Sleep apnea is a common breathing disorder in which breathing stops for a few seconds during sleep.
Sleep apnea can cause numerous complaints to the cardiovascular system and all people can be affected:
Forms of sleep apnea
Sleep apnea can be divided into three forms:
- Obstructive sleep apnea syndrome (OSAS): Obstructive sleep apnea syndrome is the most common form of sleep apnea.
During sleep, the muscles in the throat and throat relax. As a result, the airways close and the sleeping person makes frequent pauses for breathing.
- Central sleep apnea: This form occurs when the brain does not send signals to initiate the actions required for breathing.
In this way, the command to breathe does not get to the respiratory system to keep the neck open.
As a result, a series of pauses in breathing arises during sleep.
- Mixtures Apnea: This is a mixed form of obstructive and central apnea.
The causes are:
- obstruction of the respiratory tract,
- abnormal breathing control in the brain.
Causes of sleep apnea
Overweight and obesity
An excess of fat hinders the flow of air and can also lead to the collapse of the airways (with obstruction).
Many patients suffering from sleep apnea:
- are overweight,
- have a wide neck circumference.
When stomach acid rises into the esophagus, the tissue located there is damaged.
With exacerbation of the condition, the tissue structures of the vocal cords can also be damaged.
In chronic gastroesophageal reflux, scars can form inside the neck, narrowing the airways and possibly causing sleep apnea.
Asthmatics have an increased risk of nocturnal breathing interruptions.
Asthma can obstruct the airways during sleep and thus cause pauses in breathing.
The airways may be obstructed due to various factors; These include:
- nasal obstruction (e.g. curvature of the nasal septum),
- jaw shape,
- large neck,
- big tongue,
- enlarged tonsils (tonsils),
- narrow trachea,
- Palatine suppositories and soft palate may be enlarged or too long.
Smoking and alcohol consumption lead to a relaxation of the muscles in the throat, which hinders nocturnal breathing.
Drug and pill abuse can lead to central sleep apnea.
Other risk factors for sleep apnea:
- type 2 diabetes,
- chronic bronchial disease,
- Hypothyroidism (hypothyroidism).
Signs of sleep apnea
Those who suffer from sleep apnea often snore.
About 50% of snoring people also suffer from sleep apnea.
The snoring sounds can be very loud, especially with obstructive sleep apnea.
Other signs include:
- Prusting and snorting in your sleep,
- wheezing sleep,
- long breathing interruptions,
- sudden startle from sleep.
Symptoms of sleep apnea
The amount of oxygen that reaches the brain decreases through the pauses in breathing.
The symptoms of sleep apnea are:
Symptoms that occur during the day
- Concentration disorders
- Disturbances of memory
- Daytime sleepiness
- Morning headache
- Frequent naps
- Bad mood
- Personality change
- Dry mouth upon awakening
Symptoms that occur during sleep
- Tachycardia (when breathing resumes)
- Frequent getting up due to increased urination at night
- Mouth breathing
- Night sweats
The duration of the disease depends on the treatment, because it does not heal on its own.
Sleep apnea and post-traumatic stress disorder (PTSD)
This is an anxiety disorder that individuals may develop who have a traumatic event in the past:
- physical or
- of a psychological nature.
Any traumatic experience that involves fear of death or fear of losing a loved one can trigger PTSD.
Studies show that individuals affected by post-traumatic stress disorder often also suffer:
- Sleep apnea
- shallow nocturnal breathing.
Stress can affect breathing mechanisms and these irregularities in breathing can disrupt sleep.
The link between sleep disorders and PTSD is mainly attributed:
- constantly recurring memories,
In fact, the breathing irregularities caused by sleep apnea can occur more frequently if the patient relives the traumatic experience during REM or dream sleep.
Nightmares can speed up breathing, the patents are sometimes completely out of breath when you wake up.
Sleep apnea in children
Throat and palatine tonsils The most common cause of breathing interruptions in childhood sleep are swollen or enlarged pharyngeal tonsils (polyps) and palatine tonsils (tonsils
As a rule, they obstruct the airways when the child sleeps.
Since the airways of children are narrower than those of adults, this disease can be caused by a slight swelling.
Benign tumors such as nasal or throat polyps can cause sleep apnea.
Especially at night during sleep, the child’s muscles relax and the airways are blocked by the tumor.
Childhood obesity with an excessive amount of fat in the chest area leads to narrowing of the airways and can provoke sleep apnea.
Some children have neurological disorders that can affect nocturnal breathing and cause sleep apnea.
Symptoms of sleep apnea in children
- The most common symptom is snoring.
- The child’s sleep can be restless and not very restful.
- Sleep disorders and bedwetting at night are closely related.
A child with sleep apnea is more likely to develop this disorder than other children.
During the day
Unlike adults with sleep apnea, the child does not suffer from daytime sleepiness, but from psychological and behavioral disorders.
In addition, one can observe:
- Behavioural changes
- Lack of concentration
- Morning headache
- Poor school performance
- Poor memory
- Loud breathing with your mouth open
Sleep apnea in pregnancy
Pregnancy is a risk factor because there is a link between elevated progesterone levels and sleep apnea.
In the first months of pregnancy, progesterone leads to:
- abdominal swelling,
- Relaxation of the intestinal mucosa
- Nasal obstruction.
