What is Sleep Apnea?

sleep apnea is a breathing stops during sleep for a period of at least 10 seconds or higher.Sleep apnea can be of the central type (of neurological origin), when the breath stops due to a lack of nerve stimuli to the respiratory muscles: it is as if the “brain” forgets to breathe.

L ‘ obstructive sleep apnea ( OSA: Obstructive Sleep Apnea ), however, is much more common and is due to a’ obstruction or collapse of the upper airway as the body tries to breathe: the lungs try to expand, but we do not they succeed because there is an obstruction of the passage of air at the level of the upper respiratory tract. At that moment, the body is put to the test (heart rate intensifies, oxygen in the blood decreases, blood pressure increases both at a general and lung level, sleep becomes superficial, etc.).

Then there is the mixed apnea , which is a mixture of the two previous types and which must be considered and treated as an obstructive apnea.

When should sleep apnea be treated?

The syndrome of obstructive sleep apnea ( OSA ) must be cured when the number of apneas (at least 10 seconds) is greater than 5 for each hour of sleep: below this value can be considered physiological. But a fact that should not be overlooked, even if apneas are scarce, is daytime sleepiness. It is a sign of poor oxygenation and frequent “arousal” during sleep, which is fragmented and not well structured.

How do you suspect you have obstructive sleep apnea?

Am I a frequent and very loud snorer? Others tell me that I often stop making noise with pauses in the breath and then start again with moans, puffs, moans? My bed partner, who often goes to sleep in another room, tells me that I often have a restless sleep? Do I feel noticeably tired in the morning when I wake up and do I sometimes have a bit of a headache? Do I often get sleepy during the day and do I often fall asleep in front of the TV, at the computer or while reading a book? Does driving sometimes happen to lose control of the car momentarily? Do I understand that my sleep is not refreshing and I have continuous nighttime awakenings?

If you recognize yourself in these statements, it is advisable to seek medical attention: the possibility of suffering from obstructive sleep apnea is very high.

The diagnosis

It is advisable to contact a facility where there are doctors who deal with sleep problems and especially apneas. The cardinal exam is polysomnography, often performed also at home, which manages to diagnose and differentiate the most serious apneic pathologies from the much simpler and uncomplicated ones (simple snoring).

The treatment

Therapy to treat the disorder can be medical and / or surgical.

Medical therapy

A very valid therapy is CPAP . ( Continous Positive Air Press ) which consists of applying a mask at the nasal level, fixed with small straps behind the head, which is connected to a device that blows air. Very frequently this therapy resolves snoring and the presence of apneas: the continuous introduction of ambient air under pressure in the upper airways, in fact, prevents their relaxation and collapse thus avoiding obstructive and mixed apnea. In the early days, CPAP can be a little annoying, but most of the time, you just need to have a little calm and patience that you get used to. The beneficial effectsthey also make themselves felt and make everything more tolerable. The results of this device are clearly evaluated during a polysomnography with CPAP applied: there is a real disappearance of obstructive apneas. If the patient is well suited to this device, he has practically already found the appropriate therapy and already knows the results (unlike other therapies in general).

Surgical therapy

The indications for surgical therapy ( rhonchosurgery ) are certainly represented by the need to modify alterations or pathologies of the upper airways , which cause obstruction to the passage of air. If necessary, the surgeon must intervene in the areas of greatest narrowness and collaboration of the upper airways with surgical techniques that will be adequate and studied for each individual patient, so as to practically practice a “plastic” of these anatomical districts. The nose , the soft palate, the base of the tongue , the jaw , the tonsils , the adenoids may be operated, etc. with more or less complex methods and with various instruments (e.g. lasers, ultrasound scalpels, radio frequency, etc.). The otolaryngologist surgeon operates knowing, however, that, especially in the most serious patients, surgery can help but often cannot solve the whole problem if not accompanied by well-conducted dietary and medical therapies.

Prevention

In most cases it is sufficient to follow dietary , hygienic (e.g. not smoking and not drinking alcohol) and pharmacological advice , to have excellent results on night breathing. To reinforce the concept, remember that you must:

  • Lose weight
  • Stop smoking
  • Do not take alcohol or sedatives in the evening
  • Eliminate drugs with a sedative effect (e.g. antihistamines taken for other problems)
  • Avoid sleeping on your back (on your back)

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