Do you snore? If you are male, middle-aged, and fat, the answer is most likely yes. Then, did you know that snoring is a pathology? Perhaps you will laugh and snicker at this: “Pathology? I eat well and sleep well, so what’s wrong with me? That’s crazy!” It is true that people have long thought snoring is a normal phenomenon. Although snorers are often woken up in the middle of the night and complained by their family members or roommates, and although we are often tossed and turned by the sound of snoring around us, it seems that we can only put up with it because snoring is a “normal” phenomenon. In fact, snoring will not only disturb the sleep of people around you, but may even affect the relationship between you and your spouse or roommate, and more importantly, snoring may be a sign of sleep apnea at night, which will directly endanger your health.
So, how do snoring and sleep apnea develop? When breathing, air enters and leaves the lungs through the throat, and the airflow must pass through the soft and flexible pharyngeal tissues, such as the soft palate, the uvula, the tonsils, and the tongue. During the day, the muscles around these tissues are relatively tense and pull the pharyngeal tissues tight so that they do not block the airway. At night, during sleep, the muscles relax. Under normal conditions, the pharynx remains in a normal position and the airway can remain open, allowing gas to flow freely in and out. However, if the pharyngeal tissue is hypertrophied or the muscles are too relaxed during sleep, a partial narrowing of the airway may result. When the airflow passes from the nose or mouth to the narrowed area, the pharyngeal structures vibrate and resonate, resulting in the familiar snoring sound. Usually, the more obstructed the airway is, the worse the snoring. If the pharyngeal structures completely block the airway, the airflow is completely prevented from entering the lungs, at which point apnea occurs, leading to a lack of oxygen. Due to the lack of oxygen, the brain briefly awakens the body to the point where it is just able to tighten the muscles of the pharynx, thus releasing the airway obstruction, accompanied by a very loud gasp, and breathing returns to normal. The process repeats itself, making sleep so shallow and fragmented that when you wake up in the morning, you may not be aware of these processes, but you will feel very tired.
All people need enough sleep, but it does not mean a long sleep. The human sleep state is generally divided into non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM). The former is further divided into four periods, I, II, III and IV, the most important of which are periods III and IV (both together called slow wave sleep). People who sleep well generally have sufficient slow-wave sleep phases. Patients with sleep apnea syndrome, on the other hand, have very short periods of sleep in stages III and IV, or even no slow-wave sleep, due to serious disorders of sleep rhythm at night, so they still feel tired and drowsy even though they sleep for more than ten hours a day, which can easily lead to a series of social hazards such as traffic accidents and production operative accidents. And long-term oxygen deprivation will make the blood oxygen concentration drop, blood viscosity increase, the lungs, heart and other organs will be damaged, which will lead to some serious diseases, such as hypertension, coronary heart disease, arrhythmia, pulmonary heart disease, cerebrovascular accidents, endocrine disorders and neuropsychiatric disorders, etc., seriously endangering the health of patients and shortening their life span.
Since sleep apnea has such a serious danger, how can we know if we are suffering from the above-mentioned disorders as early as possible and try to avoid the danger? First of all, please try to answer the following questions together with your spouse or family members.
1. Do you snore often?
2. What is your height and weight? Is there a tendency of progressive weight gain?
3. Do you find it hard to breathe through your nose? Is there any obstruction in your nose?
4.Do you have insomnia?
5.Do you drink alcohol before going to bed?
6.Do you smoke? How many years have you smoked? How much do you smoke every day?
7.Do you often take anti-allergy drugs or sleeping pills and sedative drugs?
8.Do you snore loudly? Can you hear it in the other room?
9.Do you snore intermittently for a period of time, as if you have stopped breathing?
10.Do you often open your mouth to breathe when you sleep?
11.Do you wake up or make loud breathing sounds when you sleep?
12.Do you usually sleep in a supine position? Can your snoring be relieved when you change your sleeping position?
13.Do you feel headache and dry mouth when you wake up in the morning?
14.Do you feel very tired after waking up even though you have slept all night?
15.Do you have high blood pressure? And higher blood pressure after waking up?
16.Are you sleepy during the day? Have you ever fallen asleep while sitting at dinner or watching an interesting TV program? Have you ever fallen asleep at work or even while driving?
17.Do you often feel tired and sleep unstable?
18.Do you have difficulty concentrating or have memory loss?
19.Do you have an increased number of nighttime urination?
20.Do you have a reduced sex drive?
21.Have you been irritable and changed your temperament recently?
If you find that you have problems sleeping, please go to the hospital as soon as possible and present your condition to a specialist who will conduct a comprehensive evaluation. If sleep apnea is suspected, your doctor will arrange for you to have your sleep breathing monitored throughout the night. Overnight sleep monitoring is often an important tool to determine if you have sleep apnea. Sleep breathing monitoring records your oral and nasal airflow and oxygen saturation, heart and brain activity, muscle movements, body movements, blood pressure and snoring separately or simultaneously, and is a painless, risk-free test that usually requires an entire night. Depending on the circumstances, monitoring can be performed in a sleep monitoring laboratory or even in your own home. Once the sleep breathing monitoring results have been analyzed, your doctor will discuss them with you. The results of the sleep monitoring will help your doctor determine the nature and severity of your disease and what treatment is best for you.
