Studies have shown that the main problem of sleep is sleep apnea hypoventilation syndrome, commonly known as “snoring”, which refers to snoring with sudden pauses in breathing.
The diagnostic criteria are.
During 7 hours of sleep overnight, 30 or more apneas lasting more than 10 seconds occur, i.e. 5 or more apneas lasting more than 10 seconds every hour, and this is used as the apnea index, and anyone with an index of 5 or more is defined as sleep apnea syndrome. It is usually divided into three types: obstructive, central, and mixed, of which obstructive sleep apnea hypoventilation syndrome is the most common type. Patients with sleep apnea and hypoventilation caused by collapsed upper airway obstruction, snoring, breath-holding, sleep disorders, frequent decreases in oxygen saturation, increased carbon dioxide levels, elevated blood pressure, slowed heartbeat or arrhythmia, and daytime sleepiness.
Causes of morbidity.
1. the older the person is, the more likely he or she is to snore.
2. the heavier the body weight, the more likely it is to snore.
3.The more tired the body is, the more likely it is to snore.
4.The easier to snore when drinking alcohol or taking sleeping drugs
5. Upper respiratory tract diseases or deformities that produce snoring, such as: enlarged adenoids, enlarged palatine tonsils, sinusitis, hypertrophic rhinitis, allergic rhinitis, nasal septum curvature, nasal vestibulitis, nasal abscess, pharyngitis, laryngitis, stomatitis and overgrown soft palate or suspensory lobe, underdeveloped mandible, malocclusion of teeth, misalignment of teeth, etc.
Pathogenesis: Patients with obstructive sleep apnea hypoventilation syndrome suffer from chronic hypoxia, which causes changes in various systems of the body, leading to serious consequences.
Circulatory system: thickening of the intima, increase in the number of red blood cells, aggregation, slowing of blood flow, and increase in blood viscosity, all of which can cause pulmonary or pulmonary hypertension, leading to or triggering the occurrence of pulmonary heart disease, coronary angina and myocardial infarction, and can also cause hypertension, and many patients have been unsatisfactory simply by taking oral antihypertensive drugs, just because of neglecting the treatment of the disease
Endocrine system: endocrine disorders cause obesity, and obesity in turn aggravates sleep apnea syndrome, forming a vicious circle.
Nervous system: lack of oxygen in the brain can lead to headache, inattention and mental retardation. Severe cases can form blood clots and cause strokes.
Adult men, snoring can cause impotence, etc. Pediatric snoring, affects intellectual development Children snoring has more harm than adults Snoring is very common in infancy, which is related to the structural characteristics of their upper respiratory tract. The nasal and nasopharyngeal cavities of infants are relatively short, the nasal passage is narrow, the nasal mucosa is tender and rich in blood vessels, so the nasal mucosa is congested and swollen when infected, which easily causes blockage; their pharynx is relatively small and vertical, and the pharynx is rich in collecting lymphatic tissue, including the nasopharyngeal tonsils and palatine tonsils, the former is also called the proliferative body, which develops before 6 months of age, and if the proliferation is too large, it is proliferative hypertrophy.
Hazards of obstructive sleep apnea hypoventilation syndrome.
Social harm: snoring disturbs people; affects family happiness; traffic and safety production accidents rise; children snoring can affect intelligence and physical development, leading to the decline of national quality.
Self-damage: More than 98% of children suffering from snoring have problems such as slow growth, hyperactivity and inattention. Because growth hormone is mainly secreted in the deep sleep state at night, snoring at night will directly lead to the decline of growth hormone secretion. Therefore, children with snoring disorder generally have short stature, intellectual development disorder, inattentiveness, irritability and hyperactivity, and do not like to study. They also have ugly face, deformed chicken chest and intellectual development disorder. In adults, due to long-term hypoxia, the whole body organs are severely damaged, such as intractable headache and hypertension; coronary heart disease; fatty liver; elevated blood sugar; senile dementia; women appear particularly senile; men have reduced sexual function; in serious cases, cardiovascular and cerebrovascular accidents and sudden death can occur (3000 people/night; 5-year mortality rate 12-30%). Various diseases such as hypertension, hyperlipidemia, diabetes, myocardial infarction, arrhythmia, stroke, dementia, etc.
Causes of obstructive sleep apnea hypoventilation syndrome.
Narrowing of the upper airway above the plane of the trachea caused by various reasons can cause snoring or even apnea, specifically: nasal septum deviation, nasal polyp, etc. causing nasal narrowing; pharyngeal narrowing: tonsil hypertrophy, soft palate relaxation, excessive length of the uvula; tongue hypertrophy, tongue root tumor; small jaw malformation causing tongue suffix; obesity or overexertion; adenoid hypertrophy is mostly seen in children.
Symptoms of obstructive sleep apnea hypoventilation syndrome.
Patients usually sleep with open-mouth breathing, severe snoring and recurrent apnea, repeated awakenings during sleep, and restless sleep. Nocturnal angina and cardiac arrhythmias occur frequently. In severe cases, fear of sleep; excessive dreaming and urination at night, children are prone to urine loss; headache, dizziness, dry mouth after waking, daytime fatigue, sleepiness, drowsiness or even falling asleep during work meetings or driving. Memory loss, slow reaction, and reduced ability to work and study. Decreased sexual function, etc. Hyperactivity and difficulty concentrating in children.
Diagnosis of obstructive sleep apnea hypoventilation syndrome.
How do you know if you have snoring disorder? First of all, ask your family to see if you snore at night. If you snore, you should go to the hospital to receive sleep breathing monitoring in time, and you only need to sleep for one night under the monitoring of professional equipment to get the complete data. By analyzing these recorded data, you can clearly diagnose whether the patient suffers from sleep apnea hypoventilation syndrome and its severity, and comprehensively analyze which method of treatment is suitable for application. Regardless of the age group, once the problem of sleep snoring at night is detected, people should take the initiative to go to the hospital to receive sleep breathing monitoring for timely treatment.
Treatment of obstructive sleep apnea hypoventilation syndrome.
Single treatment mode does not achieve consistent efficacy for all cases, and comprehensive treatment can be expected to achieve satisfactory results for most cases, with treatment divided into two categories: surgical and non-surgical therapies.
For obstructive sleep apnea hypoventilation syndrome, individualized comprehensive treatment is emphasized for.
1, exercise for weight loss purposes.
2, quit smoking and alcohol, there is no drug that is exactly effective for obstructive sleep apnea hypoventilation syndrome.
3, ventilator therapy.
4, positive pressure ventilation treatment.
5.Tonsillectomy plus pharyngeal molding surgery, also known as “UPPP” surgery.
6.Microwave, laser, plasma coagulation or vaporization of the uvula, part of the soft palate, tonsils and roots.
7, soft palate implantation of three polymer rods.
New treatments for patients with severe obstructive sleep apnea hypoventilation syndrome.
(1) The soft palate is not incised, but stretched outward and sutured.
(2) The uvula is not excised, and the uvula arteries on both sides are ligated to reduce them to normal.
(3) Both sides of the tongue root are stretched tightly and sutured outward and upward.
(4) The lateral pharyngeal cord is displaced externally.
(5) Postoperative pain relief with a pain pump for 72 hours.
(6) The middle of the tongue root is treated with YAG laser coagulation if necessary.