Treatment of sleep apnea signs

       Positive airway pressure ventilation is the most effective treatment for OSAHS and is the main treatment for OSAHS. It keeps the upper airway open through positive air pressure.  Numerous studies have shown that positive airway pressure can eliminate daytime sleepiness, reduce traffic accidents, improve quality of life, and reduce cardiovascular and cerebrovascular accidents caused by long-term OSAHS.  The main mechanism of action is to mechanically open the upper airway through positive intra-airway pressure. In addition, it may also contribute to the opening of the upper airway by increasing the functional residual air due to positive end-expiratory pressure.  There are several modes of positive endotracheal pressure therapy, including continuous positive airway pressure (CPAP), bi-level positive airway pressure (BiPAP), and expiratory phase pressure reduction (C-Flex). An automatically regulated CPAP machine (AutoCCPAP) is also available.  The use of CPAP for OSAHS requires a certain pressure setting. Setting too much pressure can cause discomfort and discourage patients from using it. Setting the pressure too low can affect the efficacy of the treatment.  We often find the right pressure by titration. In clinical practice, we also set a pressure on the CPAP machine purchased by the patient based on our experience, and perform a full night trial treatment and pressure adjustment under full sleep polysomnography monitoring, and then make necessary corrections according to the AHI and patient’s feeling the next day.  The following surgical methods can be chosen according to the condition 1. nasal surgery: for the obstruction caused by nasal polyps, nasal septum curvature and turbinate hypertrophy, surgical correction should be given to reduce the obstruction.  2.Adenoid tonsil surgery: Adenoid tonsil hypertrophy is a common cause of pediatric OSAHS. Occasionally, tonsillar hypertrophy is also a cause of OSAHS in adults. For OSAHS due to tonsillar hypertrophy, removal of the tonsils should be effective.  3, Uvulopalatopharyngoplasty: This is a procedure to enlarge the posterior airway of the soft palate by removing the tonsils, removing part of the anterior and posterior arches of the tonsils and part of the soft palate and the uvula. However, this procedure has the possibility of recurrence and poorer results in patients with high preoperative AHI.  4.Laser assisted palatoplasty (LAUP):This procedure is mainly used to treat simple snoring and is not recommended for the treatment of obstructive sleep apnea.  5.Radiofrequency decompression: This is a less-invasive procedure, often done on an outpatient basis, and is mainly used for the treatment of simple snoring.  6.Chin anterior migration and hyoid suspension.  Oral orthodontic appliances are mainly used for mild to moderate OSAHS patients, although they may also be useful for severe patients. The American Academy of Dental Sleep Medicine has recently emphasized the importance of oral appliances in the treatment of patients with OSAHS.  Oral appliances move the tongue forward primarily by bringing it forward (tongue fixation device) or indirectly by moving the jaw forward (jaw advancement device).  Oral orthodontic appliances are usually fitted to the patient by the dentist. Treatment is often progressive, i.e., the jaw is moved forward conservatively and then adjusted to the optimal treatment position over a period of weeks.  There is also a “boil-and-wear” thermoplastic oral appliance that can be fitted by a respiratory physician. Salivation, temporomandibular joint pain, and impaired movement are the main side effects of this treatment.  Medications that have been tried include: medroxyprogesterone, acetazolamide, theophylline, morphine, nicotine, naloxone, protriptyline, stavudine, paroxetine, trazodone and so on.  However, these drugs cannot be used clinically because of inaccurate efficacy or pay effect. In recent years, a new drug, modafinil, has a therapeutic effect on daytime sleepiness, and can be used as an adjuvant, especially for some patients who still experience daytime sleepiness after receiving CPAP.  V. Life care 1. lose weight; 2. avoid drinking alcohol; 3. avoid taking sleeping pills; 4. sleep on the side.