Why does a person snore and how to treat sleep disordered breathing?

Symptoms to suspect OSA:

• Frequent awakenings.
• Frequent urination at night (more than 2 times a night).
• Increases in blood pressure at night and in the morning.
• Decreased libido.
• Depression, apathy, irritability.

A patient with nighttime snoring must undergo a diagnostic procedure - polysomnography.

With it, a person spends the night in a laboratory, where during sleep the main vital parameters are recorded - pulse rate, blood pressure, oxygen content in the blood (saturation).

Episodes of apnea are accompanied by a sharp drop in saturation, which is recorded on a special graph, then the severity of the disease is assessed depending on the number of attacks of respiratory arrest per hour:

• Light form - 5–15.
• Moderate - 15–30.
• Severe - more than 30.

Night snoring with pauses in breathing is fraught with the following:

1. The cessation of oxygen supply to the body is regarded by the brain as a direct threat to human life, as a result of which the stress hormone adrenaline is activated. Because of this, there is a jump in blood pressure, an increase in heart rate and stimulation of the respiratory center. Restoring respiratory movements throughout the night is carried out through stress on the heart and blood vessels, which poses a dangerous risk of developing myocardial infarction and stroke.
2. Disruption of the deep phase of sleep affects the production of testosterone and growth hormone, which is why the fat accumulated throughout the day is not able to be converted into energy and is deposited in the body as excess. A person rapidly gains weight without getting any effect from any diet or exercise, and an increase in fat deposits in the neck further aggravates the initial situation.
3. Ultimately, metabolic disorders lead to the progression of diseases such as atherosclerosis, hypertension, coronary heart disease, and heart rhythm disturbances. The risk of dying from cardiovascular complications in patients increases by 2 times.
4. Daytime sleepiness can be so high that it is uncontrollable - a person is able to fall asleep anywhere, creating a threat to himself and others (for example, at work, while driving a car, etc.).

First, you can try to determine the usefulness of nasal breathing, say, breathe alternately with one or the other nostril, while closing the opposite one. If you have difficulty breathing through your nose fully, this may be the cause of rhonopathy.
• In this case, the patient may require treatment from an otolaryngologist, both medicinal and surgical (in some cases).
• You can try to open your mouth slightly, simulating snoring. After this, move your tongue forward a little, placing it exactly between your teeth, again simulating night sounds.
• If in the second case the imitation of snoring was weaker, it is quite possible that the problem lies in the retraction of the tongue towards the nasopharynx.

You should also realistically assess your weight if you understand that you are overweight - this may be the cause of rochnopathy, which means that it is advisable to start treatment with weight loss.

It is important to ask people close to you to pay attention to whether even minimal breath holding occurs during snoring.

If so, then the problem may be the development of apnea syndrome, and it is advisable to begin treatment of the disease as early as possible, and by turning not to traditional medicine, but to practicing qualified doctors.

1. And lastly, even if snoring does not bother you too much, if snoring is not complicated by any diseases, but if you could not cope with it with home remedies within a month, it would be better, without prolonging the problem, to immediately contact experienced specialists .
2. Moreover, experienced doctors, noticing the absence of serious pathologies that led to rhonopathy, often themselves recommend alternative treatment to patients (for example, in the form of using an Anti-Snoring clip) or alternative treatment.
3. Watch our video collection:
5. Do you still think that it is impossible to get rid of snoring?

These may be the causes of snoring:

• increase in body weight (body mass index 30 kg/m2 or more);
• alcohol abuse;
• taking sleeping pills;
• smoking;
• allergic and vasomotor rhinitis;
• nasal polyps;
• enlarged pharyngeal tonsil (adenoids) or enlarged palatine tonsils (tonsillitis);
• narrowness of the nasal passages (congenital feature);
• deviated nasal septum;
• small or backward sloping jaw;
• hypothyroidism, myxedema;
• aging of the body.

We have listed only a few reasons, but it must be said that this list is not exhaustive.

Clinical example. A 29-year-old man consulted a somnologist at the Sleep Medicine Center.

He claims that he has been snoring almost since childhood, but only now has he decided to deal with this problem, since his snoring is causing growing discontent among his relatives. From the very first seconds of communication, it became obvious why this person snores.

From the outside it was noticeable that he had a small sloping lower jaw - a feature of the structure of the skull. No other possible causes of snoring were found during the examination.

We recommended that this patient use a special intraoral device that advances the lower jaw forward. The man began to use it, and the snoring disappeared. The patient quickly got used to the new “device” and now uses it every night.

When breathing, air passes through the pharynx into the larynx, and then through the trachea and bronchi into the lungs. The pharynx is a canal that connects the nasal and oral cavity with the larynx and esophagus.

Thanks to this control “from above”, the airways remain well-passed for air flow throughout the day.

So why does a person snore when falling asleep? During sleep, all muscles relax. If the lumen of the upper respiratory tract was initially narrowed (for example, by fatty deposits around the pharynx, excess tissue of the soft palate, enlarged tonsils, etc.)

), then their walls in a dream can come closer and touch each other. When you inhale and exhale, air with force passes through the pharyngeal canal, which is narrowed and partially blocked by soft tissue. The walls of the throat begin to vibrate and hit each other, causing snoring.

This explains why a person snores at night.

If the walls of the pharynx close completely, during breathing movements the air cannot overcome this obstacle and enter the lungs. Breathing stops during sleep - episodes of apnea.

