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Information about the treatment of apnea: how to get rid of temporary respiratory arrest in a dream?

Sleep apnea is a common problem that many people face. Full breathing is the basis of human life, and lack of air in a dream causes a lot of problems. It develops suddenly and is characterized by discomfort in the chest area, a person begins to experience panic, a feeling that someone is choking him.

Choking during sleep develops due to a decrease in oxygen concentration in the blood and an increase in the level of carbon dioxide. This condition is accompanied by violations of the autonomic function of the body, due to which unpleasant symptoms develop, and subsequently serious health problems are possible.

Causes of respiratory arrest in a dream

The causes of suffocation in a dream are not always associated with any disease - rare attacks sometimes occur in the absence of any pathologies after drinking alcohol, psycho-emotional stress, taking certain medications, and if there are allergens in the room where the person is sleeping. If respiratory arrest during sleep occurs constantly, you should pay attention to your own health. Among the most common factors that cause this pathology include disorders of the body from various systems and organs.

  1. Dysfunctions of the cardiovascular system (angina pectoris, arrhythmia, vascular crises, acute heart failure). These pathologies are characterized by a violation of the ability of the heart to pump blood normally, due to which oxygen metabolism is disturbed.
  2. Bronchial asthma. With this pathology, shortness of breath is often observed in patients, which can develop into nightly attacks of respiratory arrest.
  3. Thyroid disease. With some endocrine pathologies, an increase in the thyroid gland is observed, which presses on the trachea - for this reason, in a dream, it stops breathing and suffocation is felt.
  4. Sleep apnea. Syndrome of respiratory arrest in a dream is observed due to a decrease in muscle tone with excess weight, abuse of sedatives, an increase in tonsils. In the daytime, this condition is accompanied by drowsiness, a feeling of weakness, headaches in the morning, and spikes in blood pressure.
  5. Panic attacks. Unstable functioning of the nervous system causes panic attacks and symptoms similar to cardiovascular ailments (rapid or slow heartbeat, chills, intense fear of death).
  6. Sleepy paralysis. This is a condition that causes temporary immobilization. The brain does not send a signal to the rest of the body at the time of awakening, because of which a person remains conscious, but cannot move and speak, sometimes sees hallucinations and feels intense fear.

If the above pathologies are excluded, the answer to the question why you are suffocating in a dream should be sought in other factors. A list of secondary causes that can cause sleep apnea includes:

  • infectious and inflammatory processes, accompanied by swelling of the tonsils, an increase in adenoids, severe runny nose,
  • anatomical pathologies of the head, neck, face,
  • digestive system dysfunctions, autoimmune disorders,
  • excess weight,
  • smoking, including passive.

The first harbinger and another common reason for stopping breathing in a dream is constant snoring, which causes changes in the activity of the respiratory system, which is why suffocation develops. Accordingly, people who often snore are at risk for developing night apnea.

Pregnant women can also suffer from attacks of night suffocation - this often happens in the last months, when the fetus begins to put pressure on the diaphragm. This condition does not pose a serious threat to the health of the mother or child, but in order to eliminate unpleasant sensations and reduce the risk of oxygen starvation, a woman is recommended to sleep on a bed with a raised headboard, or to put pillows under the back.

How is it manifested?

The main manifestation is a sensation of suffocation and the inability to breathe fully, and sometimes breathing stops when falling asleep, and in some cases it stops directly during a night's rest. Those who had to deal with this condition describe it as follows: “I wake up from the fact that I don’t breathe, or suffocate when I fall asleep, I’m afraid not to wake up anymore, but I can’t move and ask for help.” This condition develops in several stages:

  • at the first stage, the activity of the respiratory system is activated, the frequency and depth of inspiration increase along with blood pressure and pulse,
  • the next phase is characterized by the reverse process - vital signs are reduced, fingers and nasolabial triangle acquire a cyanotic shade,
  • during the third stage, the activity of the respiratory organs is disturbed, a respiratory arrest occurs, which lasts from a couple of seconds to 2-3 minutes, the reflexes fade, blood pressure drops, convulsions or uncontrolled muscle twitching may develop,
  • during the last phase, serious respiratory rhythm disturbances occur - breathing becomes short and deep, inspirations become difficult and convulsive, and exhalations are rare.

Some people do not suspect that they stop breathing during sleep or when falling asleep. To identify violations, it is necessary to observe the state of the sleeper - he begins to snore, after which apnea occurs. Snoring and respiratory noise subside, the chest and abdomen move, and after 15-30 seconds, breathing is restored, the sleeping snoring loudly, and normal breathing is restored. Sleep at this time, as a rule, is very restless - a person rushes about, moves limbs and tries to say something.

