a serious problem that can lead to serious consequences. In other words, a person can suffocate while sleeping.

The first symptom to look out for is snoring. It often causes lung failure.

If you or your loved one feels all the signs of the disease on yourself, then immediately go to the hospital. The sooner this happens, the easier it is to eliminate the disease.

Video: Treatment of sleep apnea

Sleep apnea is an extremely common pathological condition. According to statistics, more than 60% of people over 65 suffer from it. However, now this disease is rapidly getting younger and is not uncommon even in children. It is statistically known that men suffer from this pathology about 2 times more often. From this article you will learn what sleep apnea is, why pathology develops and how to deal with it.

Usually this condition is represented by obstructive sleep apnea syndrome (OSAS), characterized by short-term pauses in breathing. This pathology can be the result of the influence of many adverse factors. Usually, to eliminate the manifestations of this condition, it is required to use a special CPAP device, which allows you to maintain the patient's respiratory function at night.

Syndrome classification

With the advent of modern methods for studying the behavior of the body during sleep, this pathological condition has been studied in some detail. There are several classifications that describe this disease. Based on the mechanisms of development, obstructive sleep apnea, as well as cerebral and mixed forms, are distinguished. Each option has its own characteristics.

Obstructive sleep apnea occurs due to occlusion or subsidence upper paths. At the same time, respiratory regulation by the central nervous system is preserved, as is the activity of the respiratory muscles. Obstructive sleep apnea is distinguished into a separate syndrome complex, which includes a number of respiratory dysfunctions that appear during sleep. There are at least 4 states of this type. The most common syndrome is hypoventilation. It is characterized by a steady decrease in lung ventilation and blood oxygen saturation. The second most common is the syndrome of pathological snoring. There are no objective reasons for the appearance of this disorder, but during sleep, the upper respiratory tract is greatly reduced, which leads to the fact that not only the level of ventilation of the lungs decreases, but also blood oxygen saturation.
Central apnea is diagnosed when there are disturbances in the work of the central nervous system responsible for the regulation of nerve impulses to the respiratory system. This variant of the disease is rare.
Another type of this pathology is represented by the obesity-hypoventilation syndrome. With this variant, gas exchange disorders caused by excess body weight are observed. With this variant of the course of the disease, there is a persistent decrease in blood oxygen saturation with daytime and nighttime attacks of hypoxia.
The syndrome of combined obstruction of the respiratory tract, manifested by bouts of apnea at night, develops due to obstruction of the upper tracts, usually at the level of the pharynx and in the lower bronchi.
Sleep apnea syndrome in a mixed form usually includes elements of the central and obstructive forms. This variant of the pathology is quite rare. An increased risk of such a disorder is present in children with congenital developmental pathologies.

There is also a classification that takes into account the degree of manifestations of sleep apnea syndrome during sleep. This parameter is very important to control, since such indicators determine how dangerous this condition is for a person. There are 4 main degrees of severity of this pathological condition.

If no more than 5 episodes per hour occur during sleep, a borderline condition may be diagnosed.
When the number of attacks is between 5 and 15 per hour, this is a mild degree of sleep apnea. In the future, the situation may worsen.
If 15 to 30 episodes occur per hour, the average severity of this disorder is diagnosed. This option requires the use of a CPAP machine for the treatment of sleep apnea.
When the number of episodes exceeds 30 attacks per hour, a severe degree of this pathological condition can be diagnosed. AT this case directed therapy is required, including with the help of hardware respiratory support.

Etiology and pathogenesis

Many causes of this pathological condition are already known. The central form of sleep apnea is of particular interest to the medical community. The appearance of this variant of the course of the disease is most often observed against the background of craniocerebral injuries, with compression of the brain stem in the region of the posterior cranial fossa. Among other things, the causes of this form of apnea can be rooted in pathologies such as postencephalitic parkinsonism, as well as Alzheimer-Pick syndrome.