When they last longer than 10 seconds (usually this period is 20-60 seconds, sometimes even up to 2-3 minutes), a complication of “normal” snoring is diagnosed: obstructive sleep apnea syndrome. This condition is a direct threat to human life and health. Every night the brain, heart and other organs experience oxygen starvation.

Against this background, the risk of heart attack and stroke, and sudden death in sleep increases sharply. It is obstructive sleep apnea syndrome that explains high blood pressure at night and in the first 30 minutes after waking up.

Due to the fact that the brain reacts to oxygen deprivation by awakenings (which a person usually does not remember the next morning), the deep sleep phase disappears or is sharply reduced

Result: the patient experiences a loss of strength and depressed mood during the day, his intellectual capabilities decrease, memory and attention deteriorate, the production of important hormones is disrupted, potency deteriorates, the risk of heart attack, stroke increases, etc.

Most of us have long been accustomed to certain noise effects that occur at night, but at the same time, there are practically no people who will like these sounds.

Rochnopathy, or in common parlance, snoring, is definitely a certain sleep disorder associated with certain disorders of the respiratory function, but why does this happen?

The mentioned sound phenomenon in a dream is able to form due to some narrowing and collapse of the walls of the respiratory tract, which during the respiratory act leads to vibrations and collisions of the soft muscle tissues of the pharynx.

Snoring, which appeared for the first time or has existed for a long time, can be either uncomplicated (by other health disorders) or complicated. The most common complication of snoring is considered to be the development of apnea syndrome in the patient.

This condition is characterized by the formation of sudden short-term stops in breathing during sleep, as a result of which the patient may experience hypoxia, cerebrovascular accidents, cardiovascular endocrine or other problems.

All of these conditions undoubtedly require that the patient be provided with timely, qualified, comprehensive treatment. Moreover, such treatment can take into account all the patient’s concomitant diseases, all possible causative factors that led to snoring occurring during sleep.

In the treatment process, the elimination of apnea deserves the most attention, since the problem of breathing disorders often remains, despite apparently restful sleep. To get rid of snoring, measures must first be taken to correct the patient’s lifestyle and habits:

Weight loss - losing even a tenth of your original weight significantly improves breathing during sleep. Smoking cessation - Cigarette smoke has a serious chronic thermal and chemical effect on the tissue of the pharynx, contributing to its swelling and a decrease in local muscle tone.

Avoiding alcohol and sleeping pills increases relaxation and collapse of the pharyngeal muscles, which significantly slows down the brain's response to low blood oxygen levels, making the risk of death significantly greater. Mild forms of snoring and OSA can be combated by weaning the patient from sleeping on his back.

A pocket is sewn to night pajamas or a T-shirt at the level of the interscapular space, into which a tennis ball is placed. Because of this, all attempts to lie on your back while sleeping will be unsuccessful; after 3–4 weeks, you will develop the reflex to sleep on your side. There is also a method of raising the head end of the bed by 10 cm, which reduces the retraction of the tongue even in a supine position.

Polymer intraoral applicators are attached to the lower jaw and move it forward, thereby increasing the lumen of the pharynx. Surgical treatment is aimed at removing excess tissue in the pharynx and soft palate. There are laser, radio wave, and cryosurgical correction methods.

CPAP therapy is a method of treating severe forms of OSA by creating continuous positive inspiratory pressure during sleep. A ventilator-like device is a compressor that delivers a stream of air through a flexible tube to the patient's face mask, preventing the airway from collapsing.

The air flow modes are adjusted individually, synchronizing with the rhythm of a person’s breathing. There are no significant contraindications to this procedure. The main inconvenience is caused by wearing a face mask, but the health benefits against the backdrop of normalization of the condition far outweigh this disadvantage.

Currently, pathological night sleep is widespread, affecting the quality and life expectancy of the population.

If there are people in the family who suffer from snoring, you should pay attention to the frequency of apnea attacks and get medical advice on how to eliminate them.

Statistics prove that almost twenty-five percent of women over thirty years of age suffer from snoring, but not all representatives of the fair sex are able to admit this, considering snoring shameful or indecent.

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However, in women there is at least one strictly specific reason why this problem may arise.

• We are talking about the possibility of provoking snoring by certain hormonal changes in a woman’s body.
• A woman's snoring can be caused by the fact that during menopause, the level of hormones (estrogen) in the female body drops sharply, which actually causes weakness of the pharyngeal muscles, and as a result, rhonopathy.
• Sometimes snoring (women and men) can be caused by certain other diseases, which we will talk about later.

It is known from medical sources that snoring occurs due to a malfunction of the pharyngeal structure during sleep.

Everything is connected with the result of collapse of the walls and obstruction of the respiratory tube, as well as a lack of hormones in the thyroid gland. This also includes the beating of the tongue against the walls of the nasopharynx.

Snoring mainly occurs in people who sleep on their backs and subsides when the person turns on their side.

Narrowing of the airways

It is worth noting that snoring sounds may occur due to narrowing of the airways. The reasons may be:

• Deviation of the nasal septum;
• Polyps;
• Malignant formations of the respiratory tract;
• Swelling of the nasal mucosa.

Obesity

Snoring can also be caused by obesity, which narrows the breathing tube; the appearance of palatine tonsils; swelling of the mucous membrane; congenital narrowness of the respiratory tube.