What is the danger of respiratory arrest during sleep?

Having discovered apnea in himself, a person first of all thinks, “If I gasp when I fall asleep, what consequences can this entail?” In addition to the serious discomfort that causes this condition, it causes chronic fatigue, decreased performance, impaired immunity and metabolic processes, and depression. In addition, people who suffer from apnea have an increased risk of developing hypertension, strokes and heart attacks - pathologies that can lead to death.

Diagnostics

The diagnosis of the development of such symptoms is made on the basis of symptoms and medical history - the identification of diseases that can cause respiratory arrest. The following methods and procedures are used for accurate diagnosis of pathology:

  • clinical tests of blood and urine to detect inflammatory and infectious processes in the body,
  • examination of the respiratory system for changes in tissues, foci of compaction, neoplasms and other pathologies (radiography, computed and magnetic resonance imaging, bronchoscopy, thorascopy),
  • electrocardiogram for assessing the activity of the cardiovascular system,
  • polysomnography, or prolonged registration of brain impulses, respiratory activity, and other vital signs of the body during sleep.

The above diagnostic methods allow you to determine the number and duration of episodes of respiratory arrest, identify changes in body functions at this time, and establish the cause of the pathology.

First aid for choking

The patient should be helped to sit down (in this position, the muscles that are responsible for breathing work better), calm him down, and then provide an influx of fresh air - unfasten clothing on his chest, open a window or window. If a person continues to sleep during respiratory dysfunction, he should be carefully woken up, sat down and forced to breathe deeply through his nose.

In cases where bronchial asthma is the cause of apnea, you can put mustard plasters on the chest, a warm compress on the feet, and take a medication inside to expand the bronchi (e.g., Eufilin). In case of respiratory dysfunction due to swelling of the larynx of an allergic origin, any antihistamine medication in the form of tablets or injections should be given to the patient, and for cardiovascular diseases - Validol, Valocordin or Nitroglycerin. It is better not to give the patient a drink, since a person’s throat is strained after an apnea attack, and fluid can provoke a relapse of the pathology and another attack.

Treatment of respiratory arrest in sleep - CPAP therapy

Treatment for holding your breath

To completely get rid of asthma attacks, you should answer the question why breathing stops in a dream - consult a somnologist and undergo a comprehensive diagnosis. The treatment of respiratory arrest in a dream primarily involves eliminating the root cause of the pathology. If respiratory function is impaired due to the intake of alcohol, smoking or the use of sleeping pills, it is necessary to abandon these habits, and soon the patient's condition will return to normal. In infectious and inflammatory diseases, therapy with decongestants, antihistamines and vasoconstrictors is necessary, and in case of obesity it is necessary to normalize nutrition, begin to play sports and lose weight. Similar recommendations are also suitable for people who suffer from suffocation during sleep due to central nervous system disorders - the right way of life, easy physical activity and walking in the fresh air will help normalize sleep function and breathing.

A good effect when stopping breathing at night is given by medical techniques that are aimed at artificial ventilation of the lungs (SINAP, VIPAP therapy, etc.), as well as special mouthguards that prevent the tongue from dropping and relaxing the muscles of the larynx. In case of violations of the anatomical structure of the palate or nasopharynx, patients are indicated for surgical intervention.

Stopping breathing in a dream is not a harmless pathology that causes discomfort and interferes with sleep, but a serious disease that requires timely diagnosis and therapy. To find out how to treat respiratory delays in a dream, you should consult a specialist immediately after the onset of the first symptoms.

What is sleep apnea

Sleep apnea is a disease of the respiratory system, which is characterized by respiratory arrest in sleep for more than 10 seconds.

As a rule, pulmonary ventilation stops for 20-30 seconds, but it happens that the breath hold lasts longer - up to 3 minutes.

Most often, this disease, like snoring in general, occurs in men due to the structural features of the nasopharynx.
The risk of sleep apnea increases in smokers and in older people.

Apnea is of 2 types:

The first type is much more common. With obstructive apnea, the muscles of the pharynx relax, and the respiratory lumen closes, hence the breath holding.

The second type of disease is quite rare. With central apnea, the signaling mechanism from the brain to the muscles involved in the breathing process is confused.

The causes of apnea are numerous: overweight, especially the respiratory tract, inflammation of the nasopharynx, obstruction of the pharynx (for the same reason, people snore) - these are the main “culprits” of this problem.

Why is night apnea dangerous?

First of all, it leads to hypoxia, i.e. lack of oxygen, because in connection with respiratory arrest, the brain receives less oxygen than usual.

