Perhaps you are still thunderous snoring for themselves and their families and bring the trouble and silently blame yourself, perhaps you think it is just a bad habit that can not be changed and do not think, if you really think so then you must give you a little alarm! You may ignore its existence at the same time health is quietly leaving you ……
There are two types of snoring, one is simple snoring, soft and even snoring, no other clinical manifestations during sleep; while some patients snore loudly and with the performance of holding awake at night, in medical terms it is called sleep apnea syndrome (OSAS), that is, in about 7 hours of sleep will repeatedly occur more than 30 times apnea, or an average of more than 5 times apnea per hour. The so-called apnea also means that the airflow in the oral and nasal cavities stops for more than ten seconds. All of these show that the harm brought by snoring to us cannot be ignored.
I. The harm of sleep apnea syndrome
Medical research in the past 20 years has confirmed that the occurrence and development of many human diseases are closely related to breathing disorders during sleep. Sleep apnea syndrome (SAS), especially obstructive apnea syndrome (OSAS) will not only affect the quality of sleep, leading to daytime drowsiness, mental concentration can not affect work and study but also cause damage to other organs.
1, damage to the cardiovascular system: the prevalence of hypertension among OSAS patients is 50% to 90%, and the incidence of coronary heart disease is also increasing year by year. The mechanism may be that hypoxia causes the coronary arteries to contract, and lipids are easily deposited under the intima, and with the increase of red blood cells, blood viscosity increases, which leads to slow blood flow, and platelets gather in the damaged intima to produce thrombus, causing coronary artery stenosis and occlusion. On this basis, angina pectoris, arrhythmia, myocardial infarction and sudden death at night are easily triggered.
2, the danger to the respiratory system: severe OSAS can appear patients respiratory center and respiratory muscle dysfunction, lung hyperventilation will also appear serious signs of respiratory insufficiency, if the apnea time is too long, there is a risk of acute respiratory failure and thus life-threatening.
3. Damage to cerebrovascular and central nervous system: OSAS patients are prone to cerebral atherosclerosis, increased blood viscosity, and increased platelet aggregation, which can lead to ischemic stroke at night or hemorrhagic stroke due to increased blood pressure at night. Long-term OSAS in children can also affect the intellectual development of dementia, causing immeasurable damage to the child’s future.
4. Effects on endocrine function: OSAS can also cause disorders of glucose metabolism, reduced glucose tolerance, and increased non-insulin-dependent diabetes. Some patients with OSAS may also suffer from hypoxia, which can lead to disorders of thalamic and pituitary regulation. Due to excessive secretion of growth hormone and androgen, acromegaly may occur.
Pathogenesis of OSAS
The pathogenesis of OSAS is not well understood, but many scholars agree that the size and patency of the upper airway is the result of the combined effect of many relevant anatomical and physiological factors. Numerous clinical studies have shown that patients with OSAS have narrow upper airways, small total upper airway volume, and varying degrees of structural abnormalities in the surrounding soft and hard tissues of the upper airway. During sleep, the compensatory neuromuscular excitation does not exist anymore, which makes these muscles relax, and the complete loss of muscle tone causes the airway to collapse, and the vortex formed by the airflow through the narrow oropharynx makes the soft palate and other tissues vibrate, which produces snoring sound. Epidemiological survey results show that OSAS patients are mostly found in middle-aged and elderly men and obese people.
III. Diagnosis of OSAS
At present, the diagnosis of OSAS is mainly made through nocturnal polysomnography to confirm the diagnosis and classification of OSAS, to determine the severity of the disease and to evaluate the efficacy. The Department of Respiratory Medicine, the Department of Otolaryngology and the Department of Sleep Snoring of our hospital have special testing instruments. According to this test, apnea can be broadly classified into three types: obstructive, which means that respiratory activity in the chest and abdomen is still present when apnea occurs; central, which means that respiratory activity in the chest and abdomen stops completely when apnea occurs; and mixed, which means that obstructive apnea is accompanied by central apnea.
Other imaging tests are available to help determine the site of airway narrowing. Clinical examinations can be performed in conjunction with other departments to rule out systemic diseases and to provide comprehensive treatment for some systemic systemic diseases that are present.
IV. Treatment of OSAS
1. Non-surgical treatment: obesity, as a dangerous curative factor, plays an important role in the generation and development of OSAS. Significant weight loss can significantly reduce apnea and increase blood oxygen saturation, especially for mild OSAS patients. Treatment of related medical conditions, such as hypothyroidism in patients with OSAS can be treated with thyroid standby products, and oxygen therapy can be considered for patients with oxygen saturation below 85%.
Ventilator therapy, invented by Australian scholars, is a method of continuous positive airway pressure treatment via the nose. The principle is to relieve apnea symptoms by compressing air, wetting it and feeding it into the upper airway through the patient’s nasal mask. The efficacy is determined, but due to the high cost of this treatment method, it is not convenient to carry, and the patient’s cooperation is poor.
2. Surgical treatment: Surgical treatment aims to remove OSAS caused by changes in oral anatomy and is mainly used in patients with severe high-risk patients with collapsed airways due to nasal obstruction, but there are risks of surgery and recurrence problems.
3. Oral orthodontic appliance treatment.
At present, the treatment of snoring by oral orthoses has become a hot spot in dentistry research and clinical practice around the world. In fact, the use of oral appliances for snoring has a long history. As early as 1934, there was a report on the treatment of OSAS by functional orthoses, and it was proposed that the small jaw deformity was the cause of posterior tongue drop or pharyngeal obstruction at the root of the tongue. Oral orthoses improve airway flow by changing the relationship between the tongue, soft palate and the upper and lower airways by changing the position of the lower jaw. It is more effective in patients with a small body mass index, a small jaw, a small jaw angle, a high hyoid position, a receding jaw, and a small oropharyngeal airway, which means that it is more effective in treating patients with obstructive and mixed conditions.
Oral orthoses need to be worn in the mouth at bedtime and stored in a glass of water during the day, and are usually adapted after about a week of use.
Compared to other treatment methods, oral appliances have the following advantages.
① safe and non-invasive, and are reversible conservative treatments.
② easier to operate, more comfortable and economical.
③ portable and not easily damaged.
④ Satisfactory efficacy when cases are properly selected.
The following types are mostly seen clinically.
1, individual production type
Oral orthodontic appliances made according to the individual situation, good retention, can be made for the patient’s occlusal characteristics, missing teeth or periodontal disease to make individual moderate adjustments, the use of resin shaping to adjust the jaw position, so as to improve the oral ventilation deficiency phenomenon.
2. Adjustable anterior mandibular relocator
Patients can adjust the amount of mandibular advancement according to the improvement of their symptoms, such as the reduction or disappearance of snoring, breath-holding at night and daytime drowsiness, and subjective comfort, which can effectively avoid the manifestation of inadequate therapeutic effect due to blind mandibular advancement.
3. Soft palate orthosis
The soft palate and the uvula are stabilized mainly by orthoses to reduce the tremors during sleep.
One third of life is spent in sleep right, a good sleep can make you have a healthy body and full of energy.