Which doctor treats snoring and obstructive sleep apnea?

Many people snore in their sleep. But snoring is not as harmless as it seems.

Often when snoring, apnea is observed - the cessation of breathing during sleep.

This can be a physiological process, for example in newborns, or a pathological process.

Impaired breathing is dangerous as it can cause a stroke or heart attack. To treat sleep apnea, you need to find out the cause.

What is it like in children and adults

Patients also experience snoring, frequent waking up, and interruptions in heart function.

Approximately 5% of people suffer from this disease, with a higher percentage among men. In women, the syndrome develops during menopause.

There is physiological apnea , when breathing stops for a few seconds no more than 2-3 times per hour. This condition does not threaten health and is normal.

Pathological respiratory arrest is considered when periods of apnea last more than 10 seconds and are repeated up to 100 times per hour. In total, the patient spends up to 3 hours per night without breathing.

This is dangerous because not enough oxygen reaches the brain and hypoxia develops.

In medicine, there are three types of disease:

1. Central form. Develops due to problems in the central nervous system or respiratory center.
2. Obstructive . It is provoked by diseases of the upper respiratory tract, in which the passage of air becomes difficult. For example, a deviated nasal septum, adenoids.
3. Mixed . Combines signs of central and obstructive forms.

Among the causes of pathology are:

1. Head injuries.
2. Diseases of the central nervous system (Alzheimer's syndrome, parkinsonism).
3. Pulmonary hypoventilation syndrome.
4. Congenital structural features of the respiratory tract.
5. ENT pathologies.
6. Obesity.
7. Endocrine disorders.

The clinical picture of the disease is represented by the following symptoms:

1. Prolonged heavy snoring.
2. Frequent waking up.
3. Excessive movements during sleep.
4. Feeling groggy in the morning.
5. Fatigue.
6. Decreased cognitive functions: attention, memory, perception.

50% of patients are diagnosed with concomitant diseases: hypertension, ischemia, asthma, tachycardia.

Which doctor should I contact?

A person cannot independently determine his apnea . Relatives can tell you about frequent stoppages of breathing.

At home, the Rovinsky method is used. During sleep, the relative should measure with a stopwatch how long the pause without breathing lasts and count the number of such periods per night.

Patients are recommended to undergo examination by a cardiologist, neurologist and ENT specialist.

To determine the cause, the following research methods are used:

1. Laryngoscopy and pharyngoscopy. Detect deviated septum, sinusitis, rhinitis, polyps, etc.
2. ECG . Helps confirm or exclude diseases of the cardiovascular system.
3. Electroencephalogram of the brain . Detects changes in the form of tumors, foci of excitation, consequences of injury and other pathologies.

Polysomnography helps to clearly reconstruct the picture of the disease.

It measures the electrical potential of the brain, air flow, the volume of oxygen passing through the lungs, and the degree of tension in the chest and abdominal wall.

What to do: how to treat obstructive and central night syndrome

Apnea therapy involves the use of medications and various sleep aids. In difficult cases, surgical intervention is resorted to.

The first step is to treat the underlying disease. This refers to the obstructive form.

For example, a patient is prescribed therapy for rhinitis, sinusitis, and bronchitis. When indicated, polyps, cysts are removed and a deviated nasal septum is corrected.

Surgery

Surgical intervention consists of the following operations:

• tonsillectomy - removal of tonsils;
• adenoidectomy - removal of the adenoids;
• Septoplasty - correction of the septum.

In most cases, after treatment of the underlying disease, breathing improves and symptoms disappear.

If the cause is an endocrine disorder or obesity, then hormone therapy is used in combination with diet.

Medications

Central apnea has a different mechanism than obstructive apnea. Therefore, it requires other treatment approaches.

The following types of drugs are used:

• Acetazolamide . Diuretic and antiepileptic drug. Removes excess fluid from the body, relieves swelling. Also reduces the activity of brain neurons;
• Zolpidem . Sleeping pill, reduces the time it takes to fall asleep, prevents night awakenings;
• Triazolam . Sedative, relaxes muscles, makes sleep longer and deeper.

The listed drugs have a central effect on the nervous system, therefore they are sold strictly according to prescription. Long-term use may be addictive. Therefore, doctors prescribe them very carefully.

Since breathing stops during snoring, anti-snoring medications can be used (Silence, Doctor Snoring). They are made with essential oils that help ease breathing.

Intraoral devices

For mild cases of the disease, you can use all kinds of devices to prevent the tongue from sticking in: a mouthpiece, a mouthguard, a retainer. They are sold in pharmacies.

These remedies help if breathing stops due to the specific structure of the jaw.

CPAP therapy at home

Treatment involves the use of a special CPAP machine that is placed on the head. It is made in the form of a mask, from which oxygen enters the respiratory tract, which maintains constant positive pressure.