Often due to apnea attacks, repeated several times during the night, the normal course of sleep is disturbed, a person wakes up at night, and in the morning feels tired and sleepy. This, in turn, helps to reduce attention and intelligence and can cause an accident, for example, sudden falling asleep while driving or injury at work due to distracted attention.

Which doctor is treating?

An apnea specialist is determined by the cause of the illness. First of all, you should contact your therapist. Most likely, you will be sent first to the otolaryngologist, he will check the condition of the respiratory tract.

Almost always, the patient is tested by a somnologist, a doctor who specializes in treating sleep disorders.

Do not neglect the visit of a cardiologist, who will help to notice heart problems in time and reduce the risk of a heart attack from apnea. Sometimes the cause of nighttime respiratory arrest is an incorrect bite - in this case, you should correct it at the dentist. In some cases, treatment is prescribed by an endocrinologist.

But, as a rule, he leads the patient and puts the final diagnosis to the somnologist.

Accordingly, in which clinics they treat apnea, it will also depend on the causes of the disease.

The following sections describe how to treat night apnea.

Medication method

How to treat apnea medication? Drug treatment of sleep apnea syndrome is not a priority. Rather, it is an adjuvant therapy.

With obstructive apnea, drug treatment is generally ineffective.

Sometimes, because apnea is accompanied by snoring, prescription drugs for snoring are prescribed: Dr. Snore, Silences and others.

They are based on natural ingredients and essential oils, which help to facilitate breathing and eliminate the overlap of the lumen of the pharynx during sleep.

If the problem is more serious, and the patient suffers from central apnea, there is a treatment with drugs to stimulate breathing. Here are the most common medications for apnea:

Sometimes drugs are used to suppress the REM phase, in which apnea occurs.

Surgical method

How is apnea treated in other ways? Surgical treatment of sleep apnea can also be used if the cause of the disease is an incorrect respiratory structure. For example, a curvature of the nasal septum, which is successfully removed by surgery, or greatly enlarged tonsils (in this case, they should be removed). If you want to expand the airways, a laser operation is performed on the soft tissues.

Often the cause of respiratory delays during sleep are abnormalities in the structure of the jaw. In this case, dental surgery is indicated.

Hardware method

How to treat sleep apnea with special therapies? Apparatus therapy is one of the most common ways to treat apnea.

If the problem is in the structure of the lower jaw, special mouthguards are used that push it forward slightly during sleep and do not allow the lumen of the pharynx to overlap.

A similar apparatus for treating apnea is the mandibular splint. It is made of rubber and is worn on the lower teeth, helping to keep the jaw and tongue in a comfortable position for breathing. Great for apnea training!

Classics in the treatment of apnea are CPAP, or CPAP therapy. This is the use of a special apparatus for sleeping with apnea, which creates positive pressure in the airways, which helps to expand the respiratory clearance. The patient puts a small mask on his nose and mouth. Air flows through the tube from the apparatus. Modern CPAP devices do not create noise and even have humidifiers.

Preventative treatment


The main treatment for snoring and sleep apnea can be supplemented with preventative measures.
If you follow them, the problem will be solved faster.Preventive measures include:

  • quitting smoking and alcohol,
  • weight control
  • treatment of concomitant diseases, if any,
  • breathing exercises.

Conclusion

Sleep apnea is not the most harmless phenomenon. Therefore, do not disregard disturbing symptoms, listen to household members if they say that you have a restless sleep, you snore severely or hold your breath in a dream. All this is an occasion to take care of your health and visit a doctor on time. Now you know a lot about apnea: what it is, how to treat it.

What is "night apnea"

By this term is meant partial or complete respiratory arrest during sleep. These periods last no longer than a few minutes, so they are practically not able to lead to sudden death. The brain manages to notice a deficiency of oxygen, after which it makes a person wake up and restore normal breathing. The disease is hidden and some people may not notice it for several years or even decades.

However, respiratory problems occur every night and cause chronic oxygen deficiency, which continues to persist even in the daytime. The patient has a metabolic disorder, a decrease in the functions of various organs, and hormonal changes. The result is the development of complications and the appearance of other diseases.

The following are the most common complications of sleep apnea:

  • Obesity,
  • Arterial hypertension - an increase in blood pressure of more than 140/90 mm Hg,
  • Diabetes and prediabetes (synonym - “impaired glucose tolerance”),
  • Atherosclerosis is the deposition of plaques on the wall of arteries that feed various organs with blood,
  • Coronary heart disease, including rhythm disturbances, angina pectoris (chest pains), heart attack,
  • Cerebrovascular disease (abbreviated as CVB). This is a group of pathologies in which the brain's nutrition and part of its functions are disturbed: memory, attention, control over emotions, etc.,
  • Chronic heart failure is an irreversible damage to the heart muscle, in which the blood begins to “stagnate” in various organs / tissues.

