apnea - a characteristic pause in breathing for a period of sleep, which is characterized by the absence or a significant reduction in air flow of less than ten seconds at the mouth and nose.The temporary cessation of breathing is a certain process oronazalnogo reduced air flow or amplitude of respiratory movements by thirty percent in contrast to the initial thoracoabdominal movements within 10 seconds, at which the oxygen saturation is reduced by four per cent.Many respiratory episodes last from 10 to 30 seconds, but sometimes it can last more than a minute.
There are several types of apnea: obstructive, central and mixed.For obstructive sleep apnea is characterized by the closure of the upper respiratory tract at the moment of inspiration when disappears oronazalny flow while preserving respiratory effort.
central character apnea occurs when a lack of respiratory stimuli, and at the same time no oronazalny flow and breathing movements.When mixed type combination marked obstructiv
This pathological condition is the most common and occur in any age group.However, generally, based on various examinations it can be concluded that almost 5% of people suffering from sleep apnea thirty to sixty years.The probability of formation of a temporary cessation of breathing increases in proportion with respect to body weight and age.
addition, obstructive sleep apnea in the male population in middle age are found in three times more often in contrast to the female half.For a long time it was assumed that the occurrence of apnea directly affects overweight, middle-aged men.But in the last decade have shown that apnea is more common in older people, in contrast to the young.In addition, for the older age group for the development of sleep apnea minor role for sex, age and body weight, accompanied by a minimum of symptomatic picture.
As a rule, there are many causes of sleep apnea.The main reasons include the process of full or significant narrowing of the lumen of the decay of the upper respiratory tract at the level of the throat.At the time of reduction of breathing, the soft palate, which is freely hanging position, often begins to vibrate in the duct, where air passes, and thus, there is snoring.The first place among the factors that influence the development of sleep apnea, obesity takes a second and third degree.Typically, patients in this group predisposing seek qualified assistance at a very severe form of apnea, although the weight gain for a long time.But alcohol and potent sleeping pills that have an effect on the central nervous system miorelaksiruyuschego nature, cause a pause in breathing in the form of long and frequent stops.
Depending on the origin of the causes of the formation, apnea can be anatomically and functionally.For anatomical reasons apnea include those that encourage physical organic narrowing.This is primarily the formation of obesity and fatty deposits around the throat of the adenoids which are considered significant pathology in children.At this point, it says anoxia due to snoring and minor sleep apnea, which can lead to the issue of growth, formation and disruption of intellectual development of the child.
congenital abnormality of the structure of the nose and throat is among the etiological factors of sleep apnea.These include congenital narrowness of the lumen of the pharynx and the nasal passages;uvula with some lengthening and thickening;small, ectopic back lower jaw having a malocclusion (retrognatiya, micrognathia).
Among the acquired causes of isolated existence of the curved nasal septum, swelling of the mucous on the background of allergic rhinitis and sprawling lower turbinate.In addition, even the dream leads to the relaxation of the respiratory muscles, and then there is sleep apnea.Against the background of menopause or malfunction of the thyroid gland also appears apnea due to a lack or deficiency of certain hormones that affect the muscle tone of the soft palate.Sometimes sleep apnea occurs even among the younger generation, who do not have all of these anomalies, so to provoke a temporary cessation of breathing can drink before going to bed, and smoked cigarettes.
Furthermore, as a result of insomnia taken hypnotics, which have muscle relaxant effects, may cause a decrease in muscle tone of the pharynx, which causes apnea.
apnea - obstructive syndrome is the cessation of breathing during sleep, which is characterized by a variety of symptoms.After waking up, caused by cessation of breathing that is sleep apnea, restless man moves his arms and legs.This is due to lack of oxygen and during REM sleep, leading to excessive sleepiness during the day, mood swings, memory loss, and depression.Very often, people with sleep apnea syndrome put the wrong diagnosis - insomnia.Also, sleep apnea often develop virtually no symptoms, so fatigue patients wrongly considered a sign of aging.