Decreased muscle tone

Decreased muscle tone helps relax the muscles in the pharynx by:

• Taking strong sleeping pills;
• Overwork;
• Drinking alcoholic beverages that relax muscles;
• Smoking, which can cause frequent coughs at night;
• Hormonal changes in the body (usually caused by pregnancy in a woman);
• Decreased production of thyroid hormones;
• Neuromuscular transmission disorders.

As already mentioned, excess weight contributes to the causes of snoring. Here we are not talking about an extra three kilograms of excess weight, but about obesity with excess body weight by 25-30 kilograms. Almost half of these people suffer from snoring at night, which can be caused by heart rhythm disturbances or a disease that affects hypertensive patients.

This is all due to the fact that fatty deposits accumulate between the tissues of the pharynx or in the area of ​​the side walls when the patency of the breathing tube narrows. And when the palatine tonsils and swelling of the mucous membrane are added, snoring intensifies and becomes frequent. There are also other pathogenic factors associated with respiratory pathology and alcohol and smoking abuse.

Women who snore wonder: “Why did I start snoring? After all, I’m not a man!” However, women snore for the same reasons as men. The only differences exist in what specific causes of snoring come first among representatives of one sex or another.

In women, snoring often occurs during periods of serious hormonal changes: during pregnancy and menopause. In the first case, vasomotor rhinitis occurs, provoked by changes in hormonal status. In addition, pregnant women experience rapid weight gain. All this leads to snoring, which often prevents your bed partner from sleeping.

During menopause, the production of sex hormones that help maintain muscle tone fades, and the turgor of the skin and mucous membranes decreases. The muscles of the pharynx weaken, the soft tissues sag - so it turns out that the woman snores in her sleep.

There are other causes of female snoring. Women are more likely to use sleeping pills to combat insomnia and are more likely to take sedatives. When using them, a person snores heavily.

This is explained simply: sleep medications additionally relax the muscles of the pharynx.

Sleeping pills also raise the brain's threshold for responding to a lack of oxygen, leading to longer pauses in breathing in sleep apnea patients and more severe snoring when breathing resumes.

Source: https://DobryjSon.ru/newest/pocemu-hrapit-celovek-vo-sne-leza.html

Causes of snoring and sleep apnea

Breathing during sleep is often accompanied by loud rattling sounds - snoring. The rolling roar prevents relatives from falling asleep, which leads to chronic lack of sleep and even family quarrels.

The “snoreer” himself is not happy either: for some reason, constant fatigue and drowsiness increases, and the general state of health worsens.

Once relatives begin to notice pauses in breathing, followed by loud snoring, it becomes completely uneasy.

About the disease

The noise that others hear when snoring is made by the soft tissues of the pharynx. Air passing through the narrowed upper airways causes the palate and uvula to vibrate. This is how one of the most hated sounds arises.

The most acute phase of snoring is inhalation. At this moment, negative pressure is created, which obstructs the airway and creates ideal conditions for their collapse.

It is at this moment that air retention may occur due to blockage of the pharyngeal tissue. When the body realizes that the supply of oxygen has been delayed, the central nervous system will send an impulse to the pharyngeal muscles. After which they will straighten out and the expected exhalation will occur. The snoring intensifies.

Stopping breathing lasts from a few seconds to 3 minutes. When the attack occurs multiple times, they talk about sleep apnea syndrome. This is a dangerous condition that threatens not only human health, but also his life. Every year, sleep breathing pathology causes about 40 million deaths.

Causes

Snoring, alternating with short-term cessation of breathing, occurs due to partial or complete obstruction of the upper respiratory tract. This condition, in turn, depends on many circumstances:

FactorDescriptionCause of occurrenceExample

Condition of ENT organs	As a result of diseases of the nasopharynx, the respiratory passages narrow, preventing air from entering the body	Infections, allergic reactions, injuries	Rhinitis, sinusitis, sinus cyst, inflammation of the tonsils
Features of the individual structure of the nasopharynx	Anatomically incorrect structure of the upper or lower jaw, nasopharyngeal tissues close the airways	Congenital anomalies, injuries	Deviated nasal septum, long uvula
Decreased muscle tone	At rest, the muscles are excessively relaxed, causing the tissues of the pharynx to sag and interfere with breathing.	Alcohol or psychotropic drug use, endocrine disorders, obesity, age-related changes	Hyperthyroidism, diabetes mellitus, age after 60 years

  Why snoring is dangerous due to apnea and how to cure it

Symptoms

In rare cases, snoring and breathing pauses during sleep can be caused by brain tumors. In this case, the conduction of nerve impulses to the muscles is disrupted and their contraction does not occur at the right moment.

People almost always know about their own night snoring. But sleep apnea can go unnoticed for a long time. How to find out whether snoring is accompanied by cessation of breathing or not? It is worth paying attention to the slightest signs of discomfort:

• fatigue;
• daytime sleepiness;
• attacks of suffocation;
• sleep disorders (sleepwalking, teeth grinding, restless legs syndrome);
• irritability;
• sudden cardiovascular disorders.

If severe snoring during sleep is accompanied by at least one of the listed symptoms, you should consult a doctor for advice.

Diagnostics

The diagnosis of “sleep apnea syndrome” can be made after a visual examination of the ENT organs. Additional examination allows us to identify the causes of snoring and determine the degree of disturbance. The patient may be recommended:

• take laboratory tests;
• undergo a somnological examination of the state of the body during sleep;
• seek advice from specialists.

Monitoring physiological parameters and breathing during sleep is one of the best methods for diagnosing snoring and apnea.