It should be noted that each of the above diseases reduces life expectancy and reduces its quality. About 500 thousand people die from these diseases every year. Of these, 40-70 thousand people suffered from apnea syndrome, which caused or aggravated the underlying disease. To get rid of him and reduce the risk of developing these pathologies is the main task of the patient who wants to extend his life.

Causes and options for the disease

There are two groups of reasons why a person is faced with this disease.

  • The first is a partial obstruction of the airways. As a rule, impaired patency occurs at the level of the nose or pharynx. It is associated with various anatomical defects or chronic diseases. Often, temporary apnea is observed in patients with obesity, chronic rhinitis, curvature of the nasal septum, polypous rhinosinusitis, etc.
  • The second group of causes is a malfunction of the respiratory center of the brain. Since in a dream a person cannot consciously control the process of respiration, this function entirely rests on the reflexes of the nervous system. During sleep apnea, the brain partially loses control over this process, which causes “interruptions” in the supply of oxygen to the blood.

Depending on the cause of apnea, three variants of the disease are distinguished:

  1. Obstructive - this form is associated with impaired air conduction,
  2. Central - oxygen deficiency occurs due to malfunction of the respiratory center,
  3. Mixed - one person has two pathological factors at the same time.

Determining the type of disease is important for selecting the right therapy, which will eliminate the very cause of the disease, and affect the mechanisms of its development.The table below summarizes all the necessary information that will help to understand this issue.

Sleep - at this time the muscles throughout the body relax and are practically not controlled by the brain. The muscles of the pharynx, which provide patency of the respiratory tract, are no exception.

In the presence of one of the factors listed above, they relax too much and close the lumen of the larynx, where air should flow. This leads to a partial or complete respiratory arrest.

When the brain detects a deficiency of oxygen in the blood, it "gives the order" to release stress hormones: adrenaline and cortisol. This leads to an increase in blood pressure, an increase in blood glucose and an awakening of the body.

Awakened body restores muscle tone and normal breathing. Then it falls asleep again, and the cycle repeats again.

  • The use of sleeping pills, tranquilizers (haloperidol, chlopromazine) or potent sedatives (diazepam, phenazepam, clonazepam, etc.),
  • Alcohol or drug intoxication,
  • Hypothyroidism,
  • Some neurological pathologies: stroke and condition after a stroke, Parkinson's disease / syndrome, Alzheimer's disease and others.
“Trigger” factor of respiratory disorders
Body response

The mixed option is the most difficult in terms of treatment, since it combines two mechanisms of respiratory failure. Therefore, to eliminate the symptoms, it is necessary to eliminate two causes at the same time. Otherwise, therapy will be ineffective.

Symptoms

Since this syndrome occurs only in a dream, it is quite difficult to detect the disease yourself. However, 100% of people suffering from apnea have characteristic breathing in a dream - periods of loud snoring alternate with interruption of breathing. Others can’t notice this. If a person sleeps alone and does not know that he is snoring, then you should pay attention to other signs of the disease, which include:

  • Frequent nightmares or restless sleep. The lack of oxygen flow to the brain leads to a change in its work and disruption of information processing. This process is manifested by a change in the nature of dreams. They become frightening, chaotic, tense. The sleep process does not refresh the patient and does not allow him to rest, but rather depresses him and causes anxiety,
  • Regular night awakenings. The production of stress hormones and the restoration of breathing are invariably accompanied by interruption of sleep. There can be a different number of such apnea attacks - from single episodes to several tens of times. If they occur constantly (within weeks or months), it is necessary to suspect the presence of a hidden pathology,
  • Daytime sleepiness. For normal performance, people need to sleep 6-9 hours daily. Otherwise, the natural biorhythm fails and a feeling of constant lack of sleep appears,
  • Decreased attention and performance. Over time, air deficiency begins to occur in patients not only at night - it continues to persist during wakefulness. An excess of carbon dioxide in the blood negatively affects the brain, which causes a disruption in its functioning,
  • Decreased mental ability,
  • Emotional lability: unreasonable mood swings, constant irritability, bitterness, tendency to depression,
  • Decreased libido in men and women.