A positive effect is achieved on the very first night: breath holding stops, sleep normalizes. This method is the most effective for treating severe forms of pathology.

There are also compact devices - EPAP. They are indicated for mild disorders. They are nasal valves that allow air in, but prevent it from coming out. This creates constant pressure in the airways.

How to get rid of it: gymnastics

Special exercises that are performed before bedtime help increase the tone of the soft palate:

1. Push your tongue forward and hold it tense for several seconds. Repeat 30 times.
2. Move the lower jaw back and forth, overcoming the resistance of the hand.
3. Press the pencil firmly between your teeth.
4. Pronounce vowel sounds loudly and clearly.
5. When inhaling, keep the muscles of the oropharynx contracted.
6. Loud singing.
7. Massage the soft palate with your fingers.

After a month of regular exercise, attacks of respiratory arrest will decrease, the patient will sleep more calmly and longer.

First aid: algorithm of actions

Sometimes apnea attacks last more than 10 seconds, which is very dangerous. If breathing is not restored for a long time, then urgent help is required.

It is necessary to call an ambulance in the following cases:

1. The patient's lips and nose turned blue.
2. The pulse dropped to 40 beats.
3. The limbs hang down involuntarily and lack tone.

These symptoms indicate the onset of asphyxia. You can help the patient by performing artificial respiration:

1. Turn onto your back.
2. Check to see if your tongue is stuck.
3. Cover the patient's mouth and nose with your lips and take two deep breaths into the mouth.
4. Continue until the chest begins to move.
5. When the chest begins to move, feel for the pulse.
6. If there is a pulse, continue artificial respiration.

• If there is no pulse, it is necessary to begin chest compressions.
• To do this, place two fingers on the middle of the chest in the place where the heart is located.
• Use your other hand to press firmly.

There should be an alternation : one press - pause - five presses. A patient with such an attack requires hospitalization.

Clinical recommendations for the patient

How to sleep with apnea? To prevent attacks of respiratory arrest, the patient should adjust his daily routine and sleep hygiene.

Often apnea is provoked by an uncomfortable bed, stuffiness and other living conditions.

Doctors give the following clinical recommendations:

1. Lose weight. According to studies, losing excess body weight leads to the disappearance of all symptoms.
2. Eat food 3 hours before bedtime. A full stomach also causes snoring and breathing problems.
3. Airing the room before going to bed.
4. Avoidance of sedatives and alcohol. They relax the muscles of the pharynx and provoke an attack.
5. Sleeping on your side. To do this, you can sew a tennis ball onto the back of your pajamas, which will prevent you from rolling over onto your back.
6. Choosing the right pillow. An orthopedic flat pillow of medium hardness is optimal. Products that are too soft or tall should be avoided.
7. Rinse your nose with salt water before going to bed. This constricts blood vessels, making breathing easier.
8. Instillation of sea buckthorn oil into the nose.

Hospital treatment is required if the patient has periods without breathing that last longer than 10 seconds and repeat several times an hour.

Also, reasons for hospitalization are disturbances in heart rhythm, blood pressure and general deterioration of the patient’s condition.

Prognosis: can it be cured?

Apnea syndrome is a dangerous pathology. Without treatment, the disease progresses, symptoms intensify, and attacks become more frequent.

In just 5 years a person can become disabled. The probability of death reaches 95% when the disease lasts for 15 years.

Using a CPAP device reduces the likelihood of death from suffocation by 50% and prolongs life.

However, the device does not stop the course of the disease or eliminate the causes. You can get rid of the problem by eliminating the root cause.

Prevention of the disease is timely treatment of ENT pathologies, maintaining a normal weight, quitting smoking and alcohol, and avoiding taking sleeping pills.

Sleep apnea syndrome significantly worsens the patient's quality of life and increases the risk of death during sleep.

Various methods are used for treatment depending on the cause and type of disease. In extreme cases, surgical intervention is resorted to.

You can learn about what apnea is and how to deal with it from the video:

Source: https://nerv.guru/zabolevaniya/rasstrojstva-sna/apnoe/terapiya.html

Snoring and obstructive sleep apnea

There is a completely unfair opinion that snoring is not a particularly pleasant phenomenon, but is completely safe for humans. In fact, severe snoring during sleep predicts the development of a disease called obstructive sleep apnea syndrome ( OSA ). Heavy snoring is one of its main symptoms.

Obstructive sleep apnea syndrome is a disease characterized by pauses in breathing during sleep. Close people who observe the person’s sleep can suspect the development of apnea in a person.

When observing such patients, it was noted that up to 400 such respiratory arrests can occur per night.

Mechanism of obstructive sleep apnea syndrome

The patency of the human upper respiratory tract is influenced by many factors. First of all, this is the tone of the pharyngeal muscles , the internal diameter of the tract , the amount of pressure during inspiration .

