At present, due to the lack of awareness and diagnosis of snoring among the general population, patients lack the awareness of active consultation, the following introduces the disease to you to popularize the basic knowledge of snoring.
Snoring: Mostly known as obstructive sleep apnea/hypoventilation syndrome (OSAHS) in medicine
Definition: It refers to each episode of apnea for more than 10 seconds, repeated episodes of apnea and/or hypoventilation for more than 30 times or respiratory disturbance index (AHI or RDI) for more than 5 times/hour during 7 hours of sleep per night.
The main risk factors for OSAHS are: obesity, age, gender, short neck, small jaw, inversion, deformity, adenoid and tonsil hypertrophy, pharyngeal mucosa hypertrophy, uvula hypertrophy, tongue hypertrophy, genetic factors, endocrine disorders (such as acromegaly, hypothyroidism, diabetes mellitus, etc.), smoking, alcohol, sedative-hypnotic drugs, etc.
Specific clinical manifestations are: loud and uneven snoring during night sleep, abnormal limb movements, frequent breath-holding and waking up, and changes in muscle activity in the upper airway; daytime manifestations are dry mouth, bitter mouth, headache in the morning, sleeplessness, daytime fatigue, drowsiness, and lack of concentration.
There are three clinical levels.
Mild: Involuntary sleep events appear, such as watching TV, reading or traveling by car, with only slight impairment of social or occupational functioning.
Moderate: Involuntary sleep events occurring at, for example, concerts, meetings or performances, producing moderate impairment of social or occupational functioning.
Severe: Involuntary sleep events occur during activities that require concentration, such as eating, talking, walking or driving, and the symptoms produce significant impairment in social or occupational functioning.
It can lead to the following consequences: increased daytime sleepiness, impairment of thinking and memory, mood disorders, public safety, traffic accidents, impairment of immune function and hormones such as sex hormones, especially in men, low sexual function, fluctuations in blood sugar, changes in blood pressure, etc.
Do you have any of these symptoms? Then which patients need to receive treatment.
1.Severe patients must be treated
2.Moderate and mild patients with daytime symptoms must also be treated
3.Patients who may cause cardiovascular disease
4.Patients who have the potential to increase mortality
Patients who affect the quality of survival
The diagnosis of OSAHS is mainly based on the two points of polysomnography (PSG) and portable sleep monitoring, but of course Friedman score (tongue localization), upper airway manometry, sleep CT, Muller test, endoscopic methods, static and dynamic laryngoscopy, and multi-planar detection methods, etc. are also required if available. Therefore, the initial diagnosis of OSAHS patients must be done with PSG. PSG diagnostic data are.
1. Sleep Apnea Index (AHI) greater than or equal to 5.
2, accompanied by clinical symptoms, such as
(1) excessive sleepiness with no other explanation.
(2) Presence of two or more of the following that cannot be explained by other causes: e.g., choking or breath-holding during sleep, repeated awakenings during sleep, sleep that does not restore energy, daytime fatigue, impaired concentration. a and b must both be satisfied.
Current treatment.
1.General treatment
2.Appliance therapy:positive pressure ventilation (simple sleep ventilator therapy), oral orthodontic appliances
3.Surgical treatment
4.Medication: the efficacy is uncertain, not as routine treatment
5.Systemic disease treatment
6, weight loss (can reduce apnea, improve the effect of other treatments)
7.Body position
8.Cessation of smoking and alcohol
Do not take sedative-hypnotic drugs
Surgical treatment: Because OSAHS patients have multi-planar stenosis, they are clinically divided into three planes: nasopharyngeal plane, oropharyngeal plane, and laryngopharyngeal plane. Surgical procedures also focus on addressing these three planes, such as
For nasopharynx, FESS surgery (nasal endoscopic surgery) is feasible to address turbinate hypertrophy, deviated septum, sinusitis and nasal polyps, as well as nasal endoscopic adenoidectomy for pediatric OSAHS.