In the last months of pregnancy, the increase in size of the uterus causes:
- displacement of the diaphragm upwards,
- altered breathing mechanics.
As a result, growth within the uterus may be delayed as the fetus receives less oxygen from the mother.
Sleep apnea and driver’s license
In order to obtain the driver’s license, whether at the first issue or renewal, patients suffering from sleep apnea and daytime sleepiness may need to:
- be evaluated by a special commission,
- take special tests.
The validity of the driving licence could be limited to 3 years, for professional drivers it could be set at 1 year.
Risks and consequences of sleep apnea
- Increased risk of traffic accidents due to daytime sleepiness.
- Increased risk of cardiovascular disease, such as:
- Lack of concentration and memory due to the reduced oxygen supply to the brain.
- Impotence due to lack of oxygen (hypoxia), in the testosterone-producing cells.
- The dangers of sleep apnea include an increased risk for pregnant women to develop gestational diabetes.
Diagnosis of sleep apnea
The specialist for this disorder is the pulmonologist.
- examines the medical history;
- asks the patient’s partner if he snores or if there are nocturnal pauses in breathing;
- subjects patients to some tests and questions, such as:
- Epworth Sleepiness Scale (ESS) – a method for measuring daytime sleepiness,
- Berlin questionnaire – assesses the risk of sleep apnea,
- STOP-BANG questionnaire with questions to be answered with yes or no; the risk and predisposition to apneas is measured.
The most appropriate method is polysomnography; this investigation shall include:
- Recording of nocturnal breathing interruptions
- Determination of sleep apnea form (central, obstructive, mixed)
- Measurement of oxygen content in the blood
- Detection of arrhythmias
What to do? Treatment of sleep apnea
Devices for sleep apnea
1. Mandibular protrusion splint It is a plastic dental splint
that must be attached to the teeth and in the mouth.
This device pushes the lower jaw forward and lifts the soft palate. This splint works because two rigid rods on the dental arches connect the upper arch with the lower one.
In this way, slipping of the jaw backwards is prevented.
- the airways are kept open,
- sufficient airflow reaches the lungs.
The protrusion splint is also used against snoring.
This device is one of the best alternatives to CPAP ventilation (CPAP stands for “continuous positive airway pressure German”).
It is an effective, convenient and cheap device.
If you are interested, you can contact a dentist or orthodontist so that the dental splint can be customized.
You can sleep in any position, you can drink and talk.
2. Tongue holding device This rubber device
is very effective for treating diseases that cause sleep disorders and snoring.
It prevents the tongue from slipping into the throat.
3. Mechanical breathing devices.
There are various devices and breathing machines that help keep the airways open during sleep.
The most common method is the CPAP breathing mask (Continuous P ositive Airway Pressure), which must be applied while sleeping.
This breathing mask increases the air pressure in the nose to prevent:
- the collapse of the neck muscles,
- the obstruction of airways.
The breathing mask is put on before falling asleep and worn all night.
Some patients may find it difficult to wear the breathing mask.
Medication: Although medication may not solve the problem, it does help alleviate the symptoms of sleep apnea. Some medicines can cause severe side effects.
For daytime sleepiness, doctors often prescribe stimulants such as modafinil (vigil).
Palate surgery: If the problem of sleep apnea lies in the soft palate, surgery is the most successful treatment measure.
In a minimally invasive procedure, part of the palate suppository and soft palate (soft palate) are removed.
This method can be used successfully:
- to reduce snoring,
- to relieve other breathing difficulties.
Today, palatine suppositories and palate can also be modelled with the help of a laser (uvulopalatopharyngoplasty – UPPP); the procedure is performed under local anesthesia.
Maxillofacial surgery: This procedure is used in patients who have a peculiar shape of the upper and lower jaw, which increases obstruction of the airways.
The surgeon corrects the position of the jaw to solve the problem.
Tracheostomy: In this procedure, the surgeon inserts a small tube into the neck with the help of a small incision.
The operation is performed under general anesthesia while the patient sleeps.
The tube is used as an aid to breathing by bypassing the blocked airways.
This procedure is performed in obese patients with severe obstructive apnea who have not improved with other treatment methods.
A tracheotomy brings various long-term complications, including:
- language problems,
- Lung infections.
Natural remedies and treatments for sleep apnea
Some alternative methods are quite helpful for controlling sleep apnea.
Diet and nutrition for sleep apnea
Excess weight should be reduced by:
- regular sports activities,
- adequate nutrition.
Sweets and foods that cause allergies should be avoided.
Exercises for sleep apnea Breathing exercises are helpful because strengthening the muscles of the mouth and throat can prevent a collapse of the airways that causes sleep apnea.
- press the tip of the tongue against the palate and return it,
- articulate some vowels quickly and continuously,
- singing lessons,
- Making music with a wind instrument.
Vervain is a medicinal plant that can be used effectively against the disease in anxious individuals.
Individuals who have suffered psychological trauma may develop sleep apnea and the calming effects of verbena help with sleep.
Self-help measures include:
- Reduce body weight.
- Abstain from nicotine and alcohol.
- Make sure that the nose is free before going to bed, for example, you can inhale steam.
- Sleep in a lateral position to prevent the soft palate and tongue from falling backwards.
- Shortness of breath or wheezing
- Dry throat at night and in the morning
- Dyspnea tachypnea and orthopnea