While a person sleeps, the tone of the muscles of the pharynx noticeably decreases. Consequently, complete collapse of the airway may occur, which occurs during inspiration, and subsequent cessation of breathing.

In order for respiratory function to be restored, the brain must be activated. It is the brain impulse that is sent to the pharyngeal muscles that opens the airways.

When the patient's breathing is restored, the oxygen level returns to normal, causing the brain to become calm again. After this, the person falls asleep. Such cycles are repeated throughout the sleep period.

Due to the manifestation of such stops in breathing during sleep, the human body begins to suffer from a severe decrease in oxygen content in the blood. Accordingly, the heart and brain, which require a lot of oxygen to be nourished, have a negative effect.

Brain hypoxia that occurs at night is manifested by a morning headache. And people who, in addition, suffer from coronary heart disease, may subsequently suffer a myocardial infarction .

In addition, when breathing stops, there is a jump in blood pressure for a short time: it rises to 200-250 mm Hg. Art.

Hypertension resulting from such disorders is less responsive to treatment with antihypertensive drugs familiar to hypertensive patients. In addition, the chronic lack of transition of sleep to deep stages, as well as nocturnal hypoxia, provoke a noticeable decrease in the release of growth hormone .

In adults, this hormone ensures fat metabolism. Growth hormone is responsible for ensuring that the fat consumed is converted into energy and not stored as fat reserves. But if growth hormone is not produced in the required quantities, then even if there is a lack of energy in the body, fat is not converted into energy.

Consequently, the patient consumes more and more food to replenish energy costs. And the excess immediately turns into excess weight . A patient who is gaining weight due to a lack of growth hormone cannot lose extra pounds with the help of diets or medications.

At the same time, rapid weight gain provokes a worsening of the situation with the manifestation of sudden stops in breathing during sleep. After all, excess fat is also deposited on the neck, thereby increasing the narrowing of the airways. Growth hormone is produced in even smaller quantities, and as a result, a kind of vicious circle arises.

If the disease progresses to a severe form, testosterone . This leads to a decrease in sexual desire and potency .

Causes of snoring

Thus, a common phenomenon - snoring - becomes the cause of serious negative changes in the functioning of the body. The causes of snoring are determined by several factors. First of all, people who have certain anatomical disorders that lead to narrowing of the airways can snore. This situation occurs due to congenital narrowness of the pharynx or nasal passages, curvature of the nasal septum, the presence of polyps in the nose or enlarged tonsils, a long tongue on the palate, and a malocclusion due to a displaced jaw. In addition, obesity .

The second group of factors that contribute to snoring during sleep are functional factors. These primarily include sleep itself, during which muscle tone decreases.

In addition, night snoring is provoked by severe fatigue and constant lack of sleep, the use of sleeping pills, drinking alcoholic beverages, and smoking.

Snoring often occurs in people with reduced thyroid function and in women during menopause . Older people are more susceptible to snoring.

Symptoms of obstructive sleep apnea syndrome

A person who has sleep-disordered breathing suffers because the overall quality of sleep noticeably deteriorates. Gradually, the patient begins to notice manifestations of frequent headaches and irritability. He is constantly in a state of drowsiness , suffers from memory impairment and distraction.

Men may gradually notice that potency has noticeably decreased. Basically, the sleep of people subject to respiratory arrest is always restless; they often turn around during sleep, can vigorously move their limbs, and speak. All of these symptoms, as well as other consequences of sleep apnea, occur as a result of chronic lack of sleep.

In addition to deteriorating the quality of life, such manifestations can pose a danger due to the increased risk of falling asleep while driving.

In this case, the position of his body can be any. If there is a milder form of the disease, then respiratory arrest occurs during deep sleep or when the person is lying on his back. Breathing is often impaired in people who drink alcohol before bed.

Diagnosis of snoring and obstructive sleep apnea syndrome

To determine whether a patient with snoring has sleep apnea, the doctor may order a special sleep study called polysomnography. Such a study is carried out by attaching a large number of different sensors to the human body, recording the functioning of the brain, ECG, respiratory movements and other parameters necessary for the study. All information is recorded during the night's sleep, and on its basis the specialist determines which anti-snoring remedy will be most effective.

• Diagnosis of apnea involves determining the presence of certain characteristic features of the patient and signs of the disease.
  Thus, a detailed examination of the patient’s condition is prescribed if he has three of the following signs: - indications of respiratory arrest during sleep (this sign is already a prerequisite for conducting an in-depth examination);
  - loud snoring at night or intermittent snoring with occasional snoring;
• - urinating too frequently at night;
• - overweight.