Electrodes and other sensitive sensors are connected to the patient’s body, which record the movements of the respiratory muscles, EEG, ECG, EOG, heart rate, oxygen saturation, snoring and its intensity.

The data is continuously recorded for 8 hours, after which the somnologist evaluates the result.

Sleep apnea and snoring are diagnosed using polysomnography, cardiorespiratory monitoring or pulsometry.

Treatment

Snoring and sleep apnea require careful monitoring and timely treatment. At the same time, specialists try to direct maximum efforts to eliminate the cause of breathing problems. If it is impossible to eliminate them, they focus on symptomatic treatment.

For moderate and severe forms of sleep apnea, a CPAP machine is selected after a sleep examination.

This is a small device consisting of a compressor and a mask, which are connected to each other using a flexible and movable tube.

Thanks to CPAP therapy, many patients are able to sleep peacefully without fear for their lives.

  Why does a child snore

Mild sleep apnea and minor snoring must be controlled to prevent progression of the disease.

In this case, you can eliminate the symptoms of airway obstruction in any convenient way:

In some cases (usually with ENT diseases and abnormalities in the structure of the nasopharynx), surgical intervention is recommended.

Snoring during sleep is a serious symptom, which, coupled with other warning signs, should prompt you to seek qualified help. Timely treatment gives good results, effectively and permanently relieving breathing problems during night rest.

Source: https://hrapless.ru/priznaki-i-simptomy/prichiny-hrapa-i-ostanovki-dyxaniya-vo-sne.html

What diseases cause sleep apnea?

Sleep apnea is a common problem that many people face. Full breathing is the basis of human life, and lack of air during sleep causes many problems. It develops suddenly and is characterized by discomfort in the chest area; the person begins to experience panic, a feeling that someone is choking him.

Choking during sleep develops due to a decrease in oxygen concentration in the blood and an increase in carbon dioxide levels. This condition is accompanied by disturbances in the autonomic function of the body, which causes unpleasant symptoms to develop, and subsequently serious health problems are possible.

Causes of sleep apnea

The causes of suffocation during sleep are not always associated with any diseases - rare attacks sometimes occur in the absence of any pathologies after drinking alcohol, psycho-emotional stress, taking certain medications, or in the presence of allergens in the room where a person sleeps. If stopping breathing during sleep occurs constantly, you should pay attention to your own health. The most common factors that cause this pathology include disruptions in the functioning of the body from various systems and organs.

1. Dysfunctions of the cardiovascular system (angina pectoris, arrhythmia, vascular crises, acute heart failure). These pathologies are characterized by a violation of the heart’s ability to pump blood normally, which disrupts oxygen metabolism.
2. Bronchial asthma. With this pathology, patients often experience shortness of breath, which can develop into nocturnal attacks of respiratory arrest.
3. Thyroid diseases. With some endocrine pathologies, there is an enlargement of the thyroid gland, which puts pressure on the trachea - for this reason, during sleep, you lose your breath and feel suffocated.
4. Sleep apnea. Sleep apnea syndrome is observed due to decreased muscle tone due to excess weight, abuse of sedatives, and enlarged tonsils. During the daytime, this condition is accompanied by drowsiness, a feeling of weakness, headaches in the morning, and surges in blood pressure.
5. Panic attacks. Unstable functioning of the nervous system causes panic attacks and symptoms similar to cardiovascular diseases (increased or slow heart rate, chills, severe fear of death).
6. Sleep paralysis. This is a condition that causes temporary immobilization. The brain does not send a signal to the rest of the body at the moment of awakening, which is why the person remains conscious, but cannot move or speak, sometimes sees hallucinations and feels intense fear.

If the above pathologies are excluded, the answer to the question of why you suffocate in your sleep should be sought in other factors. A list of secondary causes that can cause sleep apnea includes:

• infectious and inflammatory processes accompanied by swelling of the tonsils, enlarged adenoids, severe runny nose;
• anatomical pathologies of the head, neck, face;
• dysfunction of the digestive system, autoimmune disorders;
• excess weight;
• smoking, including passive smoking.

The first harbinger and another common cause of sleep apnea is constant snoring, which causes changes in the activity of the respiratory system, which is why suffocation develops. Accordingly, people who frequently snore are at risk for developing sleep apnea.

Pregnant women may also suffer from attacks of nocturnal suffocation - this occurs especially often in the last months, when the fetus begins to put pressure on the diaphragm.

This condition does not pose a serious threat to the health of the mother or child, but in order to eliminate discomfort and reduce the risk of oxygen starvation, a woman is recommended to sleep on a bed with the head of the bed raised, or put pillows under her back.

How does it manifest?

The main manifestation is a feeling of suffocation and the inability to take a deep breath, and sometimes breathing stops when falling asleep, and in some cases it stops directly during the night's rest.

Those who have had to deal with this condition describe it as follows: “I wake up from not breathing, or suffocate when I fall asleep, I am afraid of not waking up again, but at the same time I cannot move and ask for help.”

This condition develops in several stages:

• at the first stage, the activity of the respiratory organs is activated, the frequency and depth of breaths increase along with blood pressure and pulse;
• the next phase is characterized by the opposite process - vital signs decrease, fingers and the nasolabial triangle acquire a bluish tint;
• during the third stage, the activity of the respiratory organs is disrupted, breath holding occurs, which lasts from a couple of seconds to 2-3 minutes, reflexes fade, blood pressure drops, convulsions or uncontrolled muscle twitching may develop;
• During the last phase, serious disturbances in the respiratory rhythm occur - breathing becomes short and deep, inhalations become difficult and convulsive, and exhalations become rare.

