Sleep apnea
What is it
The obstructive Sleep Apnea is a condition respiratory characterized in that the people who suffer from habitual snorers have stops breathing (apneas) repeatedly and daytime sleepiness . As a result, patients who suffer from it can not rest well during sleep.
“What happens with people who have sleep Apnea is that during the night they have a collapse of the pharynx. This collapse is periodic, especially in some phases of sleep (such as REM), “explains HealthBodha Eusebi Chiner, pulmonologist and coordinator of SeparPacientes , of the Spanish Society of Pneumology and Thoracic Surgery (Separ). “When the number of apneas exceeds a certain number per hour, the syndrome known as obstructive sleep apnea occurs.”
Causes
Under normal conditions, when people sleep, the airway is permeable, that is, they can breathe easily. However, in some phases of sleep the tissues close and block the airway causing apnea .
In addition to this cause there are other factors that can increase the risk of having apnea:
- Have the lower jaw shorter than the maxilla.
- Certain forms of the palate or airway that cause the collapse of the pathway.
- Have a big neck
- Possess a tongue that can be retracted until the airway is blocked.
- The obesity .
- Have tonsils or large vegetations that can clog the airway.
symptoms
The snoring is the most visible manifestation that can alert the patient about the possibility of having sleep apnea. People who suffer from the disease usually start snoring very loudly after falling asleep. In addition, it is interrupted during a period of silence while the patient suffers an apnea. This period of silence is followed by a snort with a gasp while the patient tries to breathe again.
As a consequence of the episodes, the patient’s sleep is not repairing and daytime drowsiness appears , presence of chronic fatigue and even respiratory and cardiovascularalterations . The person with apnea often gets up frequently to go to the bathroom, wakes up frequently with a dry mouth and the next day notices fatigue, headaches and complains about the high probability of falling asleep in inappropriate situations, while driving, reading or attending Work meetings.
In addition, patients with apnea may have depression , leg swelling or be hyperactive.
Prevention
Sleep apnea is linked to certain factors such as the increase of tonsil tissue in children and obesity in adults . In fact, according to Separ Patients, 80 percent of patients with sleep apnea are obese .
For this reason, the main measure that can help prevent apnea is losing weight , as well as applying certain hygienic-dietetic measures, physical exercise, etc.
On the other hand, quitting smoking and avoiding alcohol consumption also help prevent the onset of the disease.
When there are already symptoms (snoring and apneas referred by the couple) the patient must go to the doctor to confirm the diagnosis.
Types
The rate of apnea and hypopnea , that is, how many times we have each hour, throughout the night, respiratory stops of a time exceeding 10 seconds, will mark the types of sleep apnea that can be divided into:
- Mild : when there are between 5 and 15 apneas per hour.
- Moderate : the patient has between 15 and 30 apneas per hour.
- Serious or severe : when it exceeds 30 apneas per hour.
Diagnosis
The diagnosis is made by performing a sleep test that can be complete , includes neurological and respiratory variables, called polysomnography or can also be diagnosed with more abbreviated tests, such as respiratory polygraphy , which includes only respiratory variables and can be performed in the hospital or in the hospital. home.
With these tests, doctors will establish the rate of apnea and hypopnea that will indicate the severity of the syndrome.
There is a group of patients where the diagnosis is more complicated because, although they have many apneas and snoring, they do not have daytime drowsiness . This case usually occurs in young patients and the latest Spanish studies that have been carried out confirm that in these patients the treatment is important because if not, in the long run they could develop pathologies such as hypertension or other cardiovascular pathologies. “These are the most complicated cases to diagnose because they are alerted by the companion, not by the symptomatology during the day. Sometimes they debut due to a pathology such as ischemic heart disease, acute myocardial infarction or even a cerebral stroke and what translates is that deep down there was an apnea that was not previously diagnosed, “says Chiner.
Treatments
Therapy for sleep apnea is not curative. It is aimed at alleviating the symptoms. There are several types of treatments that are applied depending on the severity:
- Conservative : the doctor will recommend weight loss, smoking abstention, sleep hygiene, sports, good nutrition , etc.
- Regular treatment : the most accepted and preferred is CPAP , recommended in almost all patients. This consists of a pressure generator that transmits through a nasal mask a continuous pressure to the upper airway preventing it from collapsing . According to specialists, this mask usually has a quick effect making night snoring and sleepiness disappear during the day. This treatment does not usually have serious side effects and in the case that they appear they are transitory and disappear after the first weeks.
- Surgical treatment : it is recommended when there are some lesions such as polypsor hypertrophy of the tonsils, or when the mask is not well tolerated due to the existence of some damage in the upper airway.
Other data
Epidemiology
Globally it is more frequent in men than in women . However, Chiner points out that from a certain age, especially during menopause, the frequency of this pathology in women tends to equal that of men .
In adults, the frequency is around 25 percent in advanced ages (60 to 80 years). In middle ages, the most frequent stripe in males, we would have about 10 percent of people who could suffer from sleep apnea.
Obstructive sleep apnea is also common in children . In fact, from SeparPatients estimate that about 3 percent of children suffer from sleep apnea. In these cases, most of the time it is related to having hypertrophic tonsils , that is, with an increase in angina.
In the case of children there are factors that can predispose to sleep apnea: some alterations of the jaws, certain diseases and childhood obesity.
Finally, this pathology can also affect babies , although it is less frequent for newborns to have hypertrophic tonsils. In these infants, the clinical picture is that of choanal atresia , which may be very narrow at birth and cause sleep apnea.
Complications
Obstructive sleep apnea syndrome can cause various complications among people who suffer from it. The hypertension is present in 50 percent of patients and frequent occurrence of arrhythmias during sleep. It also increases the risk of cardiovascular and cerebrovascular accidents , such as stroke and myocardial infarction . Also, daytime sleepiness is involved in an increased risk of traffic accidents or work accidents, and impotence and decreased libido among these patients is also common .
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