- prolonged sleep disturbance lasting more than six months;
- constant sleepiness during the day;
- arterial hypertension, attacks of which occur in the morning and at night;

Recommendations for patients with snoring and obstructive sleep apnea syndrome

Treatment of snoring at home requires strict adherence to certain recommendations designed to improve the quality of sleep and prevent unpleasant manifestations.

First of all, the correct sleeping position is important: it is best to sleep on your side, since lying on your back causes your tongue to sink, which contributes to breathing problems.

In order to prevent the patient from turning over on his back at night, you can sew a pocket on the back of the pajamas and put a small ball or other object there. It will help a person wake up when turning over on their back.

After some time, the corresponding reflex is developed, and the person no longer sleeps in a position on his back.

It is advisable for the head to be in a slightly elevated position while sleeping - this can prevent tongue retraction and reduce snoring. For this purpose, sometimes the bed is tilted by placing small bars under the legs of the bed from the side of the head, or a special medical bed is used.

It is not recommended for people who snore to take sleeping pills and sedatives . These drugs help reduce muscle tone, as a result of which the pharyngeal muscles relax. If the patient has developed a moderate or severe form of the disease, then medications with the indicated effects are strictly contraindicated.

You should not drink alcoholic beverages in the evening, as alcohol helps relax the muscles of the pharynx, aggravating the patient’s condition. People who smoke should consider quitting this harmful habit. After all, smoking provokes inflammatory processes in the pharynx and trachea, which are accompanied by swelling, which increases the risk of respiratory arrest during sleep.

If you have certain problems with nasal breathing, you should take all measures to make breathing through your nose as easy as possible. If a similar problem occurs due to colds, you should use nasal drops with a vasoconstrictor effect. If there are polyps or any other anatomical features in the nose, you should consider surgical treatment.

The doctors

Treatment of snoring and obstructive sleep apnea syndrome

Another effective cure for snoring is special nasal dilator strips. With their help, you can expand the wings of the nose, which significantly increases the passage of air.

Laser plastic surgery of the soft palate is also used to treat snoring and obstructive sleep apnea syndrome.

And with the help of so-called CPAP therapy, which consists of creating positive pressure in the respiratory tract, even severe forms of sleep apnea are cured.

To do this, use a special device - a sealed nasal mask, which is connected to a compressor. Air under pressure is supplied through a tube into the throat. Consequently, the airways do not close and air flows constantly.

Other devices are sometimes used to treat apnea, but their use is advisable in selected cases.

Treatment of snoring with folk remedies

As a cure for snoring, it is recommended to drink a glass of fresh cabbage juice with one teaspoon of honey added for one month. It is also recommended to regularly eat baked carrots three times a day before the main meal.

Another folk remedy for snoring is used for difficult nasal breathing. sea buckthorn oil a few hours before bed . Within a few weeks, breathing will become more free.

There are also special exercises to help get rid of snoring. One of them is to pronounce the sound “and”, tensing the muscles of the soft palate, pharynx, and neck. This should be repeated about 30 times in the morning and evening.

Another exercise that is advisable to repeat several times a day is done with your mouth closed. You should breathe through your nose. Initially, you need to tense the back wall of the tongue, and then pull the tongue towards the throat, applying force.

To determine whether these actions are being performed correctly, you need to place your fingers under your chin. If the muscles are tense, then everything is done according to the rules. This exercise, which strengthens the velum palatine, should be repeated about 15 times.

Complications of snoring and obstructive sleep apnea syndrome

People who suffer from regular sleep apnea often experience angina pectoris . Lack of oxygen can affect kidney health.

Also, patients suffering from this disease are much more likely to experience metabolic syndrome and manifestations of atherosclerosis . Impotence can also be a complication of severe apnea .

Such patients become irritable, may hardly feel alert throughout the day, and even show certain signs of unbalanced behavior.

Due to the constant lack of oxygen in the body, patients who experience sleep apnea are more likely to suffer from nighttime strokes and heart attacks . In severe cases of the disease, sudden death of a person during sleep is possible. Therefore, treating this disease is extremely important.

List of sources

• Blotsky A.A., Pluzhnikov M.S. The phenomenon of snoring and obstructive sleep apnea syndrome. - St. Petersburg: Special literature, 2002;
• Vein A.M., Poluektov M.G. Seriously about snoring. - M.: Eidos-Media, 2003;
• Zilber A.P. Sleep apnea syndromes. - Petrozavodsk, 1994;
• Vein A.M., Hecht K. Human sleep. Physiology and pathology. - M., 1991;
• Buzunov R.V., Legeyda I.V. Snoring and obstructive sleep apnea syndrome. Training manual for doctors. - M., 2011.

Source: https://medside.ru/hrap-i-sindrom-obstruktivnogo-apnoe-vo-sne

Where to go if you have sleep apnea

R.V. Buzunov

You're probably in one of two situations right now.