With these diseases, the risk of developing such a disorder can reach approximately 85%. Central apnea in children is often the result of primary insufficiency of the respiratory center. With this variant of the course of the disease, the syndrome of alveolar hypoventilation can be diagnosed, and any pulmonary and cardiac pathologies may be absent.

The syndrome of obstructive sleep apnea accounts for more than 90% of cases of this pathological condition. Factors contributing to the development of this disorder include:

severe obesity;
endocrine diseases;
severe stress;
physical stress.

Among other things, the anatomical features of the structure of the respiratory tract that a person has can predispose to the appearance of obstructive sleep apnea syndrome. Often people with a thick and short neck suffer from such problems. Enlargement of the tonsils, soft palate or tongue can also contribute to the appearance of such a problem. Sleep apnea often affects people who have narrowed nasal passages.

The appearance of obstructive sleep apnea is often the result of pharyngeal collapse that developed in the phase of blue sleep. The constriction of the airways that causes each episode of sleep apnea leads to the development of hypoxia, which signals the brain to wake up. During the transition to the state of wakefulness, ventilation of the lungs is normalized. A number of provoking factors stand out. These include:

elderly age;
obesity;
reception sedatives;
alcohol abuse;
smoking;
nasal congestion.

An increase in the frequency of sleep apnea in women is observed during menopause. This is due to the natural aging process of the body. In addition, the risk of developing this disorder in people who have a hereditary predisposition to it is much higher. As practice shows, if parents suffered from this disorder, their children have a 75% risk of developing a problem.

Sleep apnea symptoms

If a person lives alone, it is difficult for him to determine the presence of symptoms of sleep apnea. The attack is almost asymptomatic. Respiratory arrest usually occurs for a very short period. This disease can be manifested by pathological snoring. Often these sounds make even the person himself wake up. Snoring occurs when breathing is restored. This causes oscillatory movements of the airway walls.

Apnea in children is often manifested by frequent awakenings at night. The kid can have nightmares at this moment. This is due to the fact that the brain abruptly passes from one phase to another. In this case, the child may have serious problems with sleep, as there is a high risk of unfounded fears.

In the future, the symptoms of sleep apnea may worsen. Additional manifestations of this pathological condition are the result of deterioration of the condition. As sleep apnea progresses, symptoms may include:

daytime sleepiness;
increased fatigue;
decrease in working capacity;
irritability;
anxiety;
depression;
frequent headaches in the morning;
dryness in the throat;
night sweats;
lack of lowering blood pressure at night;
slight increase in blood pressure in the morning.

Individually, each symptom does not indicate the development of a similar sleep pathology, but their combination allows doctors to determine the nature of the problem. Moderate to severe sleep apnea causes severe disorders due to insufficient saturation of body tissues with oxygen.

In people with this pathology, an increase in body weight is observed for no reason. Getting rid of extra pounds in this case is extremely difficult. Among other things, due to insufficient blood oxygen saturation during sleep, the risk of developing sexual dysfunction increases.

It was revealed that this respiratory disorder can cause severe disorders of the cardiovascular system. Patients complain of angina attacks. Sometimes there is an arrhythmia. Some patients may have characteristics heart failure.

Sleep apnea in children is often manifested by mouth breathing during the daytime. In addition, in a child, this disorder is often accompanied by urinary incontinence at night and a desire to sleep in an unusual position. In addition, parents can understand that something is not right with their baby if he begins to snore distinctly. In children, changes in behavior may also indicate the presence of this pathological condition.

Possible Complications

This disease should not be ignored, as the consequences of this can be the most adverse. The presence of sleep apnea syndrome has an extremely negative impact on the quality of life of a person, as he constantly feels overwhelmed. Due to a decrease in the ability to concentrate, the risk of injury at work, at home and while driving a car increases significantly. At heavy snoring a person begins to interfere with others, which often leads to conflicts and the appearance of complexes.