Some people are unaware that they stop breathing during sleep or when falling asleep. To identify violations, it is necessary to observe the state of the sleeping person - he begins to snore, after which apnea occurs.

Snoring and breathing noise subside, the chest and stomach move, and after 15-30 seconds breathing is restored, the sleeper snores loudly, and normal breathing is restored.

Sleep at this time, as a rule, is very restless - a person rushes about, moves his limbs and tries to say something.

What is the danger of stopping breathing during sleep?

Having discovered apnea, a person first of all thinks: “If I am out of breath when I fall asleep, what consequences can this entail?”

In addition to the serious discomfort that this condition causes, it causes chronic fatigue, decreased performance, disturbances in the functioning of the immune system and metabolic processes, and depression.

In addition, people who suffer from sleep apnea have an increased risk of developing hypertension, strokes and heart attacks - pathologies that can be fatal.

Diagnostics

The diagnosis of the development of such symptoms is made on the basis of symptoms and anamnesis - identifying diseases that can provoke respiratory arrest. To accurately diagnose pathology, the following methods and procedures are used:

• clinical blood and urine tests to identify inflammatory and infectious processes in the body;
• examination of the respiratory system for tissue changes, areas of compaction, neoplasms and other pathologies (radiography, computed tomography and magnetic resonance imaging, bronchoscopy, thoracoscopy);
• electrocardiogram to assess the activity of the cardiovascular system;
• polysomnography, or long-term recording of brain impulses, respiratory activity and other vital signs of the body during sleep.

The above diagnostic methods make it possible to determine the number and duration of episodes of respiratory arrest, identify changes in body functions during this time, and establish the cause of the pathology.

First aid for choking

The patient should be helped to sit down (in this position the muscles that are responsible for breathing work better), calm him down, and then provide an influx of fresh air - unbutton the clothes on the chest, open a window or vent. If a person continues to sleep during respiratory distress, he should be carefully awakened, sat up, and forced to breathe deeply through his nose.

In cases where the cause of apnea is bronchial asthma, you can put mustard plasters on your chest, a warm compress on your feet, and take a drug orally to dilate the bronchi (for example, Eufilin).

In case of respiratory dysfunction due to laryngeal edema of allergic origin, the patient should be given any antihistamine in the form of tablets or injections, and in case of cardiovascular diseases - Validol, Valocordin or Nitroglycerin.

It is better not to give the patient anything to drink, since the person’s throat is tense after an attack of apnea, and the liquid can provoke a relapse of the pathology and another attack.

Treatment of sleep apnea - CPAP therapy

Treatment for holding your breath during sleep

To completely get rid of attacks of suffocation, you should answer the question of why breathing stops during sleep - consult a somnologist and undergo a comprehensive diagnosis. Treatment of sleep apnea primarily involves eliminating the root cause of the pathology.

If respiratory function is impaired due to drinking alcohol, smoking or using sleeping pills, it is necessary to give up these habits, and soon the patient’s condition will return to normal.

For infectious and inflammatory diseases, therapy with decongestants, antihistamines and vasoconstrictors is necessary, and for obesity, you should normalize your diet, start playing sports and lose excess weight.

A good effect when breathing stops at night is provided by therapeutic methods that are aimed at artificial ventilation of the lungs (SINAP, VIPAP therapy, etc.), as well as special mouthguards that prevent the tongue from retracting and the muscles of the larynx from relaxing. In case of violations of the anatomical structure of the palate or nasopharynx, surgical intervention is indicated for patients.

Sleep apnea is not a harmless pathology that causes discomfort and interferes with sleep, but a serious disease that requires timely diagnosis and treatment. To find out how to treat sleep apnea, you should consult a specialist immediately after the first symptoms appear.

Source: https://vosne.info/ostanovka-dyhaniya-vo-sne/

Snoring and sleep disordered breathing

“If your wife moves to another room at night, then you snore moderately. However, if your neighbors unexpectedly leave you, this is a serious matter..."

This joke, common among specialists in ENT diseases and sleep disorders, turns out to be not so funny at all. Because the “noise accompaniment” of night snoring is nothing more than the tip of the iceberg. Under the “water” lies a number of dangerous pathological processes, in comparison with which the neighbor’s disturbed sleep seems like a mere trifle.

And the scale of the spread of this unpleasant phenomenon makes talking about it very, very relevant. Statistics show that over the age of 35, every fifth man and every tenth woman regularly snores in their sleep. The likelihood of “acquired snoring” increases with age: after 60 years, four out of six men and every second woman snore.

How does the sound of snoring occur?

overweight are especially prone to snoring . An obese physique forces them to sleep on their backs, and excess fatty tissue in the larynx increases vibration. An effective way to treat snoring is to lose weight.

Some diseases of the upper respiratory tract can also cause snoring: runny nose, allergies, sinusitis, grade II-III adenoids - they all impair breathing.

In children, the same effect can cause extensive tonsillitis. The occurrence of snoring is also facilitated by everything that is associated with a decrease in the tone of the muscles of the soft palate.

These are disorders of neuromuscular activity, for example, intermittent hypotension, and ... alcohol, smoking.

More recently, another very serious circumstance was discovered: sometimes snoring is a symptom of a disease known as sleep apnea, sleep apnea (apnea in ancient Greek - “without breathing”).

