How does TCM recognize and treat sleep apnea syndrome?

  Snoring, commonly known as snoring, is caused by vibrating the soft tissues around the airway when the airflow passes through the narrow part of the upper airway at high speed during breathing. The nature of snoring is different for different people: the lighter ones only occur when they are tired, drinking or sleeping in supine position; the more serious ones snore like thunder at night and never stop, which is generally called habitual snoring; some people snore evenly and regularly, with the same high and low sound, generally without apnea, which is called simple snoring; some do not, with a sudden high and low sound, intermittently for tens of seconds to several minutes without any sound. The snoring sound is common in patients with sleep apnea syndrome.  Sleep apnea syndrome refers to those who have more than 3 0 repeated episodes of apnea or more than 5 sleep breathing disorder indexes per hour during 7 hours of sleep per night. It can be classified as obstructive, central sleep apnea and mixed. Obstructive sleep apnea syndrome is the most common type. Polysomnography is currently the standard method for diagnosing sleep apnea syndrome.  According to the preliminary estimation of American epidemiological survey, 20% of men and 5% of women snore in people aged 30-35 years old; in people aged around 60 years old, 60% of men and 40% of women snore; obese people snore three times more than thin people. A group of survey reports in the northeast of China showed that 52% of the 1101 elderly people had a history of snoring. During the trip and in the group dormitory, there are often people who are noisy by snoring, and there are many snorers among the friends and relatives around. For a long time, besides being regarded as a kind of noise affecting others’ rest, people did not think that snoring would cause much harm to the health of the patients themselves, so it was not taken seriously as a pathological phenomenon.  After the mid-1960s, the recognition of sleep apnea syndrome revealed that there was a close connection between snoring and apnea. Sleep snoring is not only the main sign of sleep apnea syndrome, which can affect the patient’s respiratory function, but is also closely related to the occurrence of hypertension, coronary heart disease including arrhythmia, angina pectoris and myocardial infarction, pulmonary heart disease, depression, acute respiratory failure, reflux esophagitis and other diseases. Snoring is no longer treated as a normal physiological phenomenon, and more and more people who are troubled by snoring are gradually becoming aware of the dangers of snoring.  Sleep apnea syndrome occurs in male adults and post-menopausal women, with the most frequent occurrence in middle age. The pathogenesis is still unclear, but it may be due to a combination of factors, including anatomical factors of the upper airway, central control of respiration, neurological, humoral and endocrine factors, as well as gender, age, obesity, genetics and drug factors. Western medicine advocates the use of weight loss, regular sleep time, sleep-inducing drugs, the use of soothing neck pillow, wearing mouthpiece, etc. for early and mild patients, and surgical symptomatic treatment for moderate and severe patients.  In Chinese medicine, sleep apnea syndrome is called snoring, “snoring”, nasal breath with sound, snoring sleep, also known as “snoring”, “snoring”, “snoring”. Snoring is also called “snoring”, “snoring”, “snoring” and “breath with sound”. Ancient literature such as “Nei Jing Su Wen? Inverse regulation theory”, “can not sleep and breath has sound, is the Yangming of the inverse also ……”; “typhoid”, “wind and temperature for the disease, the pulse of yin and Yang with floating, sweating, heavy body, more sleep, nasal breath must snore … …”; “The Treatise on the Origin of Diseases”, “Snoring is the sound between the throat and throat in sleep. ……”, etc., all have vivid records, describing snoring in more detail, and considering that due to various reasons The main cause of snoring is the malfunction of the lungs, spleen and kidneys in transporting water and fluids, resulting in the internal stagnation of phlegm and turbidity, which obstructs the veins and collaterals, or the intermingling of phlegm and blood, which overwhelms the clear orifices and deprives the brain of moistening.  Chinese medicine treatment generally advocates that on the basis of diagnosis and treatment, the basic principle is to benefit the qi and strengthen the spleen, expel phlegm and open the orifices, activate blood circulation and remove blood stasis, and de-stasis the qi mechanism. Commonly used basic formula is: Dan Shen, Acorus calamus, Yu Jin, Red peony, Citrus aurantium, Qing Han Xia, Chen Pi, Poria, etc., and then according to the clinical symptoms of the patient flexible addition and reduction.  If the patient is obese, drowsy, stuffy in the chest and epigastrium, dull and vomiting, with a pale tongue, white greasy coating and slippery pulse, with phlegm and dampness as the main manifestation, add Cang Zhu, Bai Zhu, White Mustard Seed, Su Zi and Su Stem to strengthen the spleen and dry dampness, smooth the qi and resolve phlegm.  If the patient has frequent inflammation of the tonsils bilaterally, obstruction of foreign bodies in the pharynx, insomnia at night, headache in the morning, irritability, coughing up yellow phlegm, dry stools, red tongue, yellow tongue coating, slippery pulse, etc., with phlegm-heat as the main manifestation, then add Guaou, Huang Lian, Bile South Star, and Sheng Gan to resolve phlegm and clear heat. If the symptoms of blood stasis are obvious, such as stuffiness in the chest, pain at times, dark face, blue lips, and dark tongue, then add peach kernel, red flower, angelica, chuanxiong, etc. to invigorate blood and remove blood stasis.  If the patient is weak and fat, sleepy and lazy, pale, tired and weak, dull and loose, pale, pale tongue and thin pulse and other symptoms of Qi deficiency are obvious, then add Astragalus, Radix Codonopsis, Rhizoma Atractylodis Macrocephalae and fried Coix seeds to strengthen the spleen and benefit Qi.  If the disease is prolonged, accompanied by weakness of the waist and knees, coldness, impotence, diminished intelligence, swelling of the lower extremities and other symptoms of deficiency of kidney yang, the addition of Pieces of Radix Aconiti, Radix Rehmanniae Praeparata, Semen Cuscutae, Xian Ling Spleen, Cinnamon, etc. to warm the kidney yang, benefit the qi and resolve turbidity.  Chinese medicine also believes that patients should advocate the use of body and brain in daily life, eat a vegetarian diet, eat less sweets, avoid alcohol and quit smoking, and sleep on their sides at night. Generally speaking, early detection, reasonable treatment, and adherence to a scientific diet and rest pattern will result in a better prognosis for most patients.