The development of sleep apnea contributes to the appearance of various pathologies of the heart in early age. The presence of this type of night breathing disorder increases the likelihood of a heart attack in relatively young men and women. In addition, a decrease in oxygen saturation of tissues creates prerequisites for the development of atherosclerosis. Among other things, sleep apnea often creates the prerequisites for damage to cerebral blood vessels. This increases the risk of stroke at a young age.

It is worth noting that this pathology can cause a complete cessation of breathing, and then the heart. This disorder is called the syndrome. sudden death. The patient may not have any gross pathologies, but the signals that are sent to the brain about a decrease in blood oxygen saturation are insufficient for awakening. Among other things, sleep apnea significantly worsens the prognosis of many chronic diseases. This sleep disturbance is especially dangerous for patients suffering from bronchial asthma, bronchitis and COPD.

Methods for diagnosing the disease

Many people have no idea which doctor to contact for this disease. To confirm the diagnosis, a consultation with a somnologist is required. However, to identify such a problem, you can conduct a test at home. The main way to detect pathology involves careful monitoring of the patient's sleep. To confirm that a person has a condition such as sleep apnea, his relatives must be awake at night and note the duration of periods of lack of breathing.

After contacting specialists, it may be recommended to undergo special studies. In clinics where there is special equipment, polysomnography can be performed. This study is very informative. The patient is placed in a separate room and special electrodes are connected. In addition, a specialist monitors sleep. With the help of special devices, he registers the course of sleep. This diagnostic measures:

blood saturation level at night;
some aspects of the work of the heart;
muscle tone;
brain activity.

Only after clarifying the severity of the pathology by the attending physician can a number of methods for treating apnea be offered. Among other things, often people with sleep apnea are advised to contact other highly specialized specialists to identify possible causes of such a problem.

Patients suffering from this pathology are often assigned a consultation with an otolaryngologist to determine the diseases and anatomical features. Considering which doctor to contact in the presence of such a violation of breathing in a dream, it must be taken into account that often in this case a consultation of a pulmonologist and a neurologist, as well as an orthodontist, is required. To identify the reasons why sleep apnea occurs during sleep, the following additional studies are carried out:

general and biochemical analysis blood;
determination of the titer of glycated hemoglobin;
detection lipid spectrum;
urine tests.

This is far from full list research conducted for people with sleep apnea. In most cases, tests are prescribed to determine deviations in the functioning of the central nervous system, respiratory organs, cardiovascular system, and also the dentition. Thus, which doctor treats this disorder depends on the etiology of apnea.

How is the treatment carried out?

Currently, many methods have been developed for the treatment of this pathological condition. First of all, the attending physician may recommend the use of conservative methods of therapy, since they can be treated quite effectively for sleep apnea. If sleep apnea occurs in a mild form, a positive effect can be achieved with lifestyle changes. Must be abandoned bad habits. When the question arises of how to cure sleep apnea, you need to take measures to reduce weight. By following the recommendations of the doctor, you can significantly improve the condition and reduce the number of seizures.

When you need to figure out how to get rid of moderate to severe sleep apnea, the use of CPAP therapy may be recommended. This sleep apnea treatment involves the use of a special machine that pumps air under pressure into the nose. The use of CPAP prevents the narrowing of the soft tissues of the airways and helps maintain a normal level of blood oxygenation. This treatment method does not side effects. It is indicated for use in both obstructive and central forms of pathology.

A CPAP machine for sleep apnea usually has a lot of settings that allow you to choose best option maintaining respiratory function at night. This device is quite expensive, but if night apnea occurs in severe form, then treatment with it is the only way to return a person to a full life. In some cases, the patient may be recommended mandibular orthodontic caps. They move the jaw so that the airways cannot constrict during sleep. Such devices make it possible to achieve an improvement in the condition of people who cannot afford to purchase a special device.

There are also operational methods treatment of sleep apnea, but they are used, as a rule, only in the obstructive form of this pathology. Typically, such surgical interventions are prescribed in the presence of a severe curvature of the nasal septum. This treatment option allows you to correct the position if the lower jaw is too small. Often required prompt removal hypertrophied tonsils to improve the condition. Surgery usually does not cure 100% of sleep apnea patients, so it is recommended only in extreme cases.