Patients in the presence of sleep apnea, complain about lack of courage after sleep, they have a morning tiredness and weakness after night.Thus they constantly feel tired and sleepy during the day.In addition, these patients are able to fall asleep during a break at work or while driving a car.In the morning, there is a pain in the head, which recurs in the daytime on the back of the head and neck.Most patients with sleep apnea greatly irritable, they marked emotional lability, decreased memory.Also, these patients have aching muscles, that is restless leg syndrome;reduced libido and sexual weakness develops character.
characteristic symptoms of nocturnal complaints are: the strong play of snoring with increased motor activity during sleep bruxism, talking in his sleep episodes of nighttime awakenings, and sometimes there is enuresis.It is important to remember that snoring apnea is characterized by intervals and after periods of snoring occur silent phase apnea.
In the study of the objective nature of detected hypertension of unknown etiology.It is believed that reducing the oxygen content in tissues and organs causes stimulation of the chemoreceptors of arteries and veins, causing the effect of stimulating the neurons and thus enhancing the effect of vasoconstrictor nerves in the arterioles and arteries.
Sleep apnea often occurs accompanied by cardiac arrhythmias.At the same time 95% of patients developed sinus arrhythmia, 35% - sinus bradycardia, and 25% - and atrioventricular sinoauricular block.
signs of tachycardia, ventricular and supraventricular arrhythmias are more common in elderly people with abnormal heart conditions.Many patients on the background of developing sleep apnea stroke, heart attack, or even sudden death.With the development of pulmonary hypertension while listening to detect heart focus on the second pitch of the aircraft.
Since many patients diagnosed with sleep apnea are overweight, then they reveal a syndrome of Pickwick daytime hypoxemia and hypercapnia, hypertension, polycythemia, pulmonary heart disease, obesity gipotolamicheskogo.With an increase in the volume of the neck, there is a risk of formation of PAS (sleep apnea syndrome).
To diagnose sleep apnea at night apply a method Rovinsky.
Such a pathological condition called respiratory arrest.As a rule, it is not dangerous if the self-hold your breath if necessary.For example, an untrained person in the state can not breathe almost forty seconds.But sleep apnea - this is the cessation of breathing unconscious.On average, it can take up to thirty seconds, and sometimes as high as three minutes.Many such patients stop breathing 10-15 times during one hour of sleep.A re-emerging symptoms of sleep apnea syndrome have caused the condition.
In sleep apnea may be of the central type, wherein in the brain for a period of time does not send signals to the muscles of respiration, however, they are inactive, and thus stops breathing.
Obstructive sleep apnea is developing at a time when the brain receives a signal, and the air flow is interrupted as a result of narrowing of the airway.
When mixed type of central sleep apnea occurs first, passing in obstructive.
Patients with sleep apnea is very bad in the morning to experience pain in the head, they have reduced work capacity, they constantly feel tired, thus worsening their attention and memory, the day they want to sleep, they are irritable, decreased sex drive, impotence develops.It's noted in the period of wakefulness and sleep apnea manifests itself in a strong snoring, nocturnal enuresis, nocturia, bruxism, talk during sleep, heavy legs, tingling, and sometimes pain, somnambulism and hypnagogic hallucinations.
Sleep apnea can cause of heart attack, stroke, cardiac arrhythmias and sudden death which developed.
fall in the risk factors people over sixty years.This is due to the fact that with age, the elasticity of the soft tissues of the pharynx is being lost.In addition, the more likely to suffer respiratory arrest men and women have sleep apnea usually occurs during menopause.Usually, it is related to the level of progesterone.One of the causes of sleep apnea is considered to be obese (70%), as the muscles involved in breathing, as well as participating in the process of breathing, and muscles of the mouth and throat are covered by a layer of fat, which leads to functional disorders of the lung capacity.Thus, respiratory failure, and episodic apnea not only becomes more frequent, but becomes even longer, which makes the syndrome amid overweight heavier.
Disturbances in the endocrine system in acromegaly, hypothyroidism, alcohol, tranquilizers, hypnotics and sedatives, different strain, and pathology of the oral cavity, pharynx and nose causing the appearance of sleep apnea.
