More than a thousand years ago, in a snowy night in October of the ninth year of the Song Dynasty, a great historical mystery occurred in the palace of Kaifeng – “the sound of the candle and the axe” – which remains unresolved.
For thousands of years, people have tried to dig, interpret and even guess the truth of this matter from various angles. Now, let’s restore the limited historical information described in the situation. Song Taizu Zhao Kuangyin is notorious for his love of wine, the night of the accident, Taizu invited his brother Zhao Guangyi to his bedchamber to drink wine, is the night of heavy snow, the two brothers more and more wine. Soon, the eunuchs and palace maids serving in the palace heard the thunderous snoring of the emperor – they have long been accustomed to. In the early hours of the morning, they heard what sounded like an axe falling to the ground in the bedchamber, and saw a figure shifting in the window. All soon fell silent. Early the next morning, people were surprised to find that the emperor had died.
So, it was assumed that Zhao Guangyi cut down his brother and came to a yellow robe after himself. In fact, a little knowledge of history and according to basic common sense, you can determine that Zhao Kuangyin could not have died. First of all, Zhao Guangyi has no reason and could not kill his brother, from the Chenqiao mutiny, Zhao Kuangyin has always trusted his brother and entrusted him with important responsibilities, not only as a hand in the capital, but also to participate in the core layer of decision-making, as the successor is also an open secret. The first thing you need to do is to take a look at the actual site. So, what happened in the emperor’s bedroom that night?
The closest true explanation is that Zhao Kuangyin died of asphyxia caused by sleep apnea. He was notorious for his snoring in his sleep, and it was no secret that his addiction to alcohol was a risk and aggravating factor for sleep apnea. That night, the two brothers went to sleep when they had reached the end of their wine. In the middle of the night Zhao Kuangyin appeared apnea was suffocated from the dragon collapse tumbled to the ground – this may be the original cause of the sound heard by people outside – many people suffering from sleep apnea have the experience of falling out of bed at night. Then he woke up, stood up and wobbled and climbed back into bed and went back to sleep – this is probably what people outside saw from the window. I did not expect the emperor to fall asleep again, his eyes closed and did not open, and at the age of 50, he passed away for the rest of his life.
What about Zhao Guangyi? History records that Zhao Guangyi was not able to win, and his drinking capacity was far worse than his brother. And often advised his elder brother to take care of the dragon’s body for the sake of the world and not to drink. But Zhao Kuangyin is my own way, I am the emperor I am afraid of who? Not only drink as usual, and every time to drink “in place”. That night, Zhao Guangyi probably see the emperor’s brother is very high, can not afford to spoil the game, and also used to it, so accompanied by a few glasses, and later really can not resist on the road back to the house. Zhao Kuangyin, however, had not yet had enough, so he poured himself a few more cups and drank until he fell asleep….
How can snoring cause death?
Snoring is known as the invisible killer in night sleep. The survey found that 1% to 4% of the population suffers from snoring, and about 3,000 people die from the disease every day worldwide. On the other hand, snoring starts earlier in men, about 20 years old, and later in women, mostly after 40 years old. Snoring is called “sleep apnea syndrome”, and now more and more people recognize snoring as a disease, but we found that in the process of consultation, patients are usually very eager to know: how to treat snoring? How does it work? How long does it take …… As a doctor, we can understand the patient’s feelings, but speed is not enough. Clinically, we need to choose the appropriate method and arrange the treatment steps according to the actual situation of each patient.
The American “Public Library of Science Journal of Medicine” recently published the results of a study, people suffering from sleep breathing disorders will face a higher risk of premature death. Sleep breathing disorders are breathing abnormalities that occur during sleep and include sleep apnea syndrome, hypoventilation syndrome, chronic lung and neuromuscular disorders caused by related sleep breathing disorders. Although earlier studies have shown that sleep apnea syndrome can lead to a variety of diseases such as hypertension, heart failure, and stroke, they have not demonstrated the magnitude of the effect of other factors such as age and gender.
Researchers at Johns Hopkins University in Baltimore followed more than 6,000 subjects and found that women with sleep apnea were 1.5 times more likely to die prematurely than the general population, and men with sleep apnea between the ages of 40 and 70 were 2 times more likely to die prematurely than the general population, regardless of age, gender, race, weight and smoking status. times more likely. In addition, sleep breathing disorders significantly increase the probability of death from coronary heart disease in men, while women are not affected. The survey also noted that mild sleep breathing disorders do not increase the risk of premature death.
