Obstructive sleep apnea hypoventilation syndrome, also known as snoring, commonly known as snoring, is due to the upper airway narrowing, collapse, obstruction caused by apnea and insufficient ventilation, accompanied by snoring, sleep structure disorders, frequent occurrence of oxygen saturation, daytime somnolence, etc., the narrowing of the upper airway in various parts of the upper airway can lead to the occurrence of snoring, and many patients with snoring may have the nose, nasopharynx, oropharynx and hypopharyngeal cavity and other upper airway Many snorers may have multiple planes of narrowing and obstruction in the upper airway, including the nose, nasopharynx, oropharynx and hypopharynx. With the improvement of people’s living standard, the incidence of snoring is increasing year by year. According to domestic literature, the incidence of snoring is about 4-10%, and the incidence of snoring in middle-aged and old-aged people is as high as about 50%. Snoring is a kind of disease with serious potential harm to human body, and in the past 20 years, people have gradually deepened their understanding of it, and realized that it causes different degrees and aspects of harm to cardiovascular diseases, and the heavier ones can die suddenly, and often combined with metabolic syndrome, which is mainly manifested as obesity, insulin resistance or type 2 diabetes mellitus, abnormalities of lipid metabolism, hypertension, coronary heart disease and hyperuricemia, and plays a very important role in the pathogenesis of cardio-cerebral and cerebral vascular diseases. It occupies an important position in the pathogenesis of cardiovascular and cerebrovascular diseases. Because the incidence of snoring population is relatively large, coupled with the lack of knowledge about its diagnosis and treatment, I will do a simple Q&A on popular science from the following aspects, hoping that it will be useful to you. A. Can breathing machine cure Obstructive Sleep Apnea Hypoventilation Syndrome (Snoring)? Ventilator cannot cure Obstructive Sleep Apnea Hypoventilation Syndrome (OSAS). Ventilator treatment is like wearing glasses for myopic eyes, it is just an auxiliary therapeutic device, and the continuous positive pressure in the airway after continuous wearing during sleep can hold open the collapsed area of the soft tissue of the upper airway, keep the upper airway open, and you will no longer snore, hold your breath, and no longer have apnea and other phenomena when you are sleeping, but you need to wear it for life instead of wearing it for a period of time to be cured. However, some patients who snore for a long time, the pharyngeal cavity will have edema, may sleep apnea phenomenon is more serious, wear a respirator for a period of time, and occasionally do not wear, the symptoms will be less than before treatment. There is also a part of the patient, wear a breathing machine after the daytime mental state became better, more willing to exercise, dietary regulation, pay attention to weight loss, may wear a period of time, the weight loss to normal or even low, and finally achieve a complete cure of the phenomenon also. Second, what are the conditions of Obstructive Sleep Apnea Hypoventilation Syndrome (snoring) to do the surgery? 1, open the mouth can see tonsil hypertrophy patients, and fiberoptic nasopharyngolaryngoscopy found that the cross-section of the airway has obvious anatomical narrowing of the patients or have obvious nasal structure abnormalities or obvious nasal septum deviation, sinusitis nasal polyps patients. 2, whether the operation can be done to monitor the severity of apnea: including the minimum blood oxygen saturation, apnea time, frequency, and then a comprehensive assessment. In general, the lighter the patient, the more suitable for surgery. Because surgical changes to the airway is limited, if the patient’s apnea has been so severe that surgery can not be completely eliminated, for example, can only eliminate the apnea of the lateral position, can not eliminate the apnea of the supine position; can only eliminate the apnea of light sleep, can not eliminate the apnea of the deep sleep when the muscles are more relaxed, this type of patient can only get partial efficacy. 3, will not cause surgical complications. Surgery should consider whether the anatomical structure can bear the necessary functions of the human body, and whether the bone structure can heal again. 4, the patient must have the desire for surgical treatment, but can accept that surgery does not achieve the desired therapeutic effect. The patient’s requirement for a change in subjective symptoms is also important. Everyone tolerates apnea differently, and some people will be awakened even if they have only one apnea all night. If the patient demands that all apneas must be completely eliminated, an assessment needs to be made as to whether surgery can do this. The degree of alterability of the airway and the severity of the condition have to be considered together. Third, can surgery be performed even if oxygen saturation is low? Or do I need to wear a ventilator before surgery? Because of the low oxygen saturation of the patient is best not to rush to surgery, because such patients usually apnea time is longer. If the oxygen saturation is so low that it takes a long time to wake this patient up, it means that his central regulation is poor. Surgery cannot treat the central problem. Although the airway is open after surgery, the center cannot command the diaphragm and intercostal muscles to move, and the patient still cannot breathe. This both affects the outcome of the surgery and poses a risk to the surgery. Such patients need to wear a ventilator for a period of time first for surgery, usually three months to six months, preferably six months. Of course, in the clinical work also encountered the lowest oxygen saturation is as low as 20% of the patients, in the absence of wearing a ventilator under the circumstances of the surgical treatment, and the results of surgery is very good, the risk of surgery for this practice is very high, the key must be accepted by the patient to work. Fourth, what kind of obstructive sleep apnea hypoventilation syndrome (snoring) patients with ventilator effect? Most of the patients with sleep apnea, if they have been diagnosed and tested with ventilator pressure in regular hospitals, and wear ventilator according to the doctor’s prescription, more than 90% of them will have good results. However, there are some patients whose initial ventilator pressure titration is not well adjusted, and they need to repeatedly re-do the manual titration before wearing the ventilator. It is also important to check the airway in patients who wear a ventilator. Some patients have heavy apnea, but his own airway is wide and just collapses into a completely closed chamber at night while he sleeps; some patients have a very narrow airway that collapses to a closed chamber even while they sleep. Monitoring these two types of patients will reveal that the severity of apnea is the same, but who is better suited for a ventilator? Obviously the patient with the wide airway. Airway wide patients, the collapsed tissue is loose, the ventilator air pressure can make these tissues displacement; airway narrow patients, tissue displacement space is very small, can only be vascular congestion after the degree of swelling squeezed a little smaller, which may be on the head of the venous return there is some interference, so such patients are not suitable for wearing a ventilator, more suitable for surgery, the narrow airway to widen. Patients with severe airway obstruction but easy tissue displacement are best suited to wear a ventilator. V. What examinations and preparations are needed before surgery for Obstructive Sleep Apnea Hypoventilation Syndrome (Snoring)? The first one is polysomnography, also known as PSG examination. The second one is sinus 3D CT examination, upper airway CT or MRI examination to evaluate the structure of the whole upper airway, including the soft tissue and bony structure, to help choose the surgical method. Upper airway CT can scan the nasal cavity, pharyngeal cavity, soft palate and other parts of the body, and then 3D reconstruction of the scans is performed to observe where the reconstructed airway is narrowed, and where the surgery is targeted: is it the plane of the nasal cavity, is it the soft palate or the tongue, should we move the lower jaw, are the bony structures of the hard palate narrowed or not, and should the tonsils be removed or not, and so on. This test is done when you are hospitalized. The third is fiberoptic nasopharyngoscopy, which looks at the cross-sectional area of the nasal cavity, nasopharynx and pharyngeal cavity through a mirror. The fourth is a nasal function test, which is done when you are hospitalized, to find out the resistance of the nasal passages. Another commonly performed test is esophageal manometry, which assesses the plane of airflow obstruction, whether it is upper or lower airway obstruction, nasopharyngeal or soft palate, and helps to choose a surgical procedure. In addition some patients may also require pulmonary function tests, etc. Therefore, the tests and treatments may be different for each patient, the so-called individualized treatment of the problem.