What is apnea

Sleep apnea is a breathing disorder that occurs in the form of periodic pauses in breathing during sleep. There may be up to several hundred such delays per night; each lasts only a few seconds, but in exceptional cases lasts up to two minutes. When the breath is held, the patient begins to fidget and convulse, but does not wake up. When breathing resumes, it is accompanied by loud, explosive snoring.

Typically, patients with apnea are very overweight men over forty; In women, such disorders are less common. During these episodes of breath-holding, the upper airway slams shut and the patient is unable to inhale.

A short-term collapse (occlusion) of the walls of the upper respiratory tract occurs, most often at the level of the larynx (pharyngeal cavity) due to pathologically weakened muscle tone.

The cause of this phenomenon is unknown, but there is reason to believe that hereditary factors play a role here too.

Sleep apnea has two main consequences. Most of these patients feel very sleepy during the day, to such an extent that they usually consult a doctor. This daytime sleepiness appears to be a consequence of frequent breathing disturbances; leading to sleep deficiency.

But in addition, apnea also has a more serious consequence: during periods of breathing pauses, the level of oxygen in the blood drops, which can cause long-term oxygen deficiency in the body. This, in turn, leads to an increase in pressure in the pulmonary circulation and disturbances in heart rhythm.

Both sleeping pills and alcohol make sleep apnea worse by further suppressing breathing during sleep.

Sleep apnea may be a cause of sudden death in older, obese people. Unfortunately, treating such disorders is not easy. Weight loss has a positive effect. In the most serious cases, a tracheotomy (dissection of the trachea) is performed to allow the patient to breathe while sleeping.

Breathing pauses during sleep can also occur in children and may be a cause of sudden “crib death” in young children (sudden infant death syndrome).

And here we again see the presence of hereditary factors, since according to statistics, siblings are at greatest risk.

A number of studies have shown that such children have greater difficulty awakening from slow-wave sleep and are therefore more likely to become victims of sleep apnea.

Various groups of researchers are intensively working on this problem, and it is hoped that the causes of these tragic cases will soon be revealed and effective ways to prevent them will be developed.

Measures to combat snoring

Getting rid of snoring is not an easy task. Conservative treatment is aimed at improving airway patency.

Breathing stimulants are prescribed, a constant supply of air to both halves of the nose with the help of a compressor is indicated during sleep, and not everyone can tolerate this.

It is also necessary to treat all changes in the pharynx, nasopharynx and nasal cavity, causing thickening and relaxation of the soft palate and uvula.

Laser treatment, coagulation, cryodestruction under local anesthesia deserve attention These are gentle methods. Although surgical, but without a scalpel. During cryodestruction, for example, several points of liquid nitrogen are applied to the soft palate and uvula. The treatment effect is achieved in 80-90% of cases.

Then why all these attempts, skeptics may say. But sometimes a snoring person feels so bad that he is ready to undergo treatment once, twice, or three times in order to feel like a full-fledged person at home, on a business trip, and on vacation.

Sometimes the doctor recommends uvulopalatopharyngoplasty - excision of the mucous membrane in the area of ​​the palatine arches and the posterior wall of the pharynx, removal of the palatine tonsils. This major surgical intervention immediately widens the airway and leads to a reduction in snoring. Some dental surgeons offer correction of the upper and lower jaw and removal of adenoids.

Exercises for the respiratory tract

The exercises described below must be performed every day, the result will appear within a month.

• Briefly and tensing the muscles of the palate as much as possible, pronounce the vowels “a”, “o”, “e” in turn.
• Hold the pencil with your jaws tightly closed for five minutes.
• Imitating eating a big apple, make the corresponding movements with your jaws ten times.
• Another exercise for the muscles of the palate. It is necessary to stick out your tongue as much as possible and try to reach the tip of your chin, while significant tension should be felt at the base of the tongue. The exercise is repeated up to thirty times.

One of the old methods of preventing snoring, the so-called finger massage . It is better to do it in front of a mirror and always on an empty stomach. Be sure to wash your hands thoroughly with warm water and soap first. Ready? Now let's get down to business.

Open your mouth wide and with the index finger of your right hand go behind the tongue and for 2-3 minutes (as long as you can) massage the muscles of the soft palate with a pendulum movement. Do the same thing, only more intensely, to the tongue.

A course of 15 procedures (one day a massage behind the uvula, the other before it) strengthens the muscles of the soft palate, and they do not fluctuate so much when breathing during sleep. If it is difficult to do such a massage yourself, ask someone close to you to help. Naturally, subject to all hygiene requirements.

Sometimes the “gag reflex” does not allow you to do a finger massage; in this case, seek help from a doctor.

However, no matter which way to combat snoring is chosen, it always requires an integrated approach and the help of an otolaryngologist, dentist, neurologist, or radiologist.

Only in this case can a person be relieved of his deficiency, balance his psyche, create normal night sleep, and restore mental and physical performance.

To get rid of such a traumatic tugging at him: “Stop snoring!”

Polunov M., professor. Based on materials from the magazine “Health”

Source: https://www.vitasite.ru/articles/noze-article/hrap-article/

Sleep-disordered breathing: snoring and apnea

Snoring is a problem not for the patient, but for others. However, snoring can be a symptom of a serious medical condition. What are the causes of snoring and how to get rid of it?

Snoring is a sound phenomenon during sleep caused by vibration of the soft tissues of the upper respiratory tract under conditions of limited inspiratory flow. In most cases, it occurs during the inhalation phase, although it can also occur during exhalation.