Also, one should not forget about the objective signs of the disease. Constant respiratory arrest during apnea inevitably leads to the development of complications. You can suspect them by the following criteria:

Increased blood pressure over 140/90 mm Hg

An increase in body mass index (BMI) of more than 30 BMI =

Fasting glucose increase:

Whole blood - more than 6.1 mmol / l,

Venous blood (plasma) - more than 7.0 mmol / L.

Change in blood lipid concentration:

Total cholesterol - more than 6.1 mmol / l,

LDL - more than 3.0 mmol / l,

HDL - less than 1.2 mmol / l,

Triglycerides - more than 1.7 mmol / l

  • The formation of persistent arterial hypertension and chronic heart failure,
  • Increased risk of vascular accidents: strokes, heart attacks, transient ischemic attacks,
  • The development of cerebrovascular disease.
  • The development of obesity,
  • Increased likelihood of diabetes and prediabetes,
  • The formation of atherosclerosis and coronary heart disease,
  • Perhaps the development of fatty liver damage.

Changing laboratory indicators
The level of C-reactive protein is more than 4 mg / lIncreased risk of heart and vascular diseases: angina pectoris, rhythm disturbances, heart attacks, chronic heart muscle failure.

Gold Standard Diagnostics

According to European recommendations, the best method for diagnosing the disease is a polysomnographic study. However, in Russia this method is used extremely rarely, only in large scientific centers or private clinics.

The principle of polysomnography is quite simple:

  1. The patient falls asleep or is immersed in a dream using hardware or drug methods,
  2. In the process of sleep, the patient undergoes the following studies: electroencephalography, electrocardiography, evaluation of the blood coagulation system, chin electromyogram, pulse oximetry, air flow assessment, counting respiratory movements of the chest and abdomen, leg muscle electromyography,
  3. The doctor evaluates the results and compares them with the norms.

To perform such a comprehensive examination in the Russian Federation is almost impossible. Therefore, the diagnosis of this pathology is based on patient complaints, the presence of risk factors, questionnaire data and pulse oximetry.

Causes of Obstructive Sleep Apnea Syndrome

Factors contributing to respiratory arrest in sleep with OSAS:

  • Violations of the structure of the jaw. If the jaw is not large enough, during sleep, the person’s tongue sinks backward, blocking the airways.
  • Too big language.
  • Small or short neck.
  • Excess weight or obesity - in this case, a fatty “clutch” surrounds the pharynx, squeezing it.
  • Enlarged tonsils or adenoids - create a mechanical barrier to air intake.
  • Drinking alcohol or sleeping pills - they relax the muscles of the pharynx to such a state that they practically stick together, preventing a person from breathing in a dream.
  • Recent operations on the upper respiratory tract.
  • Chronic diseases of the upper respiratory tract - sinusitis or vasomotor rhinitis.

When breathing stops caused by OSAS, a person feels a sharp oxygen starvation, since oxygen retention lasts for a rather long time. To finally get the necessary oxygen, the brain awakens sharply and sends a signal to the lungs, which forces a person to take a sharp, noisy breath. After this, a person can snore quite loudly until the muscles relax again and the next episode of apnea occurs.

Modern treatment principles

To successfully get rid of the disease, you need to know its variant (obstructive, central or mixed) and the immediate cause of the pathology (curvature of the nasal septum, the presence of adenoids, etc.). Only after this can we begin treatment of sleep apnea, the purpose of which is to restore the patency of the respiratory tract.

Causes of central sleep apnea syndrome

SCAS can be caused by a number of reasons related to the work of the brain:

  • Opioid drug use - heroin, morphine, methadone.
  • Heart or kidney failure.
  • Being high in the mountains.
  • The passage of CPAP therapy. During this therapy, SCAS is a side effect that disappears after therapy ends.

How to treat apnea: a healthy lifestyle

First of all, the traditional advice: a person who has been diagnosed with sleep apnea should change his lifestyle. There are patients who need to lose their weight to get rid of sleep apnea. Overweight is one of the main causes of the disease. Apnea syndrome and weight are interconnected - 77% of overweight people suffer from various sleep disorders, and 70% of apnea patients are overweight. It was noticed that even with a slight decrease in weight, the quality of sleep improved, and vice versa: with the treatment of apnea, a person began to lose weight.

In 2009, researchers at the Swedish Carolina Institute under the guidance of Professor Martin Neovius showed that after 9 weeks of a diet with a calorie restriction of up to 500 per day, overweight men experienced a weakening of apnea symptoms to 21 attacks per hour. In the final study, it was found that over the next year after losing weight, despite the fact that men gained most of the weight, the improvement continued. Even not with such a strict calorie restriction, but only at 1200-1500 calories per day, the diet among the study group of 250 people in studies conducted by a professor at the School of Medicine at the University of Pennsylvania showed an improvement in the condition of patients 3 times more often than in the control group.

