sleep apnea

Sleep apnea: description

Snoring is a common phenomenon that increases with age. Almost every second person produces nocturnal noises – but there is no respiratory arrest.

Sleep apnea is one of the sleep-disordered sleep disorders, abbreviated SBAS. They occur exclusively or primarily in sleep. The term “sleep apnea” comes from the Greek: “A-Pnoe” means something like “without breath”. Sleep apnea disturbs sleep and ensures that a person with sleep apnea syndrome does not wake up in the morning. This also often applies to the bed neighbor, who feels disturbed by the particularly loud and irregular snoring. Sleep apnea is dangerous, because the breathing interruptions during sleep can extend to a prolonged, threatening respiratory arrest.

There are no exact figures about how often sleep apnea actually occurs – not every “snorer” goes to the doctor. However, it is estimated that about two to four percent of the adult population between the ages of 30 and 60 is affected by sleep apnea. The frequency increases with age. Especially overweight people are affected: Around 80 percent of patients with sleep apnea syndrome are too fat.

Obstructive sleep apnea (OSAS)

Obstructive sleep apnea syndrome is the most common form of sleep apnea. During sleep, the muscles of the soft palate, which is located behind the uvula, become slack and the tongue falls back. As a result, the airways close partially or completely and the sleeper gets too little or no air.

The lack of respiration decreases the oxygen content in the blood (hypoxemia) and leads to a deficiency supply of the tissue. As a result, the body starts a “wake-up reaction”. It abruptly activates the respiratory muscles of the diaphragm and chest, and the heart also increases its power and blood pressure rises. The sleeping person usually wakes up for a short time. This awakening caused by sleep apnea is called “arousal” by physicians. Then resumes breathing, usually followed by several deep breaths. The respiratory arrest may take ten seconds to two minutes and occur up to 100 times a night. The person concerned can usually not remember the next morning that he has woken up at night because of lack of oxygen.

Central sleep apnea

The second form of sleep apnea is central sleep apnea. The trigger of this form is a malfunction in the central nervous system (CNS). Although the upper respiratory tract remains open, the respiratory muscles of the chest and diaphragm do not move sufficiently. Central sleep apnea mainly affects the elderly. This variant of the breathing disorder is often harmless and usually does not need to be treated. Unless it occurs in combination with heart failure or nerve disorders – then you should consult a doctor.

Sleep apnea: symptoms

Typical symptoms of sleep apnea are repeated Breathing interruptions in sleep, The respiratory arrest lasts between 10 and 120 seconds and occurs more than five times per hour. There are phases of excessive breath (Hyperventilations) as well as loud and irregular snoring (if the patient is straining to catch his breath). Partners and relatives not only notice the snoring but also the breathing pauses at night, while they are not aware of the person concerned.

Sleep apnea has consequences. In general, sleep is disturbed, so people with sleep apnea suffer from a chronic sleep deficit and daytime fatigue. They are also forgetful and can concentrate badly. This also increases the risk of accidents in traffic. Some people with sleep apnea also suffer from anxiety or depression. In part, the respiratory disorder leads to headaches (especially in the morning) and reduced sexual desire. Men may experience erectile dysfunction.

Children may also be affected by obstructive sleep apnea syndrome (OSAS). According to experts, respiratory disorders may also play a role in sudden infant death syndrome. Older children with OSAS are often sluggish and cumbersome. They are often noticed at school due to poorer performance.

Sleep apnea: causes and risk factors

There are several factors that determine the emergence of a obstructive sleep apnea syndrome favor. These include:

• Too high body mass index (overweight)
• Age (the older, the more vulnerable to sleep apnea)
• Gender (men are more affected than women)
• Taking sleeping pills or sedatives (muscles on the palate relax faster and close the airways)
• Deviations in the structure of the facial skull (craniofacial peculiarities): An example is a too small or falling back lower jaw or a crooked nasal septum.

Other risk factors include smoking, alcohol, pregnancy or existing conditions such as rheumatism, acromegaly, hypothyroidism or polycystic ovarian syndrome. Also, a large tongue, enlarged tonsils (tonsils), nasal polyps or much fat and connective tissue at the entrance of the respiratory tract may promote sleep apnea. Generally, irregular periods of sleep can aggravate the symptoms.

The central sleep apnea is rare and is caused by disturbances in the central nervous system (CNS). Due to neurological damage, the control of the respiratory muscles works poorly. One cause may be, for example, neuroborreliosis, a stage of tick borne Lyme disease.

Sleep apnea: examinations and diagnosis

Snoring often falls on the partner first. If respiratory arrest occurs, it is advisable to go to an ear, nose and throat (ENT) doctor. There is not “one” sleep apnea test, but different methods of diagnosis are used. The doctor will first introduce you to your medical history (Anamnese) ask, for example:

• Are pre-existing diseases known?
• Do you suffer from sleep disorders?
• Do you take any medications (such as sleeping pills or tranquilizers)?
• What about your alcohol consumption?
• Do you take drugs?
• What sleep habits do you have? Since your partner often knows this best, he should also take part in the survey if necessary.

The ENT doctor then looks for anatomical abnormalities in the nose and throat area – for example, bite abnormalities (position of the jaws to each other), curvature of the nasal septum or nasal and pharyngeal polyps. The paranasal sinuses can be visualized well using imaging techniques.

Sometimes it’s a walk into it sleep-laboratory unavoidable. Physicians analyze sleep patterns, respiration and other factors that indicate sleep disturbances (sleep apnea screening). As a rule, the stay in the sleep laboratory lasts one to two nights. Here, doctors use electrodes on the skin to measure, among other things, the airflow of the respiratory system, the pulse rate, the oxygen content in the blood and the movements of the chest. All this is under the term “Polysomnography” summarized.

In some cases additional sleepiness examinations are necessary. Of the Multiple Sleep Latency Test (MSLT) means that the patient should hold a short sleep of about 20 minutes several times a day, two hours apart. The test measures the tendency to fall asleep and the degree of daytime tiredness.

Sleep apnea: treatment

All major sleep apnea therapies can be found in the article sleep apnea treatment

Sleep apnea: disease course and prognosis

Obstructive sleep apnea should be treated unconditionally because it affects health as well as professional and private life. Patients with daytime sleepiness have a three to sevenfold increased probability of accident on the road. Sleep apnea is associated with hypertension, cardiac insufficiency, coronary heart disease, and cardiac arrhythmias (e.g., atrial fibrillation). Also, a link with pulmonary hypertension (hypertension), diabetes mellitus, renal insufficiency and atherosclerosis seems likely. Overall, obstructive sleep apnea syndrome is associated with increased mortality.

Quite apart from that, the snoring and the burden sleep apnea also the partnership is not negligible.