Prevention of sleep apnea syndrome

To prevent the development of pathology, first of all, it is necessary to timely treat disorders of the ENT organs and lungs. In addition, in order to prevent the occurrence of a condition such as apnea in older adults, they need to manage as much as possible. healthy lifestyle life. Mandatory is not only the rejection of bad habits, but also sports, which can improve the condition of the respiratory tract and the cardiovascular system.

In addition, the use of tranquilizers and sleeping pills should be avoided. To prevent the development of such a pathology, it is necessary to take care of the maximum good conditions for sleep. It is necessary to eliminate sources of noise and light in advance. Don't read books or watch TV. Taking relaxing baths with decoctions of medicinal plants, a course of massage and meditation can have a positive effect.

Sleeping people can sometimes experience sleep apnea. This disease is characterized by frequent interruption of sleep due to respiratory arrest during it. Awakening during an apnea attack is a common reaction of the body of a sick person. It is necessary to treat the disease. The fact is that it affects not only human life. A sleeper with sleep apnea gets a lower quality rest, which affects his performance and immunity. In addition, such attacks cause:

increased blood pressure;
increased risk of heart attack, stroke, heart disease.

Treatment of this syndrome can reduce the risk of such complications.

This advice is one of the most common for all sick people, and not only patients with sleep apnea. As soon as this syndrome is discovered in a person, he will have to change his usual routine of life. This is one of the elements of how to treat sleep apnea.

Sleep disturbance of this kind and a person's lifestyle are seriously related and affect each other. For some patients being treated for sleep apnea, simply losing weight is enough. Excess weight puts pressure on everything internal organs human, and the respiratory system is no exception. As soon as the interference disappears, the apnea disappears.

Treating sleep apnea with weight loss is a common technique. 77% of all overweight people acquired various sleep disorders along with it. And 70% of people suffering from nocturnal respiratory arrest, in addition to the syndrome, are overweight. Experts noticed that as soon as a person lost weight, his quality of sleep improved. The opposite effect was also observed: as soon as the patient started treatment for sleep apnea, his weight decreased.

Back in 2009, the staff of the Karolinska Institute in Sweden, led by Professor Martin Neovius, thought about what sleep apnea is and how to treat it with maximum efficiency. Studies have shown that after only 9 weeks of severe calorie restriction (up to 500 calories per day), overweight men lost weight and received a reduction in the frequency of sleep apnea attacks to 21 per hour.

The final part of the study clearly states that even a year after such a strict diet, and if the subjects gained back most lost weight during the experiment, the quality of their sleep remained at the same, improved level.

Apnea is often the result of being overweight. Treating sleep apnea with weight loss is a very effective technique.

Even if the sleep apnea syndrome was treated with a less restrictive diet (ranging from 1200 to 1500 per day), a positive trend was still observed. Such a study was carried out by scientists already in Pennsylvania. The size of the group of subjects is 250 people. Compared with the control group, the condition of the subjects improved three times.

When treating sleep apnea, the patient should pay attention to how he spends his time before going to bed. Dinner should be no later than 4 hours before a person is going to go to bed. 2 hours before bedtime, a heavy, hearty dinner is prohibited. If you want to eat, it is better to intercept something light, like a glass of kefir with cookies, an apple.

Before going to bed, it is forbidden to take alcoholic beverages and sedative drugs, as they weaken the tone of the muscles of the pharynx and, as a result, make it difficult for a sleeping person to breathe. Reduced tone causes the wall of the airway lumen to fall, and the person simply stops breathing.

The best sleep is on the side. When a person lies on their back, the risks of retracting the tongue during snoring and blocking their airways increase. This is another common cause of sleep apnea.