Situation 1 . You (or a loved one) may be suffering from sleep apnea. Snoring, nighttime respiratory arrest, daytime sleepiness, high blood pressure... Common sense, the Internet or a doctor hint that the diagnosis needs to be clarified and treated.

Situation 2 . You (or a loved one) have already been diagnosed with sleep apnea. Perhaps it was diagnosed some time ago, and now you are “ripe” for treatment and are looking for someone to trust with your health.

From this article you will learn which doctor you can contact for this problem, and which you should not go to under any circumstances.

Can medications help?

Snoring is either a harbinger or one of the symptoms of apnea. These two states have a common nature. Therefore, many patients believe that they can be treated the same way. Sprays, tablets, anti-snoring pacifiers, mouth guards or other means/devices available in pharmacies.

But sleep apnea is no longer ordinary (uncomplicated) snoring. When snoring, the walls of the pharynx lose their tone and vibrate when breathing during sleep, but the quality of breathing does not suffer.

They are contraindicated! While you are trying to be treated with their help, your health is deteriorating every day. Or rather, at night.

“I’ll go to a therapist and he’ll direct me where I need to go.”

This seemingly win-win technique will most likely not work.

Very often patients come to me and tell me the following stories: “I came to the therapist complaining of snoring. He told me that my wife saw me stop breathing in my sleep. He advised me to change my pillow. Did not help. I read it on the Internet myself, and that’s how I found you.”

I often lecture to doctors and like to ask the audience: “How many of you have made at least one diagnosis of obstructive sleep apnea in the last year?” Usually just a couple of people raise their hand.

I ask further: “Exactly how many diagnoses were made?” They proudly: “Three!” (For example).

Three? But, if you are a therapist, then one or two out of ten patients definitely have respiratory arrest! Why only three diagnoses in a year?

This is not to say that therapists are stupid. In no case. Sleep medicine is just not their area of ​​expertise. There is practically no mention of sleep apnea in the documents of the Ministry of Health, and they are definitely not in the standards of medical care. Sleep medicine is not taught in universities. In Russia, somnology is a very young, developing branch of medicine.

To a cardiologist?

There are more and more doctors among cardiologists who have an understanding of sleep apnea and its treatment. If your cardiologist has completed advanced training in sleep medicine, then you are in luck! But most, like therapists, have little knowledge about this disease. And some, unfortunately, even oppose somnologists.

Let's imagine a cardiologist who has been observing a patient for many years and treating him for arterial hypertension, coronary heart disease and arrhythmia. He does not know that the patient has sleep apnea.

One day the patient finds out that there are somnologists in the world, turns to such a doctor, receives a diagnosis and treatment.

The cardiologist sees this and realizes that he is not qualified enough. He missed the disease and did not treat the patient quite correctly. What will the doctor do? There are very few people who admit their mistake: and you can understand why.

Those who will deny the existence of sleep apnea and dissuade the patient from using CPAP are the vast majority.

After all, it is better to preserve your authority for the patient than to admit to a lack of qualifications... Even though you have to assert yourself at the expense of the patient.

Watch the video why cardiac arrhythmias develop when breathing stops during sleep.



To an otolaryngologist?

Some cases of uncomplicated snoring caused by excess soft palate tissue require surgical treatment. But this is about a tenth of all patients with snoring. The rest require other treatment.

Therefore, surgery cannot be considered as an absolutely effective remedy, and otolaryngologists cannot be considered as the only potential saviors from snoring.

When breathing stops, surgical intervention is generally contraindicated and causes harm instead of benefit.

Unfortunately, not all otolaryngologists are so competent. In Moscow, there are dozens of ENT centers where they operate on all snorers: without examination, on the day of treatment, without specifying the presence of apnea. As a result, the health of patients suffers. Snoring and breathing pauses get worse.

See a somnologist!

This is the only specialist who professionally treats sleep apnea.

• First, the doctor consults the patient, establishes a preliminary diagnosis, and finds out the possible causes of the disease.
• Next, the patient is examined. He undergoes a polysomnography (sleep study), which provides information about the severity of the apnea and other important details.
• Having assessed the causes and severity of apnea, the doctor prescribes individual treatment.

As a result, the patient stops snoring and suffocating in his sleep. Other symptoms of the disease disappear and health risks are reduced.

Check if you have sleep breathing disorders due to snoring. To do this, take the online test.

Do you have any signs of it? Contact a somnologist .

Somnologist R.V. Buzunov

If you are looking for the best expert in treating snoring and sleep apnea, schedule a consultation with R.V. Buzunov.

• 23 years in sleep medicine;
• Professor, Doctor of Medical Sciences, Honored Doctor of Russia;
• Director of the country's largest Sleep Medicine Center, which has successfully helped more than 11,000 patients with snoring and apnea;
• Author of a number of treatment programs that have already been completed by about 5,000 people.

