Is snoring a disease? For a long time, people are used to snoring (commonly known as snoring) in daily life, and consider snoring in sleep as a sign of a good sleep. So is snoring a good sleep, or is it a disease? Snoring is medically known as snoring, which is actually sleep pathological breathing, and is classified according to the severity of the condition: 1. Primary snoring (or simple snoring): the main symptom is snoring, snoring intensity above 50 decibels, no awakening during sleep, no breath-holding, no oxygen saturation reduction. This condition affects the sleep of others and has no significant effect on one’s own health. Some scholars believe that 50% of simple snoring is likely to develop into obstructive sleep apnea hypoventilation syndrome. 2. Obstructive sleep apnea hypoventilation syndrome (OSAHS): snoring during sleep, repeated awakening, sleep structure disorder, frequent apnea or hypoventilation, with nocturnal hypoxia and hypercapnia, leading to excessive daytime sleepiness. These patients hold their breath severely, which scares bystanders, but the patients themselves do not feel like holding their breath or waking up. 3. Upper airway resistance syndrome: snoring at night, sleep awakening, often waking up with suffocation, and excessive daytime sleepiness, but without apnea and reduced oxygen saturation. Most scholars believe that increased upper airway resistance is a prelude to the pathological changes of OSAHS and belongs to the compensatory phase of OSAHS. It can occur at any age and is less closely related to obesity. Patients with nocturnal breath-holding symptoms are more pronounced than in OSAHS, with frequent awakening and chest pressure. However, there are no respiratory events such as apnea or hypoventilation during routine polysomnography monitoring. Obstructive sleep apnea hypoventilation syndrome is the most serious disease among the above snoring disorders. As these patients snore with frequent apnea or hypoventilation during sleep, it leads to decreased oxygen saturation and increased carbon dioxide concentration, long-term hypoxemia and hypercapnia, resulting in abnormal function of the autonomic nervous system, causing pulmonary hypertension, hypertension, heart rate abnormalities, which eventually often leads to serious cardiac, pulmonary and cerebral complications, and even Sudden death. Several studies have shown that 60-90% of patients have hypertension, and it is often refractory. About 80% of patients with hypertension have significant bradycardia during sleep, 57%-74% have ventricular ectopic beats, 5-16% have second-degree AV block, and 2% have third-degree AV block. It has been reported that patients with OSAHS are 1.2-6.9 times more likely to develop ischemic heart disease than normal subjects, and 23.8% of OSAHS suffer from ischemic heart disease. Because of the significant cardiovascular effects of OSAHS during sleep, it may be an important reason for the increased rate of sudden death at night. Some scholars analyzed 460 cases of sudden death and found that most of the sudden cardiac death patients were habitual snorers, and it is believed that snoring is a risk factor for sudden cardiac death from 4:00 am to noon. It has also been shown that untreated patients with severe OSAHS have a 5-year morbidity and mortality rate of 11-13% and an 8-year morbidity and mortality rate of 37%. In addition, due to repeated awakenings during sleep, sleep structure disorders cannot enter stage 3 and 4 sleep (deep sleep), daytime sleepiness, poor concentration, memory loss, and reduced work efficiency, often leading to car accidents and accidents. 1989 comparative studies in the United States on computer simulated driving devices confirmed that when driving, OSAHS patients have slower reaction time and braking time, more sideways bias than drunk people and farther off track than drunk people. Studies in developed countries have found that drivers with OSAHS are 3-7 times more likely than normal to be involved in car accidents and account for 80% of malignant accidents. In addition, a proportion of patients often have hypogonadism. Knowing this, do you now think snoring is a disease? What kind of people are prone to snoring with OSAHS? 1. Upper airway stenosis: The part of the trachea from the front nostril to the neck is called the upper airway, and if there is anatomical or disease-causing stenosis in this part, it is easy to snore. OSAHS can be caused by nasal obstruction, or aggravated by nasal obstruction. Nasal obstruction can make patients switch from nasal breathing to open-mouth breathing, while open-mouth breathing increases the risk of backward tongue fall and aggravates snoring. 