Regardless of when it occurs, snoring is caused by the opening and closing (we might call it fluttering) of structures in the upper respiratory tract, including the soft palate and the base of the tongue.

Snoring is also caused by mucous secretions due to chronic inflammation.

According to modern concepts, snoring is divided into two types: habitual and isolated. Habitual is most often combined with obstructive sleep apnea in combination with complaints of daytime sleepiness and fatigue.

If polysomnography was performed and no other breathing disorder was found, such snoring is called isolated snoring.

Also, isolated snoring is not combined with metabolic syndrome and cardiovascular diseases.

Obstructive sleep apnea is a pathology that is characterized by repeated episodes of cessation or reduction of air flow during sleep due to obstruction (that is, blockage) of the upper airways, accompanied by a decrease in blood oxygen saturation.

Central apnea, unlike obstructive apnea, is not accompanied by blockage of the airways. With this pathology, there are no ventilation impulses generated by the respiratory center of the brain.

The symptoms of apnea are as follows:

• constant snoring at night;
• sleep apnea;
• feeling of suffocation at night;
• daytime sleepiness;
• increased motor activity during sleep;
• morning headache;
• constant fatigue;
• impaired concentration.

The main diagnostic task is to distinguish between isolated snoring and snoring, which is combined with pauses in breathing during sleep. The objective assessment in this study is the measurement of snoring (graphic, quantitative), which is based on the use of special devices (during respiratory monitoring or polysomnography in a sleep laboratory).

The choice of diagnostic method depends on the clinical picture of the disease. Polysomnography is a rather expensive method.

Its use will be justified if there are indications of respiratory arrest, complaints of daytime drowsiness, fatigue, or insomnia.

And also if the patient has concomitant diseases, such as metabolic syndrome, arterial hypertension and heart rhythm disorders.

In addition to the above examinations, the following are used in the diagnosis of respiratory disorders: cardiorespiratory test, EEG (electroencephalogram), ECG (electrocardiogram), measurement of the flow of inhaled and exhaled air.

The causes of snoring and apnea are varied.

Predisposing factors are: male gender, overweight, old age, large tonsils or tongue, gastroesophageal reflux (or GERD), a history of snoring and apnea in relatives.

Causes of snoring also include deformation of the nasal septum, chronic rhinitis, sinusitis, swelling caused by respiratory tract infection, and the appearance of nasal polyps.

Usually these are nasal dilators, various moisturizers for the mucous membrane of the nose and throat, nutritional supplements, and special pillows.

More reliable treatments for snoring include lifestyle modifications, oral devices, nasal septum surgery, and non-invasive mechanical ventilation during sleep (CPAP therapy).

Lifestyle modification, first of all, means losing weight, stopping drinking alcohol, and stopping smoking. Intraoral devices can also be used to treat snoring in the presence of a healthy bite. Surgical treatment of snoring can be performed in its isolated form, but only in cases where the anatomical substrate contributing to the development of snoring has been identified.

Continuous positive upper airway pressure (CPAP) therapy is commonly used to treat patients with apnea. But it is also known that CPAP therapy successfully combats snoring.

The device is a portable compressor that delivers air under constant positive pressure into the patient's airways, thereby preventing upper airway obstruction during sleep.

A mask (there are different versions, including oral, nasal and nasal masks) is attached to the breathing circuit, through which air is supplied. To achieve a clinical effect, it is recommended to use therapy for at least 5 hours during sleep for at least 70 nights.

The most common side effects of CPAP therapy are local irritation of the skin under the mask, dryness of the nasal and pharyngeal mucosa, nasal congestion or discharge, and conjunctivitis. However, these violations may be associated with incorrect use of masks or incorrect choice of operating mode of the device.

Source: https://MedAboutMe.ru/zdorove/publikacii/stati/sovety_vracha/narushenie_dykhaniya_vo_sne_khrap_i_apnoe/

Breathing disorders during sleep

More than 350,000,000 people on planet Earth suffer from sleep-disordered breathing.

“Never sleep, you die too often in your sleep”         Mark Twain.

From WHO statistics: It has long been no secret that sleep is given to a person to restore strength after being awake. But we are talking about healthy sleep! Only he is able to “unload” the human brain.

Increasingly, people go to bed, but the next morning they find themselves more unhealthy and stressed than at the end of a hard day at work. “It’s all about bad sleep,” most will say, not realizing that the concept of “bad sleep” has long been a terrible diagnosis that leads to death.

And sleep disturbances hide dysfunctions of the whole body! So, we will talk about breathing disorders during sleep.

What are sleep breathing disorders?

The inability of the lungs to saturate the tissues with oxygen is most often a consequence of prolonged nighttime cessation of breathing during sleep, otherwise apnea - which translated from ancient Greek means calmness or lack of breathing. Experts divide apnea into obstructive and central.

Obstructive sleep apnea syndrome (OSA) occurs due to obstruction, that is, narrowing of the upper airways. The muscles relax, the tongue sinks into the airways and prevents the flow of oxygen into the lungs.

Doctors call OSA a “disguised killer”, because it really works “under the guise” of seemingly “banal” snoring, to which everyone has become accustomed and has long since let it float freely. But oddly enough, snoring is a bell, in some cases an alarm bell: “you have a serious problem and it requires an immediate solution!”  

not as bad as the breathing disorder that snoring “masks”

In turn, pauses in breathing during sleep can last a minute and be repeated more than 20 times per night , and in total amount to more than an hour. Ultimately, this sleep disorder leads to hypoxia of the brain and other organs - the inability of oxygen to saturate the body. All this leads to a serious imbalance in the body.

