Sleep apnea - what is it? Obstructive sleep apnea syndrome

Classification of major sleep disorders includes the so-called sleep apnea syndrome. What is this, it is understandable is not all. When he appears in a dream, a person has long periods of stopping breathing. This phenomenon is quite dangerous, as in some cases it can lead to death.

In other words, apnea is a complete stop of the registered nasal and oral breaths, which lasts no less than ten seconds and is caused by a decrease in the pathways in the pharynx. In this case, respiratory effort can both persist and be absent.

The main types of apnea

To date, there are three main types of this concept. It is central, obstructive and mixed.

Central apnea is defined as insufficiency of air flow due to the fact that temporarily there is no impulse of the central nervous system, which activates the respiratory effort. As a rule, this type is found in people who have disorders of mechanisms in the process of breathing regulation, and it is associated with deep and anatomical damage to the CNS conductive pathways.

The syndrome of obstructive sleep apnea is a serious, often life-threatening condition. It is usually characterized by the development of respiratory arrest for more than ten seconds and at intervals of fifteen times per hour. Obstructive or peripheral apnea is characterized by an overlap of the air flow in the upper respiratory tract. Because of this, all the exhaled air can not reach the lungs, and therefore there is a lack of air flow.

Mixed Apnea

Mixed apnea consists of the characteristics of both of the above types. The most common, as indicated by the data of most laboratories that investigate sleep, is obstructive sleep apnea, but mixed is often observed.
Most of the situations of obstructive sleep apnea are caused by an incorrect coordination of CNS pulses relative to the respiratory muscles. In such cases, the muscular dystonia of the central pharynx occurs.

In men, nocturnal sleep apnea (which is described above) is about twenty times more common, usually from forty to sixty years. Most of these people suffer from obesity.

Clinical forms of apnea

According to the classification of sleep apnea, in addition to dividing into the above types, which are related to the pathogenesis of this syndrome, there are also clinical varieties consisting of the following forms:

• Snoring with the elements of sleep apnea;
• Pickwick syndromes;
• Acute apnea in children (sudden death syndrome) ;
• Central hypoventilation;
• The curse of Undine.

Night snores are manifested by a sound that occurs when breathing in the course of air passage into the narrowed oral and nasal region of the pharynx.

The so-called Pickwick syndrome is characterized by the presence of obesity, night snoring, polycythaemia, and hyperemia.

Apnea in infants

Sudden apnea in children occupies a significant place in the number of deaths up to one year. This phenomenon arises from the not completely perfect regulation of breathing. As a rule, it often occurs in preterm infants. And worsened if there is catarrhal inflammation and respiratory duct bruises.

The cause of the appearance of VAGD in infants with an underdeveloped central nervous system may be the overheating, because of which the normal thermal regime was violated. Moreover, newborns develop mixed apnea syndrome, and in its appearance both the central and obstructive mechanism participate.

The curse of Undine is also a form of such a pathology as nighttime apnea. That this is not known to many. This phenomenon is rather rare. With this form, automatic control over the regulation of ventilation is lost, so breathing can be controlled arbitrarily, which is impossible during the sleep period. When a person sleeps, regulation is not carried out, and apnea occurs. This is often the case with the presence of tumors, inflammation or dystrophic lesions of the head of the spinal cord, in addition, with surgical intervention of the conducting pathways.

Central form of obstructive sleep apnea

This option in the position of a person lying on the back is usually found in people with mild manifestations of the disease. Apnea obstructive is characterized by the presence
Complaints of constant snoring and drowsiness during the day, however, when there is a polysomnography, there is a syndrome without respiratory efforts of the thoracic lead, which is characteristic of the central variety of the disease. Treatment of apnea of this kind is easy to implement, since it is quite possible to recognize this form by recording a dream on video, i.e., on specific noise when opening the airways in each episode of apnea.

The main mechanisms of this phenomenon can be related to the fact that suppression of respiratory efforts occurs through the recession of the pharynx in the supine position. In this case, local anesthesia leads to the usual manifestations of sleep apnea.

Laryngeal form of sleep apnea

This option is much less common than obstructive sleep apnea. Mostly this form takes place when the obstruction of the upper respiratory tract during the sleep period develops after disorders in the innervation of the larynx, which lead to the fact that it overlaps. People around them tend to notice unusual snoring, as well as other symptoms, including drowsiness, headaches in the morning, and the nebula of consciousness. Causes can serve as central and peripheral disorders.

Night spasms of the larynx appear quite often due to exposure to vocal chords of hydrochloric acid. A person can not breathe normally, and breathing becomes intermittent, after which he suddenly wakes up. Such symptoms usually last two or three minutes.