This pathological condition possible to determine on the basis of a survey of the patient, as well as through the comprehensive polysomnography, which includes pulse oximetry, oksikapnografiyu, impedance plethysmography, pneumotachograph, electrocardiography, electromyography, electrooculography, electroencephalography.
danger of sleep apnea is the formation of hypoxia.The air flow ceases to flow, but is not enough oxygen in the blood, and the man who had just snoring subsides, and then begins to turn blue.As a result, the patient wakes up constantly, and it violates the uniformity of sleep, that is, during the phase of deep sleep marked relaxation of muscles, reduces blood pressure and certain hormones are produced.A frequent spillage does not allow the body to recover from a deep sleep and night.
In addition, there is an assumption that the image of hypoxia, pressure fluctuations inside the breast that occur during sleep apnea, waking or surface phase of sleep cause significant activation of the sympathetic part of the nervous system, vascular spasm and increase blood pressure.
to start treating sleep apnea syndrome cancel receiving hypnotics, sedatives, and refuse alcohol and eating the food before bedtime, and if necessary, reduce excess weight.A good result shows the method of using the apparatus of continuous positive airway pressure.This method readily practiced in the home, although it does not cure patients with apnea, sleep and restores but relates to the prevention of complications of this status.If necessary, this machine uses the sick every night.
When anatomical defects of the pharynx and nose resort to surgical treatment.
Obstructive sleep apnea
Obstructive sleep apnea disease or stop breathing during sleep is produced during the sudden truncation of snoring with frightening respiratory arrest, after which a person has a loud snoring, he begins to toss and turn, and then again to breathe.Sometimes apnea can occur up to 350 times in one night, and such violation causes a deterioration in the quality of sleep of the patient.So sleepy people complaining about the appearance of his headaches, constant drowsiness, reduced his attention, memory, the potency in men, as well, a strong irritability.
People with obstructive sleep apnea syndrome do not remember how they wake up at night.This pathological condition is the most common disorder that develops in the soft tissues decay back of the throat and close the airway, whereby air is able to get into the lungs.This is all happening because of the relaxation of the pharyngeal muscles.
Obstruktivnoe apnea - is a particular episode, characterized by a lack of air flow for more than ten seconds.Constricted upper airways during sleep provoke the development of obstructive sleep apnea.Sometimes blocking the breathing process is incomplete, so developing obstructive hypopneas, and this leads to a continuous, slow and shallow breathing.
Obstructive sleep apnea reduces the oxygen content in the blood, and it becomes the cause of the defect in the lungs.This may come a time suffocation patient with signs of snorting sound.It is a pathological condition characterized by five or more episodes of apnea per hour of sleep the patient with significant daytime sleepiness.
On the occurrence of obstructive sleep apnea affects some of the characteristics of the neck, skull and face.For example, if you have a wide neck increases the risk of obstructive sleep apnea.Also, various abnormalities of the skull and face as micrognathia, retrognatii, narrow upper jaw, enlarged tongue, tonsils and palate may promote the formation of obstructive sleep apnea.
But the weakness of the muscles that surround the path of breath, or disease, can sometimes intensify obstructive sleep apnea.
Risk factors for the disease state include gender, age, genetic predisposition, obesity, alcohol, smoking.Typically, this condition is more common in men, but the risk of sleep apnea increases in women during menopause.Furthermore, it is formed mainly in adults from forty to sixty years, but may occur even in the newborn.But obesity is considered a major predisposing factor for the formation of this pathology.This is due to throat tissue filling fat.
Also, there are some diseases that can trigger the development of obstructive sleep apnea.These include diabetes, gastroesophageal reflux disease, and polycystic ovaries.
Symptoms of obstructive sleep apnea is made up of daytime sleepiness, morning headaches, irritability, disturbances of mental and emotional functioning and snoring.It usually occurs as a result of an interrupted night's sleep.And snoring occurs mainly as a result of suffocation or labored breathing in the supine position.In addition, it often causes the awakening of the patient during night sleep.
Symptoms of this syndrome is not always possible to notice, so to confirm the diagnosis used additional methods of research, such as polysomnography or split-night polysomnography.
apnea in children
The children suddenly appearing in a small temporary cessation of breathing during sleep is called sleep apnea syndrome.