Be careful about bedtime. The last meal should be no later than 4 hours before bedtime, 2 hours before bedtime only a light snack is allowed in the form of kefir, cookies, apples. It is necessary to abandon alcohol before bedtime and not take sedatives - they cause a decrease in the tone of the muscles of the pharynx. These factors provoke a decrease in the wall of the lumen of the respiratory tract, which causes respiratory arrest.

You need to sleep on your side. Sleep on the back can contribute to the retraction of the tongue during snoring, which again leads to an attack of apnea. In order not to roll over on your back in a dream, it’s enough to make a small life-flash - sew on your pajamas pockets on your back and put a tennis ball in it. The ball will put pressure on his back and wake the sleeping person when turning. After 4 weeks of torment, the body will get used to sleeping on its side.

The pillow also affects the frequency of seizures. On a high pillow, the head takes an incorrect position and the airways are constricted. The pillow must be replaced with either a flat or orthopedic one. An even better option is to purchase a bed with a slightly raised headboard.

Positive pressure treatment

CPAP therapy, a method based on the creation of constant positive airway pressure, has recently become widely used to treat sleep apnea - temporary respiratory arrest in sleep. To apply this method, a special CPAP device is used. Before going to bed, the patient wears a special mask on his nose, reliably fixes it on his head so that it does not slip during sleep. Through it, oxygen is supplied to the respiratory tract under pressure, which helps to maintain the airway clearance in a normal working condition. The pressure level can be individually adjusted to adjust it to more effectively prevent airway lumen collapse.

Thanks to CPAP therapy, obstruction is eliminated, respiratory delays in sleep cease, sleep is normalized and the patient's well-being improves from the first night of use. Regular use of the device reduces the risk of heart attacks, strokes, and hypertension. CPAP therapy is by far the most effective method for treating sleep apnea in patients with moderate and severe forms of obstructive apnea.

In addition to CPAP equipment, more compact devices based on the method of treatment with positive pressure have been developed and are successfully used. Nasal EPAP special nose devices have 2 valves that allow air to enter and prevent it from exiting.Nasal EPAPs are effective for people with mild illnesses and help reduce it to moderate. They are also used for frequently traveling people who have apnea syndrome.

Intraoral devices

If airway obstruction occurs due to retraction of the tongue or other structural features of the lower jaw, patients are advised to use special intraoral devices during sleep. All kinds of mouthpieces, mouthguards and other fixatives push the lower jaw forward and keep the tongue from falling. In this position, the airway at night does not overlap. These devices only help with mild forms of the disease.

Surgery

If nocturnal apnea is caused by reasons subject to surgical treatment, then a variety of surgical treatment methods are used, including:

  • nasal septum correction,
  • removal of tonsils and adenoids,
  • uvulopalatoplasty - a change in the shape of the soft palate, partial / complete removal of the palatine tongue, sometimes the installation of soft palate implants, etc.

To select the method of operation and the site of intervention, a dynamic assessment of the upper respiratory tract is performed using polysomnography or respiratory monitoring or other studies.

For many, single operations are ineffective, the effect can be achieved by a multilevel modification of the upper respiratory tract, performed surgically simultaneously or in stages. The standard protocol is uvulopalatopharyngoplasty (removal of the palatine tongue, soft palate, tonsils) with extension of the chin-muscle, hyoid myotomy and maxillo-mandibular displacement (increases the space of the posterior airways). Operations are performed using minimally invasive methods of laser and radio wave surgery.

The main benefit of the operation is that it increases the oxygen saturation of arterial blood. In 2008 The Stanford Center for Somnology and Sleep Medicine published a study according to which 93.3% of operated patients achieved a normal standard of living. Surgical intervention has led to an increase in overall productivity, activity level, social results, attentiveness, communication and personal life.

Medicines

Medicines are mainly used to treat central apnea, apnea, which has other mechanisms than obstructive. For treatment, an agent such as acetazolamide or zolpidem and triazolam is used. Unfortunately, long-term use of acetazolamide is poorly tolerated, and acetazolamide and zolpidem have certain risk factors. Therefore, only the attending physician will be able to make an appointment.

As for obstructive apnea, several approaches to drug therapy have been developed:

  • increased respiratory activity,
  • tone of the upper respiratory tract
  • micro-awakening threshold
  • REM sleep suppression.

The effectiveness of these drugs has not been proven.