Snoring is caused by three factors: 1) central disorders; 2) obstructive disorders; and 3) mixed disorders. Generally speaking, adults have the most mixed symptoms and children have the most obstructive problems. Snoring is also likely to be caused by other physical causes. Current research shows that patients with high blood pressure and cardiovascular diseases have a higher chance of snoring, and those who are more obese than normal are also more likely to have snoring problems. Narrowing or blockage of any anatomical part of the airway can lead to obstructive sleep apnea.
There are four main causes of snoring or obstructive sleep apnea: ① Insufficient tension of the palate, tongue and pharyngeal muscles to keep the airway open during the inspiratory phase of the respiratory cycle. ②The soft palate and uvula are too long, which causes the nasopharyngeal airway to narrow and vibrate when breathing. ② Occupational lesions in the pharyngeal cavity . This encroaches on the pharyngeal airway. ① Restricted nasal ventilation can cause greater negative pressure in the collapsed airway portion during the inspiratory period. The airway of snorers is usually narrower than normal, and the compensatory contraction of the muscles in the pharynx keeps the airway open during daytime wakefulness without blockage. However, at night when sleeping, the neural excitability decreases, the muscles relax, and the pharyngeal tissues are blocked, so that the upper airway collapses, and when the airflow passes through the narrow part, it generates eddy currents and causes vibration, thus snoring occurs, and in serious cases, breathing stops temporarily, thus affecting the health of the person.
The cause and diagnosis need to be clarified by the following examinations: 1) sleep monitoring: monitoring of heart, brain activity, respiratory movement, oral and nasal airflow, blood oxygen saturation, blood pressure and snoring; 2) nasal endoscopy: pictures of the nose, soft palate and pharyngeal cavity to determine the nature and severity of snoring.
For treatment.
(1) Surgery: Patients with narrowing and obstruction of the upper airway caused by lesions in the oral cavity, pharynx, larynx, nose, tongue muscle, soft palate and uvula, or even sleep apnea phenomenon, need surgical solution. The methods of surgery are generally radiofrequency ablation, laser, microwave and even tracheotomy. At present, the most widely used, safe and effective method is the application of plasma radiofrequency ablation system for low temperature ablation of the lesion. It can effectively solve the problem of pharyngeal obstruction, and it can also easily solve the problem of tongue root hypertrophy and other problems that did not have a better solution before, especially for the obstruction caused by turbinate hypertrophy, plasma is the most ideal treatment method.
This surgical treatment is suitable for patients with upper airway obstruction, such as: nasal turbinate hypertrophy, nasal septum deviation, tonsil hypertrophy, uvula hypertrophy and soft palate hypoplasia, etc. The ventilation problem can be solved by surgical methods such as nasal septal correction and palatopharyngoplasty.
1.Radiofrequency ablation therapy. Suitable for mild to moderate snoring patients, using plasma cryogenic elimination system to reduce the volume of the hypertrophied tissue in the pharynx, this method is simple, less traumatic, no bleeding, and can generally be treated on an outpatient basis.
2.Tranasal positive pressure ventilation treatment. The air is pressurized by a special ventilator to blow open the patient’s airway, which is no longer blocked, and cure the complications of airway obstruction and oxygen deprivation. This method is non-invasive, but the patient needs to wear a nasal mask when sleeping, and should be under the guidance of a specialist physician to purchase and use the ventilator.
3. Mouthpiece treatment. A special dilator is placed into the pharyngeal cavity at bedtime to expand the pharyngeal cavity and reduce upper airway resistance. Because of the discomfort of having to put the dilator in the mouth at bedtime, it is not easy for patients to accept.
(2) Conservative treatment: medication, weight loss, continuous positive pressure ventilation snoring apparatus (CPAP) and tongue rest, etc. Some people with obesity and short neck whose upper airway is narrower than normal people are prone to snoring, and some others snore due to bad sleeping posture, for which the doctor will suggest him to lose weight, quit smoking and drinking, change bad sleeping posture, or use some drugs. Usually these people do not need surgical treatment, and the snoring will disappear.
(3) Chinese medicine treatment
At present, the Department of Chinese Medicine and Respiratory Medicine of China-Japan Friendship Hospital has carried out the program of Chinese medicine treatment for this disease. Based on the agreed prescription “Snoring Formula”, the patients are divided into two categories of deficiency and actual and are treated with evidence, which has initially shown to be safe, inexpensive and effective.
The causes of snoring are multifaceted and often require multidisciplinary collaboration and comprehensive analysis before an individualized, humanized and appropriate treatment plan can be determined.