Snoring and sleep apnea rarely heal on their own, but they can be treated. Many doctors used to believe that surgery was the most effective way to treat sleep apnea, but the long-term results of surgical treatment are now considered unsatisfactory, and the use of non-invasive, comprehensive treatment is more effective for many sleep apnea patients. Whether you suffer from sleep apnea or not, there are simple things you can do to reduce your snoring symptoms or sleep apnea, such as
Weight control and weight loss: In fact, sleep apnea occurs mostly in obese people; and obesity can make snoring worse. The extra weight puts pressure on the tissues of the lungs and neck, making the airway narrower. Losing some weight may significantly reduce the symptoms of apnea. Dieting and regular exercise are the best ways to control weight. Walking is an effective method of exercise for almost everyone, but you can also try small amounts of exercise, such as walking up and down stairs.
Avoid drinking alcohol and taking certain medications before bed: Alcohol and some medications such as sedatives, sleeping pills, and anti-allergy medications can make breathing shallow and slow and can make muscles more relaxed than usual, which makes the tissues in the throat more likely to block the airway and aggravate snoring and sleep apnea.
Take side sleep position: taking side sleep position can prevent the tissues of the pharynx and the back of the tongue from blocking the airway, it can also reduce the airway pressure caused by the extra weight of the abdomen, chest and neck, so it can help reduce snoring symptoms and even treat sleep apnea. You can sew a pocket on the back of your pajamas, put some hard items inside and sleep in this pajama, or you can sleep with a foam-filled backpack or a wedge-shaped pillow or a small leather ball, which will prevent you from sleeping in a supine position.
Quit smoking and keep your nose clear: If you smoke, try to quit because smoking can irritate the nasal passages and lead to chronic inflammation of the nasal and respiratory passages, blocking the airways. And if you have allergies, nasal polyps or other conditions that cause nasal blockage, medication or surgery for these conditions will help improve snoring or sleep apnea.
If your sleep apnea is more severe, or if the above methods do not improve your sleep apnea significantly, your doctor will recommend dental braces or continuous positive pressure ventilation.
Braces: Braces worn in the mouth at night may be used to prevent snoring and treat mild sleep apnea, or as an adjunct to continuous positive airway pressure treatment when the condition has subsided. If your doctor thinks you need them, they should be tried on after an examination by your dentist and usually require repeated adjustments for best results. After the trial, regular visits and even sleep breathing monitoring should be performed to ensure that the device fits properly, that your jaw and teeth have not been damaged, and that your sleep apnea has not worsened.
Continuous Positive Airway Pressure (CPAP): CPAP is by far the most effective method of treating sleep apnea. The method involves connecting a small air compressor to a nasal mask through a hose. While you sleep, the mask is put on and the machine is turned on, which sends a gentle, steady stream of positive air pressure through the nasal cavity into the pharynx, where the air pressure forces the soft tissues of the pharynx not to collapse, thus keeping the airway open. The amount of this airflow pressure to keep the airway open is determined by the surgeon after sociological monitoring.
Depending on the indications for surgical treatment, your doctor may recommend that you undergo surgery. There are several surgical approaches that may be effective for sleep-related breathing problems.
Uvulopalatopharyngoplasty (UPPP): UPPP is the most common surgical treatment for snoring and sleep apnea and involves the removal of the uvula, part of the soft palate, and the tonsils. UPPP is usually performed in the hospital. Anesthesia is required prior to the procedure. You may be hospitalized for 1-2 days after the procedure for observation, and more severe throat pain may last for several weeks, during which time you may only be able to eat liquid food. Full recovery usually takes about a month.
Laser-assisted uvulopalatoplasty (LAUP): LAUP is a modified surgical treatment in which the surgeon uses a laser to remove part or all of the uvula and part of the soft palate. These methods can treat snoring and to some extent mild obstructive sleep apnea. The procedure can be performed on an outpatient basis, with the patient remaining awake and using local anesthesia to eliminate pain. Only liquid food should be eaten during the day of surgery.
Other surgical procedures that can improve snoring and sleep apnea are
1. nasal surgery to remove nasal polyps or to correct a deviated septum.
2.Surgery to remove enlarged tonsils and adenoids.
3.Jaw surgery to make the lower jaw and tongue protrude forward and enlarge the airway.
4. Tracheotomy: Tracheotomy is necessary if you have severe, life-threatening sleep apnea or if other treatments have failed. In this procedure, an opening is made in the breathing pathway (trachea) in the neck, which is covered during the day and opened at night, allowing air to enter and exit the lungs directly without passing through the blocked pharyngeal airway.
Effective treatment of sleep apnea can provide you and your family with quiet and adequate sleep, and refresh and energize you during the day, as well as eliminate or reduce the multi-organ damage and complications caused by recurrent episodes of snoring or sleep apnea hypoxemia, improving health and prolonging life.