Sleep apnea

Sleep apnea

Description of sleep apnea

Sleep apnea syndrome is a relatively common disease belonging to the sleep disorders. It is a disease characterized by impaired breathing manifesting arrest.

It is accompanied by snoring and reduced supply of oxygen to the body during sleep. Apnea called. Apnea tend to last longer than 10 seconds, and usually there are more than 10 per hour.


The cause of sleep apnea

Sleep apnea syndrome (SSA) is divided into three types. The first is obstructive sleep apnea is the most common. It represents 90% of all the SSA. The reason is in the upper airways. When inhalation is normally in the pharynx negative pressure vacuum, which tends to narrow the lumen of the pharynx. Lumen is maintained in a healthy person the muscles in the wall of the pharynx, their muscle tone (tension). The muscle tone is reduced but the patients, which may lead to collapse of the pharynx.

An important role is also played by the size of the soft palate and palatal cancer (uvula) in terms of enlargement, enlarged tonsils, more rarely, tumors restricted unobstructed nasal cavity and nasopharynx, which thus reducing the scope of the palate and pharynx.

For some patients it is crucial for reducing the area of the root of the tongue, which is given by example. Congenital smaller lower jaw, or saving a language that is more in the back.
Also, larger deposits of fat in the subcutaneous tissue neck are one of the factors which are involved.

The individual factors can be combined in various ways. The main reason for the occurrence of the trouble lies in the fact that these factors act as a barrier to sufficient passage of air.

The second type is central in central nervous system. In this type of lack of intrinsic activity of inspiratory (inspiratory) muscles. This is caused by different mechanisms (ie. Inflammation, mechanical, pharmacologically or vascular diseases) damage to the respiratory center, which is located in the medulla.

And then there is a third type, called. Mixed, which is a combination of the previous two.

The disease incidence in the population is measured in the range of 1 to 10%. It occurs mostly above 40 years of age and more frequently in men than in women. Approximately 21% of men and 9% of women. According to different studies, it suggests a genetic relationship of the disease. It demonstrated a higher incidence among individuals whose first degree relatives (ie. The parents, blood siblings) suffered from this disease.


Risk factors for sleep apnea

Risk factors include male gender, for its frequent association with the disease than in the female sex. Another important factor is obesity with higher BMI (Body Mass Index = ratio of body weight to the square of height) greater neck circumference, higher age (over 4O years).

Risk factors are also the aforementioned anatomical changes, anomalies (small lower jaw, large and flabby soft palate, enlarged tonsils, etc.), use of alcohol before bedtime, taking some sedatives, hypnotics, muscle relaxants (drugs muscle relaxant).


Preventing sleep apnea

Prevention SSA is the elimination or restriction effect of the above risk factors. Of course it concerns the factors that you can delete (maybe a sex change is already too late).

These include so-called životosprávná measures which advises to lead a life with regular and adequate sleep time. Eating the last few hours before bedtime. Avoid the use of alcohol and be careful with hypnotics before bedtime.

It is recommended to weight reduction in obese patients and smoke. And also try to sleep to avoid the supine position. I prefer to try to sleep on the side.


Signs and symptoms of sleep apnea

During the night, striking loud snoring (snoring). When partially narrowed lumen pharyngeal air flows inside the pipes turbulently and vibrate any part of the pharynx, which results in a characteristic zvukem- hoarseness. This occurs even at an ordinary simple snoring but where the obstruction only partially.

In sleep apnea syndrome is a complete obstruction, there is a complete closure of the pharynx and the air ceases to flow into the lungs. There is apnea, in which the patient sometimes longer than 10 seconds breathing.

Lack of oxygen and excess carbon dioxide, which the body with apnea abridges, the organism alarms, activating sympathetic to the patient wakes up from sleep (alone it but sometimes do not realize the majority are mikroprobuzení, after which immediately fall asleep) and loud breath,accelerates his respiratory rate, increasing the pressure.

This cycle may occur in advanced disease repeated more than ten times per hour. Consequently so poor sleep and rest, the patient wakes in the morning tired, feeling unwell and a little refreshing sleep with, headaches, dry mouth and throat, low mood to depressive states.

During the day it occurs fatigue, difficulty concentrating, thinking. It reduced výbavnost memory, as well as reduced work efficiency. There are episodes mikrospánku, sleep, especially during monotonous activities, which increases the risk of accidents. It is several times increased risk of traffic accidents.


Treatment of sleep apnea

Besides conservative procedures in the treatment of emphasis on respect for the principles of diet, and reducing excessive weight, quitting smoking, avoiding alcohol before bedtime, good sleep hygiene (etc. see prevention), is the most effective method of choice is the use of nasal positive pressure ventilation (CPAP).

It is a device which secures the nasal mask using continuous positive airway pressure. It prevents the collapse of sagging walls of the pharynx. The patient uses the device in the home every night, and his regular use improves the course of the disease and reduce its mortality rate.

Treatment with drugs intended to cure complications and diseases whose formation is connected with sleep apnea syndrome.

Another option is to some patients surgical treatment. It includes processes that lead to the removal of obstacles in the airways, thus improving the throughput. These include a sculpture of the nasal septum, removal of tonsils, sculpture storey cancer and soft palate (ie.Uvulopalatopharyngoplastika), which is the performance of the most commonly performed for the lighter to moderate obstructive sleep apnea syndrome. It has a high success rate. Removing a part of the soft palate, palatine arches, cervix, and both tonsils.

In early 90s have been developed a laser technique that can be performed on an outpatient basis.Today, it is used even for simple snoring.

The surgical methods should be mentioned technique, which is reserved as a last resort, and that the tracheostomy when trachea artificially leads to the skin surface of the body.


How can I help myself

In the first place emphasis on compliance with proper diet – reduction of excess weight, stop smoking, eat the last few hours before bedtime.
Do not drink alcohol before going to sleep with a degree taking hypnotics or sedatives.

Compliance with these principles is essential to prevent and reduce the symptoms of the disease already up and running. Of course, the more advanced stages, it is necessary to seek medical help when the disease examined and proceed professional steps.


Complications of sleep apnea

Simple snoring itself mainly bothers the patient’s surroundings. Patient does not have health consequences. But it’s worse with obstructive sleep apnea syndrome. It is shown the relationship of sleep apnea primarily to diseases of the cardiovascular system.

Patients suffering apnoí- apnoici suffer increasingly high blood pressure (hypertension). Observed to have a higher incidence of myocardial infarction, ischemic heart disease, heart rhythm disturbances (arrhythmias) and heart failure.

It describes also a significantly higher incidence of cerebrovascular accident (stroke), which is related to low oxygen delivery in the brain during apnea.

Also present are disorders of peripheral nerves through changes in sensitivity and angular momentum.

Apnoici, except that he usually overweight, a result of this disease, its weight also increases, having an increased amount of fats in the blood, and observing the increased tendency to developdiabetes.

The illness leads to a significant disruption of sleep architecture, in that there are frequent excitation, sleep is fragmented. It then headed for various disorders of thinking, intellectual and sexual funkcí- mainly potency disorders.

Finally, all this leads to problems and disagreements in the family and social spheres.

Other names: sleep apnea syndrome, SSA, sleep apnea syndrome, SAS

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