Home treatment

At home, you can reduce the number of apnea attacks, and sometimes even cure if apnea syndrome occurs against the background of obesity. To do this, you must follow a diet and give the body the necessary physical activity. For example, daily apnea training of soft palate muscles will help increase muscle tone:

  1. Pull the tongue as far forward as possible, tighten it, hold for a couple of seconds. Do 30 times in the morning and evening.
  2. Move the lower jaw up and down, while holding it with your hand (also 30 repetitions).
  3. Use your teeth to grip the wooden pencil for 4 minutes.
  4. Pronounce vowels clearly and loudly in any order.

With a regular approach and responsible execution, positive results will be visible after a month of classes. Effectively complement this exercise regular singing at home. During vocal exercises, it is precisely those muscles that fall during an attack that are trained.

Another method of training the muscle tone of the upper respiratory tract can be considered ujai-pranayama, during which the muscles of the nasal and oropharynx are held in a compressed state during inspiration. Exercise is also called snake breathing. With regular yoga practice, "snake breathing" forms a stable muscle stereotype.

Some help with a simple finger massage. You need to do it on an empty stomach and in front of the mirror. Open your mouth wide in front of the mirror and with your index finger go over the tongue and for a couple of minutes (how much will turn out), massage the muscles of the soft palate with a pendulum movement. Make more intense movements in the area up to the tongue. A course of 15 days strengthens the muscles of the soft palate.

Some more tips:

  • Before going to bed, rinse the nasal passages with water and sea salt or aquamaris, drawing the solution into you,
  • to facilitate nasal breathing, drip 4-5 drops of sea buckthorn oil in your nose for 3-4 weeks.

List of used literature:

  • Wayne A.M., Eligulashvili T.S., Poluektov M.G. Sleep apnea syndrome. - M .: Eidos Media, 2002. - 218 p.
  • Nikolin K.M. Sleep Apnea Syndrome (lecture for doctors). - St. Petersburg, 2005 - 21 p.
  • Pustozerov V. G., Zhulev N. M. Modern methods for the diagnosis and treatment of sleep disorders: a training manual. - St. Petersburg: SPbMAPO, 2002. - 13 p.

Causes of Sleep Apnea

During apnea, breath holding lasts 10 seconds or more. In rare cases, the delay time can reach 3 minutes, which in turn has a negative effect on health. In the running version breathing can stop up to 300-500 times per night. At the same time, for the whole dream a person does not breathe for a total of 2, or even 3-4 hours.

Night apnea is preceded by loud snoring when a person sleeps lying on his back.

The cause of apnea is associated with relaxation of the muscles of the pharynx. Due to weak muscles in the throat, negative pressure is created, while the walls of the respiratory tract simply stick together. As a result, air first enters the lungs in limited quantities, thereby leading to snoring, and then does not pass into the respiratory tract at all.

The brain responds to apnea by awakening, while the person with apnea does not remember the awakenings themselves. Such a shake is necessary because it “reminds” the body that oxygen does not enter the lungs. By the way, if the brain did not give signals of awakening, each apnea would end fatal.

In addition to relaxing the muscles of the pharynx, the causes of apnea can be:

  • excess weight,
  • brain diseases
  • atrophy of the muscles of the body,
  • irregular structure of the nasal septum,
  • improper head position during sleep.

Adult Apnea: Symptoms

Before we talk about the treatment of apnea at home, we describe the main symptoms of the disease.

  • Snore. If your partner says you snore at night, you are clearly at high risk for apnea.
  • Drowsiness during the day. Due to lack of oxygen and frequent awakenings, the brain does not rest fully. Therefore, a person with sleep apnea constantly feels tired and irresistible drowsiness.
  • Skin color changes on the face. Disturbed breathing in a dream gives the skin a bluish tint. The reason for this, again, is oxygen deficiency.
  • Nightmares. Deterioration of the brain provokes the appearance of nightmares.
  • Dry mouth in the morning. Intermittent breathing dries out the oral mucosa. Because of this, a person with apnea is very thirsty after waking up.
  • High blood pressure. During night apnea, the level of adrenaline in the blood rises - a stress hormone that increases blood pressure.
  • Persistent headaches. Improper breathing in a dream leads to spasms of the vessels of the head, which leads to frequent headaches.

If you find at least one of the listed symptoms, you should see a doctor.

Sleep Apnea in Children

Separately, it is worth talking about sleep apnea in children.Causes of the disease in childhood are usually similar to those observed in adults. The respiratory arrest in children at night is associated with an increase in tonsils, weak swallowing muscles and neurological pathologies. Apnea is especially common in premature infants and children with cerebral palsy.