2. People with obesity and short neck: the submucosal fatty tissue in the pharynx is deposited, and the pharyngeal cavity is often narrower. 3.People with small jaw: often the tongue root is posteriorly placed, resulting in narrow tongue plane. 4, the elderly: muscle relaxation, easy tongue root posteriorly. 5, endocrine disorders: such as hypothyroidism, mucinous edema of the soft tissues of the upper airway, hypertrophy of the uvula, relaxation of the soft palate and tongue body occur in these patients, causing obstruction of the upper airway. In the case of acromegaly, the hyperproduction of growth hormone due to pituitary tumors is manifested by hyperplasia of the old, cartilage and soft tissues, which can cause OSAHS. Do I need treatment for snoring? How is it treated? If snoring is not accompanied by breath-holding, it can affect other people’s sleep and is not harmful to your health. However, attention should be paid to weight control and reduction of alcohol consumption, because if these patients continue to develop, they may develop into obstructive sleep apnea hypoventilation syndrome (OSAHS). If not only snoring but also breath-holding and apnea during sleep, we should pay attention to it and intervene as early as possible to prevent the occurrence of cardiovascular and cerebrovascular diseases and to stop the vicious circle, because snoring and breath-holding in OSAHS often lead to endocrine and metabolic disorders, and endocrine and metabolic disorders lead to patients becoming more and more obese and not easy to lose weight. At present, there are mainly the following methods to treat snoring at home and abroad: 1. Behavioral treatment: 1. Patients and family members should learn about this area and have a full understanding of the harm caused by snoring; 2. Positive nasal pressure ventilation (CAPA): the efficacy is indeed, without risk. As long as there is no nasal congestion, allergic rhinitis, and can be tolerated, there are no contraindications, and it is the first choice for OSAHS patients. The disadvantage is that it needs to be used for a long time and carried on business trips. 2.Oral dainty appliance: It is suitable for mild to moderate OSAHS, with heavy tongue root plane stenosis, especially for the elderly. 3.Surgical treatment: 1.Palatopharyngoplasty: mainly to solve the stenosis of palatopharyngeal plane 2.Hard palate shortening – soft palate advancement: mainly to solve the stenosis of palatopharyngeal plane, hard palate retraction to narrow the front and rear diameter of palate plane 3.Chin tongue muscle advancement – hyoid suspension: to solve the stenosis of tongue root plane 4.Maxillary advancement: suitable for severe OSAHS due to maxillofacial deformity, with better efficacy, but the surgical damage is large 4.Minimally invasive treatment 1.Low-temperature plasma radiofrequency ablation: Ablation of inferior turbinate, soft palate, tonsils and tongue root is feasible to solve nasal, palatopharyngeal and tongue root plane stenosis, which is suitable for mild to moderate OSAHS. its biggest advantage is that it has less injury, less intraoperative bleeding, short operation time, can be completed by outpatient local anesthesia, and has light postoperative pain. 2.Soft palate stent implantation (Pillar soft palate implantation): It mainly treats snoring and also treats mild OSAHS, with higher price. 3.Lingual suspension and hyoid traction: mainly to solve the stenosis of tongue root plane, the price is higher. How to seek consultation if you suspect OSAHS? If you not only snore during sleep, but also have breath-holding and apnea, you should go to the hospital for consultation. So where and how do I go for a consultation? You should go to the Department of Otolaryngology, Head and Neck Surgery for the following examinations: 1. Physical examination: check whether there are enlarged turbinates, deviated nasal septum, nasal polyps, enlarged adenoids, enlarged tonsils, low hanging soft palate, enlarged uvula, enlarged tongue, small jaw, etc., and calculate body mass index BMI. 2. Sleep monitoring: it is the gold standard to confirm the diagnosis of OSAHS 3. Electronic nasopharyngoscopy + Muller 4.Lateral cephalometric film, upper airway CT: The above tests can confirm the diagnosis of OSAHS, clarify the severity, and assess whether there is anatomical stenosis. For those with anatomical stenosis of the upper airway, surgery may be considered as an option. However, it should be noted that overly obese individuals should lose weight while using a positive pressure ventilator (CAPA) to correct hypoxia and then operate at an elective date. If there is no significant anatomic stenosis, CAPA or oral appliances should be used.