Appointment with a somnologist in Moscow:

Source: https://buzunov.ru/lechenie-apnoe-v-moskve/kuda-obratitsya-pri-nochnom-apnoe/

Snoring and obstructive sleep apnea syndrome

Many of us face the problem of snoring, sometimes personally, sometimes with loved ones. This seemingly harmless pathology can cause a number of problems. First of all, social ones, when relationships with relatives deteriorate, because we do not allow them to get enough sleep, waking them up with snoring at night. Secondly, with health, when obstructive sleep apnea syndrome develops as a result of snoring.

Snoring is a vibration of the soft tissues of the nasopharynx and oropharynx under the influence of air flow during exhalation, which is accompanied by a characteristic sound. Apnea syndrome is a phenomenon when, due to snoring, the regulation of our breathing and heartbeat is disrupted.

This sound phenomenon occurs during one of the phases of sleep, since it is during sleep that complete relaxation of the muscles of the entire body occurs, including the muscles of the oro- and nasopharynx.

What are the causes of snoring?

A particularly important role in the development of snoring is played by the soft palate, which, being in a relaxed state, begins to vibrate like a curtain under the influence of powerful streams of exhaled air.

Pronounced vibration can also be created by: the tongue, or uvula, especially with a pronounced increase in its size; enlarged (hypertrophied) palatine tonsils (tonsils), which create an obstacle to the passage of air from the inside; the actual anatomical structure of the oropharynx, with its narrowness and small size; difficulty in nasal breathing, as a result of a deviated nasal septum, vasomotor or vasomotor-hypertrophic rhinitis, when there is no possibility of exhaling air through the nose; dystrophic changes in the muscle tissue of the soft palate, as a result of which it sags; as well as excess weight, which contributes to the accumulation of excess subcutaneous fat not only in the abdomen, hips, but also in the oropharynx, causing its narrowing, and in the soft palate, causing its lower location.

In addition, the cause of snoring can be not only the above-mentioned upper parts of the pharynx, nasopharynx and nose, but also the structural features of the tongue and lower jaw. For example, snoring is formed when the lingual tonsil, located in the area of ​​the tongue root, is enlarged, or when the mandibular joints are dysfunctional, when the lower jaw moves back, narrowing the lumen of the pharynx in the anteroposterior direction.

It would seem that loud snoring is just annoying sounds that keep those next to you from falling asleep and prevent him from being alert. But the patient himself, who suffers from snoring during sleep, also cannot get a full night’s sleep and experiences constant weakness and fatigue.

The fact is that with severe snoring, the periods of inhalation and exhalation change in the time interval. This creates a short inhalation and a long exhalation.

Because of this, the carbon dioxide accumulated in the body is not fully compensated for and eliminated, and the body begins to experience constant stress. First of all, it affects the brain - hypoxia occurs.

Therefore, attempts like using earplugs for snoring only mask the problem and do not get rid of it.

Sleep apnea is dangerous because it leads to irreversible changes in the brain - strokes, or complete cessation of breathing during sleep.

It is nighttime sleep apnea that requires treatment in the first place, as it poses a threat not only to comfort, but also to health.

Therefore, it is worth paying great attention to snoring and apnea, and looking at this problem, as well as the approach to treatment, from different angles. Since this problem is multifaceted and has many causes, it is worth paying attention to all the factors that lead to snoring.

What are the causes of snoring?

In order to choose the anti-snoring remedy that is optimal for you, you need to determine the causes of snoring, and what specific features of the structure of the respiratory tract cause it. Afterwards, you can choose the optimal treatment regimen for snoring. Sometimes it is enough to carry out special exercises for snoring, and sometimes personal intervention from a doctor is required, surgery for snoring.

Sometimes, removing the cause of snoring, which does not lie in the main trigger points (deviated nasal septum, vasomotor rhinitis), is enough for the complete disappearance of snoring and obstructive sleep apnea syndrome. To get rid of snoring if you have problems with the oropharynx, you may need laser snoring treatment or uvulopalatoplasty.

The most important end goal is to eliminate your sleep apnea episodes.

At the ABC Clinic, apnea and snoring are treated using radio wave surgical devices, and you can be sure that healthy sleep will return to you and your loved ones in the shortest possible time.