The person involuntarily rolls onto their back during sleep. To prevent this from happening, you can go for a little trick. At the level of the back to the clothes in which you go to bed, sew a small pocket. button closure. There you need to get a tennis ball. As soon as the sleeper begins to turn on his back, the ball will begin to bring discomfort.

As a result, the sleeper wakes up and again assumes the correct position. True, for those who are very active tossing and turning in their sleep, such a trick may not work - too often the dream will be disturbed.

True, such suffering is justified - you will have to endure at least a month so that the body gets used to sleeping on its side and the person stops rolling over on his back.

Proper pillow selection also affects the frequency of seizures. If it is too high, the head will take the wrong position on the pillow and the airway will eventually be blocked. This will eventually lead to respiratory arrest and awakening again. It is better to replace the pillow with a flat or orthopedic one. Most the best option- replace the bed with a new one, with a slightly raised headboard, then you don’t have to pick up a pillow for yourself.

Positive Pressure Treatment

Today, the treatment of obstructive sleep apnea is carried out by various methods. The most modern of them is injection of positive airway pressure. Otherwise, this technique is called CPAP therapy.

For permanent use of the method, you will need to use a special apparatus. A special mask is put on the patient's face, and it is securely fixed on the patient's head so that it does not fall off the sleeping person's head. Through the mask, oxygen is supplied under pressure into the respiratory tract of a sleeping person. This keeps the airway open and prevents sleep apnea syndrome starts to interfere with sleep again.

A typical CPAP therapy preparation: compressor, flexible tube and mask.

To make the mask more effective, the level of pressure at which oxygen is supplied to the airways can be adjusted to suit the individual patient.

The effectiveness of the mask is very high - already on the first night of use, sleep apnea symptoms disappear. Blockage of the airways, their clamping, holding the breath of a sleeping person automatically stops. With regular use of the device, a person will get rid of increased risk heart attacks, strokes, hypertension.

While using the device, the patient forgets what sleep apnea is.

The use of CPAP therapy at this point in time is practically the only way to alleviate the condition of people suffering from moderate and severe forms of obstructive sleep apnea syndrome. This equipment is quite massive, and not everyone can use it at home. If you need to constantly use such a mechanism, then you can use more compact devices.

They are now quite common and also work using the technique of injecting positive oxygen pressure into the airways. Special Nasal EPAP nasal devices have two valves to let air in and close the passage to the outside. Such devices can also be safely used for patients with mild sleep apnea.

Mouth devices

If the cessation of breathing during sleep is caused by the retraction of the tongue and the blocking of the airways with its help, as well as other features of the structure of the lower jaw of a particular patient, sleep apnea attacks can be prevented using devices for the mouth.

As a rule, these are mouthpieces, mouthguards and clamps that do not allow the tongue to sink in, pushing the jaw forward. In this position, the tongue simply cannot fall into the airways. But such devices help only if the patient has a mild form of the disease.

Surgical treatment

Sometimes sleep apnea can only be corrected with a technique such as surgery. The methods of surgical intervention are varied, they include:

correction of a deviated nasal septum;
removal of tonsils and adenoids;
soft palate reshaping, cutting or complete removal uvula, implantation in this area, etc.

The method of operation is chosen after assessing the condition of the upper respiratory tract in the process of computerized sleep research, respiratory monitoring, or other methods.

Unfortunately, for most patients, one-time surgery may not help. In this case, doctors have to perform one complex operation in several stages or perform several simpler interventions.

As practice shows, the standard protocol is most often used. It includes: uvulopalatopharyngoplasty, extension of the genioglossus muscle with hyoid myotomy and maxillo-mandibular displacement. This allows you to increase the lumen of the posterior airways and makes breathing easier. Sleep apnea symptoms subside.

In order to prevent surgical intervention negative impact on the vocal cords and airways, surgeons use laser and radio wave techniques - this allows you to reduce incisions with a scalpel.

The main advantage of surgery is that arterial blood finally gets more oxygen saturation. Already in 2008, Stanford University published the results of studies, according to which 93.3% of all operated patients were able to restore normal level sleep and life.

