Nearly 60-year-old bus driver, Master Li, known as the “snoring king” of the nickname, he has always thought that it is a good sleep and did not pay attention to. But in recent years, with the increase of age, the family found that Master Li snoring more and more serious, sometimes snoring ears, sometimes snoring and suddenly stop for tens of seconds can not hear the breathing, and often headache during the day, to doze off, a few times when driving yawn almost got into a traffic accident, high blood pressure is always out of control. Master Li then began to worry, so he found the Shanghai Tenth People’s Hospital respiratory consultation, the doctor according to his performance, he did a simple polysomnography, and soon clarified the cause of the disease. It turned out that Master Li was suffering from sleep apnea hypoventilation syndrome (SAHS for short). Is snoring a disease? The root cause of snoring is the obstruction of the airway. Snoring patients usually have narrower pharyngeal cavity structure than normal people (for example, obese people), and during sleep, the muscles of the four walls of the pharynx are looser, and the hyperplastic mucous membrane around the pharynx and the back fall of the tongue root can make the pharyngeal cavity narrower, and the air entering the airway generates vortex and causes soft tissue and other vibrations, thus producing snoring. When the airway obstruction increases, the snoring becomes louder and louder. If snoring only occurs during sleep, but there is no snoring pause, i.e. apnea, it is customarily called “simple snoring” or “benign snoring”. Snoring can occur whenever you are overworked, drink alcohol, or after a deep sleep, and this kind of snoring is generally not harmful to the body. If, in the process of snoring in bed, not only the snoring is loud, but also there is always a pause in breathing for more than 10 seconds or even 1-2 minutes, then it is abnormal. If a person has more than 30 times of apnea and hypoventilation in 7 hours of sleep at night, the doctor can diagnose him with sleep apnea hypoventilation syndrome. In fact, this is a common disease, multi-morbidity, according to statistics, 20% of the snoring population is “malignant snoring”, the total prevalence of the population is about 1-4%, the elderly over 65 years old, the prevalence is higher, up to 20%-40%. The prevalence of sleep apnea hypoventilation syndrome increases with age, and there are significantly more male patients than female. In addition to genetic, physiological and disease related factors, risk factors for sleep apnea include obesity, alcohol consumption and smoking. The “standard body shape” of sleep apnea patients is obesity, short thick neck, fat accumulation at the neck, resulting in narrowing of the airway and blockage of the airway by the back of the tongue root, so most of the obese people who are more than 20% of the standard weight are moderately to severely snoring. In the outpatient treatment, the patients lose weight and their snoring will be reduced to varying degrees. Long-term heavy alcohol consumption and heavy smoking are also risk factors for sleep apnea. In addition, any disease that can cause narrowing of the anatomical structure of the upper respiratory tract, such as tonsil hypertrophy, nasal polyps, nasal septum curvature, uvula and tongue hypertrophy, lymphoid tissue hyperplasia at the root of the tongue, jaw deformity, small size, chronic rhinitis sinusitis, chronic pharyngitis, nasal tumors, etc. can produce narrowing of the airway in the nose and throat, or even obstruction. There are also some systemic diseases out can be related to sleep apnea hypoventilation syndrome, such as hypothyroidism when the whole body mucous membrane, skin edema, acromegaly, metabolic syndrome, type II diabetes mellitus and other endocrine system diseases. Many experts suggest that the above-mentioned groups of people who are accompanied by frequent night snoring and repeatedly waking up, daytime fatigue and lack of energy, as well as symptoms such as persistent hypertension, should promptly go to the hospital respiratory specialist for screening such as polysomnography. Of course, people can also do a simple self-examination at home, before going to bed at night, put a tape recorder beside them and record for 7 hours continuously, calculate their own snoring time during the night sleep. If you have repeated and prolonged pauses in your sleep, you should be highly suspicious of this problem. Snoring is a fatal disease “accomplice” For a long time, people think that snoring in sleep is at most a lack of rest, and do not feel particularly uncomfortable anywhere, so there is no need to see a doctor. In fact, sleep apnea hypoventilation syndrome is a systemic disease, which can be harmful to all systems and organs of the body. Because regular apnea at night will lead to intermittent hypoxia, the lungs, heart, brain and other organs of the body will be damaged to varying degrees, and 30% of hypertensive patients will be aggravated by the disease, leading to intractable headache and hypertension; snoring is also an important “accomplice” in causing coronary heart disease, nocturnal angina, myocardial infarction, cerebral hemorrhage, respiratory failure, diabetes and Alzheimer’s disease. It is also an important “accomplice” in causing coronary heart disease, nocturnal angina, myocardial infarction, cerebral hemorrhage, respiratory failure, diabetes, Alzheimer’s disease and other serious diseases. Snoring in children can lead to ugly faces and affect intelligence and physical development. For drivers suffering from this disorder like Master Li, dozing during the day is more likely to cause major traffic accidents. “Choose the right weapon to destroy the enemy” Sleep apnea hypoventilation syndrome is rarely cured automatically, but it can be treated. Therefore, once suffering from sleep apnea hypoventilation syndrome, should not be taken lightly. The first thing you should do is to go to a hospital that specializes in “sleep breathing disorder (snoring)” or “sleep disorders”. Since most patients are unaware of what is happening during sleep, it is best to be accompanied by the patient’s partner or to use a tape recorder to record snoring for 1-2 nights so that the doctor can understand the condition. For patients suspected of having sleep apnea hypoventilation syndrome, the doctor will arrange a sleep apnea monitoring test, which is the only reliable way to confirm the diagnosis of the disease and determine the severity of the condition. Based on the results of the sleep apnea monitoring, the doctor will develop a reasonable treatment plan. To treat the disease, the first step is to identify the specific cause of the disease and target the treatment. For upper airway obstruction where the cause can be identified, removing the cause of the narrowing can have an immediate effect. There is no effective drug to treat this disease (except for endocrine disorders, of course). For example, sleeping in the lateral position can reduce or prevent the soft tissues of the pharyngeal cavity and the root of the tongue from dropping back; thus helping to reduce snoring and prevent apnea. To change the habitual supine sleeping position is generally difficult, try sewing a tennis ball on the back of your pajamas right in the middle to ensure a side-lying position at night. For obese patients with the disease, diet control and physical exercise to reduce weight are key. Active smoking cessation and timely treatment of nasal and sinus disorders will help to improve the patency of the airway. Continuous nasal positive airway pressure ventilation is an effective and safe treatment for sleep apnea hypoventilation syndrome, and is suitable for patients with various degrees of sleep apnea hypoventilation syndrome. This treatment is currently used by 70-80% of patients worldwide. This treatment involves wearing an apparatus (positive pressure ventilator) while sleeping, which gives a continuous positive pressure to the airway while the patient sleeps, thus preventing airway collapse and improving the patient’s ventilation. Dental braces (also known as oral appliances) can be used as an adjunct to positive airway pressure ventilation treatment. Wearing a pair of dental braces in the mouth during sleep can prevent snoring, but this method is not suitable for the elderly and patients with loose teeth and oral diseases. Lastly, surgical treatment is more complicated and costly. Surgery can be considered for patients with no serious systemic complications, mild to moderate cases not caused by obesity, and patients with obvious anatomical narrowing of the upper airway found during physical examination. In conclusion, adequate and quality sleep is not only necessary to keep energetic, but also the most basic requirement for good health. 21 March is “World Sleep Day”, let’s pay attention to healthy sleep and keep away from snoring.