Primary source: ABC Clinic medical center

Source: https://lor.klinika-abc.ru/useful/khrap-i-sindrom-obstruktivnogo-apnoe-sna.html

Personal website of somnologist A.M. Katyshev | Complicated snoring

• Table of contents:
• Page 1 - uncomplicated (primary) snoring.
• Page 2 - what is complicated snoring, or sleep apnea disease.
• Page 3 - symptoms and complications of sleep apnea.
• Page 4 - diagnosis of sleep apnea.
• Page 5 - treatment of snoring and sleep apnea.
• Page 6 - treatment of sleep apnea using CPAP therapy.
• ​
• obstructive sleep apnea syndrome or sleep apnea disease
• ​

Obstructive sleep apnea syndrome (sleep apnea disease, sleep apnea, or OSA for short) is a disease characterized by snoring, periodic collapse of the upper airways at the level of the pharynx and cessation of pulmonary ventilation, decreased blood oxygen levels, severe sleep fragmentation and excessive daytime sleep. drowsiness (Christian Gilemino et al., 1978).

​

Despite the fact that sleep breathing disorders were first described in 1965, and in 1978 the “classical” definition of obstructive sleep apnea syndrome was given (in the future we will use the abbreviation OSA), unfortunately, not all Russian doctors know about it disease and what consequences it can lead to.

The main reason for the lack of awareness among doctors is the banal absence of this disease in the educational program of medical universities and postgraduate training of medical specialists (internship, residency, graduate school) or only a nominal presence (how can teachers teach what they themselves do not know?).

Therefore, in Russia, hundreds of thousands of people suffer from this dangerous disease and do not even know it!

What is the prevalence of OSA? OSA affects 5-7% of the total population over 30 years of age. Severe OSA affects about 1-2% of them. In people over 60 years of age, the incidence of OSA increases significantly and is about 30% in men and about 20% in women.

In people over 65 years of age, the incidence of OSA can reach 60%.

The prevalence of clinically significant sleep-disordered breathing in therapeutic patients reaches 15% - in practice, this means that every seventh person who goes to a hospital or clinic with any complaints (except for surgical problems) suffers from sleep apnea. Isn't that impressive? These figures were obtained based on foreign data, where they have been diagnosing and treating OSA for several decades. There is no data on morbidity in Russia and, it seems, there won’t be for a long time...

​

What are the severity levels of OSA? A generally accepted criterion for the severity of OSA is the frequency of apnea (complete cessation of pulmonary ventilation for 10 or more seconds) and hypopnea (a decrease in respiratory flow by 50% or more from the initial values, accompanied by a decrease in the oxygen content in the blood - saturation - by 3% or more) in hour - the so-called apnea/hypopnea index (AHI). It is considered inappropriate to separately count the number of apneas and hypopneas, because they carry similar risks for developing cardiovascular complications.

• Mild severity of OSA – AHI from ≥5 to

Source: https://www.sleep34.ru/hrap-2

Snoring and obstructive sleep apnea syndrome

• Branches and centers
• Treatment methods
• Diagnostic methods
• Diseases and symptoms

Snoring is a rhythmic vibration of the soft tissues of the pharynx in the flow of inhaled and exhaled air. Snoring occurs against the background of a decrease in the tone of the pharyngeal muscles during sleep and the transition of breathing to the night “automatic” mode. Over the age of 40, every third man and every sixth woman snores.

The most dangerous disease associated with snoring is obstructive sleep apnea syndrome (breathing stops during sleep).

Obstructive sleep apnea is characterized by periodic collapse of the soft palate and root of the tongue (against the background of snoring). This leads to cessation of breathing lasting from a few seconds to 3-4 minutes. The result is a drop in oxygen concentration in the blood by 10-20% - desaturation.

Desaturation (low blood oxygen levels) is perceived by the body as a threat to life. In response, the stress hormones adrenaline and cortisol are released. They “wake up” the brain. The brain, waking up, tones the muscles of the pharynx. The “plug” in the upper parts of the pharynx “opens” and breathing is restored.

This moment is accompanied by intense “snorling”. But after a few minutes the brain falls asleep, and breathing stops again. This is repeated up to 20-30 times per hour. If you add up all the apneas per night, the total time can be up to 3-4 hours. All this time, every night the patient does not breathe (or breathes incorrectly).

The oxygen level in the blood periodically drops from 95 to 60-70%.

Repeated awakenings of the brain (the patient himself does not know about it) destroy the structure of sleep. Low blood oxygen levels lead to constant nighttime hypoxia of the brain and heart. As a result, a person sleeps 8-9 hours, but wakes up with a “heavy” head and high blood pressure.

Symptoms of obstructive sleep apnea:

• Constant night snoring, complaints from relatives about respiratory arrest due to snoring;
• Morning fatigue, “heavy head”, “red eyes”;
• Increased sleepiness during the day;
• Persistent increase in blood pressure at night and in the morning, despite taking antihypertensive drugs at night;
• Frequent urination at night;
• Excessive night sweats, especially of the head - “damp night pillow”;
• Belching sour at night.

Who suffers from obstructive sleep apnea (OSA)?

