One of the most common sleep disorder among young people - it is obstructive apnea in which during sleep, periodic cessation of breathing, resulting in a drop of blood oxygen saturation.The prevalence of the syndrome of obstructive sleep apnea in men aged 30-60 years is 4%, and among women - 2%.
breathing stops during sleep lasts from 10 seconds to 2-3 minutes in severe cases, can be observed just before the 400-500 stops breathing per night total duration of up to three or four hours.This happens due to the fact that during the inhalation suction force acting on the airway wall (including the nasopharynx and oropharynx), overcomes the resistance of muscles, seeking to keep them open.Vibration in the narrowed section causes snoring and complete coverage of the respiratory tract leading to apnea.The most common overlap occurs in the oropharynx zayazychnom department.
danger of partial or complete airway overlap is at this point that falls blood
addition apnea episodes that might notice the patient's partner is sleeping with him in bed, sleep apnea symptoms are:
- irregular snoring (seen in 95% of patients);
- severe daytime sleepiness (90% of patients);
- feeling short of breath after waking;
- a restless night's sleep;
- night trips to the bathroom;
- morning headaches;
- the absence of a refreshing night's sleep effect.
Son patients apnea, does not restore the vitality of the body, since breathing stops transferring patients in a more superficial sleep stage (all the while a little wake him), it is less deep REM sleep stagesand shorter REM sleep.Furthermore, they are characterized by a longer time to fall asleep and the sleep duration less.
Sleep disturbance as a result of sleep apnea leads to development of diseases of the cardiovascular, nervous and endocrine systems.Episodes of respiratory failure accompanied by an increase in blood pressure.The result is a first nocturnal hypertension, then turning into day, and it is fraught with an increased risk of cardiovascular disease: coronary heart disease, heart attack, stroke.Suffer from lack of oxygen pulmonary capillaries that leads to the development of pulmonary hypertension, and subsequently - cor pulmonale (10% of patients).Also, the lack of oxygen leads to the development of insensitivity to insulin that contributes to type 2 diabetes.
Contributing to apnea factors are:
- weight: 75% of these patients have some degree of obesity.By reducing the weight by 10% the number of pauses in breathing can be reduced by almost two-fold;
- gender: women suffer from sleep apnea in 2-8 times less often than men.This is due to women's hormonal and features of the fat deposits on the female type - to a greater extent in the lower parts of the body;
- age: age decreases muscle tone, maintaining patency of the upper airways, and increases the amount of subcutaneous fat in the neck area;
- anomalies of the facial skeleton structure, which are accompanied by a decrease in the size of the upper respiratory tract;
- the presence of ENT diseases: narrowing of the nasal passages due to the curvature of the nasal septum or polyps in the nasal cavity, increasing the palatine, pharyngeal or lingual tonsils.
Diagnosis Diagnosis of obstructive sleep apnea syndrome, a sleep doctor performed by a study called polysomnography.Its essence lies in the fact that during sleep the patient is recorded snoring, nasal and mouth breathing, movement of thoracic and abdominal wall, blood oxygen saturation, performed electrocardiogram, electroencephalogram, electromyogram.The same study allows to establish the degree of respiratory disorders.
method of treating sleep apnea largely depends on its cause, but the therapy always involves weight correction - this is a very important factor.If the reason was the ENT pathology, surgical treatment methods are used:.. Correction of a deviated septum, removal of tonsils, etc. One of the most common operations - uvulopalatofaringoplastika (UPPP), at which the removal of the tongue with a portion of the soft palate and tonsils.This extends the airway lumen.
main method of treatment of sleep apnea - a method of CPAP-therapy (CPAP), based on the creation of continuous positive airway pressure.This is achieved by using a special device and the mask, and the result is that the airways do not collapse.pressure level is chosen in a sleep lab, then the patient is using the device at home every or almost every night.
article was prepared using the materials of the magazine "attending physician"
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