Untreated obstructive sleep apnea leads to death in three out of five cases .

First, a person complains of high blood pressure, then of uncontrolled weight gain, in some cases diabetes mellitus, chronic fatigue, apathy, coupled with cardiac disorders, leads to heart attacks and strokes.

Unfortunately, people die without knowing that the culprit is not hereditary cardiovascular pathology or excess weight, but an insidious disease - obstructive sleep apnea syndrome .

Apnea is also neurological in nature . And it's called central sleep apnea syndrome.

What happens in this case?

Since central sleep apnea is a consequence of a disorder of the central nervous system and differs from obstructive apnea in that it is dependent on a neurological plan, and not a physiological one, this means that breathing disorder during sleep occurs from the brain.

Sleep and breathing disorders occur in the part of the brain that controls breathing.

With central sleep apnea, the airways are completely free for air to enter. sleep apnea syndrome is much less common, but doctors who deal with sleep problems should certainly know the nature of your “bad sleep.”

For this purpose, several years ago, a unique diagnostic device was introduced into the circulation of somnologists - polysomnography .

What is polysomnography?

• This diagnostic equipment is designed to give a complete description of sleep and all functions of the human body during sleep, to determine the nature of the sleep disorder.
• Sleep diagnostics today is the only chance to make an accurate diagnosis and “not miss” in the unequal struggle of doctors with breathing disorders during sleep.

Poly - from lat. a lot , dubiously - sleep , graphy - writing . Diagnosis of sleep using polysomnography is the diagnosis of breathing disorders during sleep.

Polysomnography involves studying the basic functions of the body during sleep under normal human conditions.

In a simulated bedroom, breathing function, heart function, brain function, blood oxygen saturation level, motor activity of the chest and abdomen, the nature of snoring and much more are monitored. Based on the results of polysomnography, the doctor gives the patient a diagnosis over the next day. After this, the patient is offered treatment.

CPAP therapy (CPAP therapy) is recognized throughout the world as the gold standard for the treatment of apnea .

CPAP therapy is artificial ventilation of the lungs, which occurs through a small compressor. A tube with a mask is attached to the compressor. Coming out onto the tube and then onto the mask (which is attached to the patient's face), a constant stream of air flows directly into the respiratory tract . CPAP machine therapy is used by doctors and patients to treat sleep apnea, snoring, respiratory failure, insomnia, depression and other sleep problems.

It is worth noting that CPAP therapy can only be prescribed by a doctor, after diagnosing sleep - polysomnography.

Treatment of apnea and snoring with CPAP therapy can last a year, in some cases a lifetime. Patients get rid of bad sleep once and for all, they begin to lose weight, their blood pressure returns to normal, the problem of snoring “dissolves”, healthy sleep takes pride of place in a person’s bedroom! Having slept well once, as a rule, patients never part with their CPAP machine! Moreover, modern CPAP machines weigh no more than 2-3 kg and can be used not only at home and away, but also on business trips, on vacation, in the car and even on an airplane!

Patients with chronic obstructive pulmonary disease (COPD) for physiological reasons have rapid shallow breathing that occurs during REM sleep.

As a result, alveolar ventilation decreases and the level of hypoxemia increases - all this leads to additional disorders.

Doctors call this situation “crossover syndrome .

Treatment of breathing disorders during sleep in patients with COPD consists of “unloading” breathing during sleep using the same CPAP therapy.

Treatment of breathing disorders during sleep in such patients does not exclude treatment of the primary disease - COPD with oxygen therapy .

As with the treatment of OSA, treatment for sleep disordered breathing in patients with COPD is prescribed by a doctor after diagnosing sleep and diagnosing sleep disordered breathing (polysomnography).

Symptoms of sleep-disordered breathing that should prompt you to seek medical help:

1. You snore.
2. Difficulty breathing during sleep and immediately after waking up.
3. Frequent awakenings during sleep.
4. Increased urination at night.
5. Nightmares.
6. Headache in the morning.
7. Fainting immediately after waking up.
8. Sharp weight gain over the past 2 years.
9. High blood pressure.
10. Sleepiness during the day.
11. Absent-mindedness.
12. Irritability.
13. Unmotivated depression.
14. Shortness of breath while walking or doing exercise.

OSA does not have to present with all of the above symptoms. Just snoring or just obesity is enough! This is the insidiousness of OSA . People mistakenly believe that poor sleep is associated with nightmares, excess weight with depression, shortness of breath with excess weight, snoring with a difficult day, headache with something else, and this chain closes on ignoring the symptoms. A person does not see a doctor because he cannot accept the idea that all this is a manifestation of a serious illness.

American doctors even compiled statistics on the problems of sleep-disordered breathing and came to the sad conclusion that every second person dies from the consequences of a sleep disorder due to simple ignorance about their diagnosis, as well as a frivolous attitude towards the problem of snoring.

And remember, treatment for sleep disordered breathing begins with a sleep diagnosis! Making an accurate diagnosis and systemic treatment will not only relieve you of bad sleep and return you to a normal healthy life, but will also prolong your life for many years! After all, OSA and the problem of snoring in themselves are not as terrible as what they lead to - cardiovascular diseases and death.

Don’t forget, health is, first of all, healthy sleep!

Source: https://centrsna.by/articles/treatment-of-sleep-disorders550/narusheniya-dyhaniya-vo-sne/