[Case Sharing] A patient’s family asked this question on the website: Hello, Professor! My father is 60 years old, he has been snoring for the past 5 years, he often can’t catch his breath during sleep, and then he can’t catch his breath again, he dozes off during the day, and he suffers from hypertension. 1 week ago, the World Sleep Day TV program mentioned some characteristics of patients with obstructive sleep apnea hypoventilation syndrome (OSAHS for short) that are similar to my father’s performance. Obesity is the most common cause of this disease, but my father is not fat, so I don’t know if he suffers from this disease, and what other causes can cause this disease besides obesity? Who is prone to this disease? The patient’s performance indicates that he is likely to have OSAHS, but ultimately the diagnosis needs to be confirmed by sleep apnea monitoring. OSAHS can be caused by a variety of factors, including the presence of a narrow upper airway structure that increases negative pressure in the upper airway during sleep or abnormalities in the nerves and muscles that control the dilator muscles of the upper airway that reduce the tone of the dilator muscles to overcome the negative pressure in the upper airway. 1. nasal diseases: congenital anomalies of nose and nasal tract, hypertrophic rhinitis, nasal tumor, nasopharyngeal tumor, nasal polyp, deviated nasal septum; 2. oral and pharyngeal diseases: macroglossia, tonsillar hypertrophy, uvula hypertrophy, oropharyngeal tumor, adenoid hypertrophy, oropharyngeal stenosis; 3. facial diseases: small jaw deformity (i.e., small chin), mandibular recession (commonly known as Tianbaodi, as opposed to Diaphoresis); 4. neck diseases: cervical diseases: cervical collapse (i.e., small chin), mandibular recession ); 4, neck diseases: short neck (usually described as a large head and short neck, or thick neck), cervical dislocation, head and neck deformities, neck tumors, goiter; 5, metabolic and endocrine diseases: hypothyroidism (patients with pharyngeal mucus edema), acromegaly (patients with pharyngeal mucosal hypertrophy); 6, old age; 7, neurological diseases: stroke, brain tumors, encephalitis, Parkinson’s disease, spinal cord lesions, peripheral neuropathy. The first 5 etiologies narrow the upper airway and increase the negative pressure in the upper airway during sleep, while the 6th and 7th etiologies can both lead to a decrease in upper airway dilator muscle tone during sleep, resulting in frequent collapse of the upper airway and causing sleep apnea. If this patient is diagnosed with OSAHS, the physician will make a diagnosis of the cause and develop a treatment plan based on his physical examination and ancillary test results. In addition, people with the following characteristics are prone to OSAHS. 1. Age: The incidence of OSAHS increases with age and is most common in those who present between the ages of 50 and 70. The incidence of sleep disordered breathing is generally considered to be about 4% in the general adult population. The incidence of sleep disordered breathing increases significantly with increasing age. It may be due to the decrease in the function of various organs with age and the decrease in pharyngeal muscle tone. 2, obesity: obesity is an independent risk factor for OSAHS, more than 60% of OSAHS patients are obese. In obese people, the increase of fat in the pharyngeal wall leads to the reduction of pharyngeal cavity volume and the increase of negative pressure in the upper airway, and the direct compression of the pharynx by fat in the neck and the decrease of residual air volume of pulmonary function due to obesity are related to the occurrence of OSAHS. 3. Gender: In the population, the incidence of OSAHS is about 2-3 times higher in men than in women. The ratio of men to women is reported to be as high as 8-10:1 among patients attending sleep centers at home and abroad. currently it is thought to be related to sex hormones. Estrogen has a potential protective effect on women, therefore, the incidence of OSAHS is low in premenopausal women, while the incidence of OSAHS increases significantly in postmenopausal women. 4, genetic: OSAHS occurrence has family clustering and racial differences. Obesity has family tendency, while non-obese people may have abnormal maxillofacial structure (congenital small jaw deformity, mandibular deformity, etc.), narrow upper airway and increased uvula. The snoring is characterized by obesity, short neck, receding jaw and small chin, narrow pharyngeal cavity and easy collapse. Scientific tips] OSAHS is mostly caused by the narrowing of the upper airway and diseases that reduce the tone of the upper airway dilating muscles.