• It occurs 5-8 times more often in men than in women.
• Excess body weight is a major risk factor for the development of OSA. With a body mass index greater than 30, the probability of OSA is more than 80%.
• An increase in neck circumference of more than 43 cm in men and more than 37 cm in women.
• Features of the facial skeleton: small, posteriorly displaced lower jaw. Even with low body weight, OSA can develop.
• Chronic tonsillitis with enlarged tonsils.

Why is obstructive sleep apnea syndrome dangerous?

According to international studies, OSA is one of the most significant risk factors for the development of heart attack, stroke and death from cardiovascular causes. With OSA, the risk of cardiovascular death is 6-8 times greater than in a person who does not suffer from this disease.

The high risk of cardiovascular mortality in OSA is due to:

• Rapid progress of atherosclerosis, the outcome of which is heart attack and stroke;
• Nocturnal cardiac arrhythmias in every second patient with OSAS;
• Nocturnal myocardial ischemia and a high probability of myocardial infarction at night;
• Development of nocturnal arterial hypertension, resistant to the action of drugs that lower blood pressure.

One of the main clinical manifestations of OSA is excessive daytime sleepiness. People fall asleep all the time after meals, in front of the TV, and during meetings and work events. Their managers usually perceive this “behavior” as laziness and lack of interest in work. As a result, OSA leads to social maladjustment and can cause job loss.

The most dramatic consequence of excessive daytime sleepiness is falling asleep while driving. This often happens in the morning, when a driver in a state of cerebral hypoxia (after several hundred breathing stops per night) gets behind the wheel. Falling asleep at the wheel often leads to fatal accidents and serious injuries.

Diagnosis of snoring and obstructive sleep apnea syndrome in Samara

If your loved ones are worried about your “heroic” snoring with pauses in breathing during sleep, this is an important reason to immediately contact a somnologist.

In Samara, the Center for Diagnostics and Correction of Sleep Disorders operates on the basis of the First Neurology Children's Center.

The consultation is conducted by a doctor of the highest category, somnologist, neurologist Leonid Sergeevich Derevyanko, address: st. Buyanova, 12, tel. (846) 333-03-50.

The Sleep Disorders Center examines the patient, fills out sleep quality and daytime sleepiness scales, as well as the hospital Anxiety-Depression scale.

When the diagnosis of sleep apnea is in doubt, the somnologist performs overnight computer pulse oximetry. A pulse oximeter records blood oxygen concentration and heart rate throughout the night. Low oxygen levels and unstable pulse are indications for an overnight polysomnographic study (PSG).

In the case of an obvious clinical picture of sleep apnea, the patient is prescribed an overnight polysomnographic study.

PSG over 8 hours of sleep at night records the intensity of snoring, the number of apneas and desaturations, and the average blood oxygen content throughout the night.

Only after performing PSG can a somnologist make a diagnosis of OSA and accurately determine the severity of the disease.

Considering the rapid progress of atherosclerosis and constant hypoxia of the brain, all patients with OSA undergo color duplex mapping of the brachiocephalic vessels - CDB BCS (ultrasound of the great vessels of the neck) and examination of small vessels of the fundus by an ophthalmologist. Patients with chronic tonsillitis, deviated nasal septum and impaired nasal breathing are examined by an ENT doctor.

Treatment of snoring and sleep apnea syndrome in Samara

Treatment tactics for snoring and OSA depend on the severity of the disease.

For mild apnea syndrome, the following are used:

• Correction of body weight.
• Positional treatment.
• Correction of nasal breathing.
• Gymnastics for the muscles of the oropharynx.
• For uncomplicated snoring, surgical intervention on the soft tissues of the palate and pharynx (uvulopalatopharyngoplasty) is possible. In the presence of sleep apnea syndrome, surgical treatment is not effective and only temporarily reduces snoring without affecting the frequency of breathing pauses.

For moderate to severe obstructive sleep apnea syndrome, the only effective treatment method is CPAP therapy. CPAP therapy is the standard treatment for sleep apnea worldwide.

At the First Neurology clinic in the Somnology Center, a somnologist selects a mask and pressure using the auto CPAP ResMed S9 device. Pressure parameters are individual for each person.

Next, patients receiving CPAP therapy are observed at the Sleep Correction Center.

In addition to CPAP therapy, the First Neurology Children's Center provides treatment for chronic cerebral hypoxia and excessive daytime sleepiness:

The risk of developing a stroke or heart attack in the pre-dawn hours (3-6 am) against the background of sleep apnea syndrome is quite high. And hypoxia of the brain and heart and excessive daytime sleepiness do not allow a person to live and work normally.

Correction of sleep-disordered breathing leads to a reduction in cardiovascular risk and an increase in life expectancy and quality of life.

Our specialists

• Ask a question Doctor - neurologist of the highest category, vertebrologist, somnologist, epileptologist, botulinum therapist. Head of the center for diagnosis and treatment of sleep disorders. Experience: 22 years.

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