Drug treatment

Medications are used only to treat central sleep apnea, which has a different mechanism of action compared to obstructive sleep apnea. From medicines use acetazolamide or zolpidem and triazolam. However, their use is associated with certain health risks, so their prescription and use is controlled by a doctor.

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For the treatment of obstructive sleep apnea, breathing training is one of the effective methods. It is necessary to increase respiratory activity, keep the muscles of the upper respiratory tract in good shape, set the threshold for micro-awakenings and suppress REM sleep.

At this point in time, doctors have not scientifically proven the effectiveness of all the drugs used.

Treatment at home

At home, the patient is able to reduce the number of attacks or cure it. However, the latter is only possible if the apnea is caused by obesity. For treatment, you need to follow a diet and give the body physical activity.

Training will also be required for the muscles of the mouth:

we put forward the tongue, hold it at the maximum possible distance for a couple of seconds. Approaches - in the morning and in the evening 30 times;
move the lower jaw. holding it with your hand, up and down. Again, 30 times per approach;
we hold a pencil or other piece of wood with our teeth for 4 minutes. You need to hold on with all your might;
pronounce the vowels loudly and clearly.

Such training gives the effect after a month of repetitions. Sometimes a finger massage of the palatine uvula helps.

In addition, before going to bed, rinse your nose with water with the addition of sea salt or aquamaris, instill sea buckthorn oil into the nostrils to facilitate breathing.

A plump, red-faced fellow was sitting on the box, sunk in a slumber.
- Amazing little one! said Mr Pickwick. Does he always sleep like this?
- Asleep! said the old gentleman. - He always sleeps. In his sleep, he follows orders and snores while serving at the table.

Charles Dickens
The Posthumous Papers of the Pickwick Club

It is believed that snoring in a dream, although it can create significant inconvenience for others, is a kind of norm. In fact, in many cases this is far from the truth. Snoring is not just a sound phenomenon, it can indicate difficulty in passing air through the upper respiratory tract during sleep.

Here's how it goes. During sleep, all our muscles relax and the muscles responsible for keeping the pharynx open are no exception. As a result, the air passing through the upper respiratory tract at this time causes vibrations in their walls, similar to how a flag is rinsed with gusts of wind. This vibration of the soft tissues of the oropharynx leads to the sound of snoring. If such fluctuations are large enough, then the walls of the pharynx periodically completely close, for some time not allowing air to enter the lungs, while the chest continues to make respiratory movements, unsuccessfully trying to take another breath. Such respiratory arrests associated with periodic obstruction of the upper respiratory tract are called obstructive sleep apnea.

If respiratory arrests occur frequently, then by saying medical language, such a person suffers from obstructive sleep apnea syndrome.

Other possible causes of sleep apnea

Sometimes even quite healthy people in certain phases of sleep, a short-term cessation of breathing may occur due to a failure in the mechanism of its regulation by the central nervous system - the so-called central apnea. A feature of central sleep apnea is the absence of respiratory movements of the chest with normal airway patency. Such rare respiratory pauses are a variant of the norm, are not accompanied by health problems and do not cause disturbances in the functioning of the cardiovascular system.

However, if the mechanisms of central regulation are unstable all the time and such respiratory disorders occur frequently, then a person develops a disease - central sleep apnea syndrome with the onset of symptoms that pose a serious threat to the patient's health or even his life. Most often, central sleep apnea occurs in patients with chronic heart failure or stroke.

In the case when both obstruction of the upper respiratory tract and a violation of the excitability of the respiratory control center in the brain become the cause of the development of sleep apnea syndrome, the prognosis of the disease worsens even more.

Why is obstructive sleep apnea dangerous?