The concept of hypopnea

This phenomenon is a respiratory event that is characterized by a partial decrease in nasal and oral airflow, and also by a decrease in the amplitude of at least two times in combination with a decrease in oxygen saturation by three percent, with a duration of at least ten seconds. The hypopnea syndrome can have both an obstructive and a central type.

Such concepts are collectively called common respiratory disorders. These phenomena serve as the basis for the definitions of the pathology of the syndrome of obstructive sleep hypopnea.

To date, there is no clear definition of the syndrome of sleep apnea. Initially, his interpretation was based only on the number of respiratory events per hour of sleep. Moreover, snoring is one of the most characteristic and indispensable symptoms of obstructive sleep apnea, and also the main risk factor. However, not all snoring people have a syndrome of obstructive sleep apnea, and the risk of their occurrence in them is significantly higher than those who do not snore.

Degrees of severity of apnea

In addition, today there is another classification of apnea, based on the degree of severity. Its criteria is the number, as well as the duration of seizures per one hour of sleep at night.

As a rule, there are three main degrees of severity of the course of apnea:

- a non-severe form (from five to twenty attacks per night);

- moderate weight (from twenty to forty seizures);

- severe form (more than forty attacks).

Depending on the variety, a different treatment for sleep apnea is used. In addition, the expression, as well as the duration of the process of oxygen saturation and seizures themselves, are of great importance here. The level of the severity of sleep apnea syndrome is estimated by the indices of respiratory disorders, which are calculated by a special formula.

Also, the additional conditions for assessing the severity of apnea may be indices of oxygen saturation of blood on the basis of seizures, the degree of night sleep, and also - cardiovascular disorders, which are associated with abnormalities of breathing.

Definition of obstructive sleep apnea

Today, the most complete definition of the syndrome of obstructive sleep apnea can be identified. This is a condition in which a person has many recurring stops of breathing due to complete or partial apnea. Causes may be the cessation of pulmonary ventilation, and despite the fact that the respiratory effort that is characterized by the presence of snoring, and still - lowering oxygen in the blood and fragmentation of sleep.

There may be frequent awakenings and excessive daytime sleepiness. In order to identify the apnea, the breathing at which is significantly different from the normal state, it is necessary to determine whether its episodes lasted no less than ten seconds and appeared fifteen times per hour.

Features of obstructive sleep apnea

In more severe cases, up to five hundred breath stops can occur at night with a total duration of three or four hours. It is extremely necessary to treat apnea. The presence of such a pathology can lead to acute and chronic hypoxemia, which significantly increases the possible risk of developing hypertension, and also leads to violations of heart rhythms, myocardial infarction, strokes and even a sudden death in a dream.

In the daytime, people suffering from such an ailment experience seizures, increased irritability, decreased attention, worsening potency and prolonged headache. In addition, attacks of sleepiness are quite dangerous during the management of the vehicle, since there is a certain risk of the occurrence of traffic accidents.

History of apnea

For the very first time the manifestation of the apnea syndrome was described in detail in 1919. As an example, young people who had excessive body weight and complained of present drowsiness during the day were taken. Already in 1956, a condition was described that had such recognizable signs as obesity, snoring at night, hypertension.

The syndrome of Undine's curse is a rare form of central apnea. What is it, do not know a lot. This condition is usually accompanied by a marked hypoxia and changes in brain activity leading to fairly frequent awakenings at night. In addition, there are cases of the existence of apnea in people with the optimal body weight and with the lack of sleepiness during the day.

Effects of apnea

Insomnia and various sleep disorders, which causes the syndrome of obstructive sleep apnea, people have a strong impact on their daily lives. Immediately declining labor productivity, increasing medical costs, increasing the duration of sick leave and so on.

In addition, apnea (what it was, it was indicated earlier) leads to a decrease in the production of oxygen in conjunction with a decrease in the quality of sleep, resulting in the release of stress hormones that can increase blood pressure, increase heart rate and lead to stagnation in the heart. Also, apnea leads to a violation of energy exchange, which is responsible for the risk of overweight and diabetes.

As a rule, a sharp decrease in the level of oxygen in the body can lead to a headache in the morning, a decrease in the ability to concentrate attention, to think logically, to learn and remember something. In addition, insomnia leads to changes in the mood and behavior of the patient, as well as the depressed state. Therefore, sleepless nights increase the possibility of accidents both at work and on the road.

Attacks of nocturnal apnea (what it is and how to deal with them, we considered in our review) are perfectly explained by modern medicine. Today they are quite easy to treat, the principles of which depend on the combination of various causes and the severity of the disease. If there is an uncomplicated snoring and a mild form of apnea, then special laser and radio frequency methods for treating the soft palate and palatal tongue are very effective . Also, a rather important moment in the treatment process is operative intervention with difficulty breathing.