The cessation of breathing leads to oxygen starvation. This in turn stimulates the brain, forcing it to wake up in order to avoid death by suffocation. In this case, not a complete awakening usually occurs, but a short-term transition to a state of drowsiness, which in most cases is not stored in the patient's memory. Nevertheless, this time is enough to increase muscle tone, restore the patency of the upper respiratory tract and normalize the breathing process. After the blood is sufficiently saturated with oxygen, the person falls asleep again, the muscle tone decreases again and the whole cycle of abnormal respiratory events repeats again and again.

In patients with severe sleep apnea, respiratory arrest can occur almost every minute, due to which from a third to a half of the time spent in sleep, the person does not breathe at all and may develop severe respiratory failure.

Emergency micro-awakenings, which allow the patient with sleep apnea to breathe, are stressful for the body, accompanied by the release of adrenaline, which causes vasospasm and overload of the heart. Combined with oxygen starvation caused by sleep apnea episodes, this leads to accelerated wear and tear on the cardiovascular system.

In addition, micro-arousals caused by episodes of obstructive sleep apnea disrupt the normal structure of sleep, making it ragged and superficial. As a result, those deep stages of sleep almost completely disappear, during which there is a good rest and analysis of the information accumulated during the day. Instead of normal sleep, such a person spends most of the night in an unsuccessful struggle for his own breath.

Risk factors: when and who gets obstructive sleep apnea

Obstructive sleep apnea syndrome is not the only, but the most common breathing disorder directly related to sleep. It can occur at any age from childhood to old age, in men and women, but is usually most common in overweight middle-aged men.

External manifestations and consequences of obstructive sleep apnea syndrome

Main features this disease- night snoring and excessive daytime sleepiness, which is a natural consequence of sleep disorders associated with apnea.

The concept of drowsiness is quite subjective. Therefore, long-term ill people can partially get used to their condition and perceive it as a feeling of fatigue, weakness or fatigue during the day, finding an explanation for this in a tense rhythm of life and overload at work. However, drowsiness usually becomes apparent when the person is relaxed, and is manifested by falling asleep while resting, reading, watching television, and in severe cases even during vigorous activity and while driving.

But it's not just a bad quality of being awake. oxygen starvation of the brain during sleep, combined with drowsiness during wakefulness, leads to the fact that a person's memory, attention, and reaction speed are weakened. As a result, patients with severe sleep apnea not only find it difficult to cope with their work, but are much more likely than other people to experience car accidents, accidents at work and at home.

The following complaints are also common:

increased mobility during sleep;
nightmares;
waking up, sometimes with a feeling of lack of air;
nighttime heartburn;
frequent urination at night;
sweating during sleep;
dryness and bad taste in the mouth at night and in the morning after waking up;
morning headaches;
decreased sexual desire and potency.

As mentioned above, obstructive sleep apnea has an extremely negative effect on the state of the heart and blood vessels. Direct consequences of obstructive sleep apnea include:

poorly amenable to traditional drug treatment arterial hypertension, including with an increase in blood pressure during a night's sleep;
dangerous cardiac arrhythmias;
heart failure;
high risk of myocardial infarction and stroke.

A significant proportion of deaths, including sudden deaths, formally related to cardiovascular problems, are in fact a direct or indirect result of undiagnosed and therefore untreated obstructive sleep apnea. The results of many scientific studies prove that in severe sleep apnea, the likelihood of death from cardiovascular disease increases by 4-5 times.

Impact of sleep apnea on life expectancy

Obstructive sleep apnea not only significantly worsens, but also shortens life. One third of untreated patients with severe obstructive sleep apnea die within the next ten years. At work, I see many patients with sleep apnea between the ages of 40 and 65. But among older people, not just snoring elderly people, but patients with a severe form of obstructive sleep apnea are practically not found. Over the long years of my medical practice, perhaps there will be a little more than a dozen patients with a newly diagnosed severe form of sleep apnea who would have crossed the 70-year mark. Where do you think all these people go?

On the other hand, timely effective treatment not only significantly improves the quality of life, but also radically reduces the likelihood of dangerous cardiovascular complications, creates all the prerequisites for living to a deep and happy old age.