You can detect a disease in a child by the following symptoms:

  • coughing during sleep
  • daytime sleepiness
  • wheezing when breathing
  • sweating
  • bluish skin tone.

Apnea: diagnosis of the disease

Close people living with the patient will help in the diagnosis of apnea. One of them will observe the frequency of breath holdings in a dream. If it turns out that the number of respiratory arrests is more than 15 per night, it is worth taking measures to treat apnea at home or with a specialist doctor.

In addition to the number of apnea attacks, you need to calculate BMI - body mass index. It is calculated by the formula "body weight in kg divided by height in meters squared". The resulting value should be less than 30. If more, it is time to lose weight, since in this case the risk of developing apnea increases.

For example, we calculate the normal BMI for a person with a height of 180 cm and a weight of 100 kg. We are counting: 100 / 1.8 * 1.8 = 30.8. BMI in this case is higher than normal, which means that there is a high probability of developing apnea.

Blood pressure is greater than 140 to 90 mm RT. Art. increases the risk of apnea. Moreover, the risk of developing the disease increases if the pressure is combined with excess weight.

Authentic availability of apnea will help to find out polysomnography. The procedure is a dream with sensors connected to the body that fix physiological parameters. This diagnostic method determines the frequency and duration of respiratory arrest in a dream. In addition, polysomnography shows the level of brain and respiratory activity.

Classification

Typically, holding your breath in a dream does not exceed three minutes, because the brain responds to oxygen deficiency, forcing a person to wake up, while restoring normal functioning.
Depending on the factors that cause respiratory arrest, the following varieties of apnea are distinguished:

  • obstructive, arising from the appearance of obstruction (blockade) in the upper respiratory tract,
  • central, due to an imbalance in the functioning of the brain or heart,
  • mixed, indicating the presence of a complex of respiratory disorders.

In accordance with the number of respiratory arrests per night, three degrees are distinguished that characterize the severity of the course of the disease:

Proper identification of the type of apnea becomes a priority condition for the appointment of effective therapeutic measures.

Causes of Night Apnea

Known causes of apnea are varied and vary depending on the type of disease.
Considering the factors that provoke the occurrence of obstructive apnea, several of their types are distinguished.

1. Obstruction of the airways for free movement of air.

Such a phenomenon can occur for several reasons:

  • congenital pathology of the respiratory tract, expressed in their narrowing,
  • Thornwald cyst, polyps localized in the nose,
  • curvature of the nasal septum,
  • adenoids,
  • frequent relapses of tonsillitis,
  • allergy,
  • underdeveloped lower jaw with displacement back,
  • tumor processes in the pharynx,
  • tongue enlargement as a result of acromegaly,
  • obesity.

2. Loss of tone of the pharyngeal muscles.

The following adverse factors can provoke such violations:

  • alcohol abuse
  • taking certain medications that promote muscle relaxation - some sleeping pills, tranquilizers, muscle relaxants,
  • thyroid disease
  • the appearance of an imbalance during the passage of nerve impulses generated by the brain, which are designed to keep the muscles in good shape, with the development of myodystrophy and other muscle pathologies,
  • damage due to trauma or surgical intervention of peripheral nerves.

By analyzing which reason is key to the development of central apnea, characterized by a sudden lack of signals from the brain to the respiratory muscles that control breathing. several groups of adverse provoking factors should be distinguished.

  • A sharp decrease in the normal functioning of the respiratory center located in the brain. A similar condition is observed with Undine's syndrome, brain stem injury, the development of tumors, cysts, or hemorrhage.
  • Inadequate blood supply or impaired gas exchange. Such causes of respiratory arrest in a dream appear with cardiovascular or pulmonary diseases.

It is noted that in identifying apnea in adults, men are more often at risk.

Sleep apnea: home treatment

The treatment of apnea at home suggests the following factors.

  • Sleep in the right position. For the prevention of night apnea, it is better to sleep on your side. However, during sleep, it is difficult to lie without turning on your back. To avoid sleeping on your back, tie or tape a small ball that will not allow you to turn on your back. In addition to the position of the torso, the correct position of the head is also important, which should be slightly raised. And for this you need to choose the right pillow.
  • Refusal of sleeping pills and muscle relaxants. The drugs of these groups relax the muscles of the respiratory tract. So, their reception will only enhance nighttime sleep apnea. Also note that these drugs can be dangerous for patients with apnea. When using them, the brain may not signal the body about awakening during apnea, but this is fraught with a complete stop of breathing.
  • Slimming. If you are overweight, then for the treatment of apnea should get rid of a few pounds. This will help you count calories, proper nutrition and physical activity.
  • The use of CPAP therapy. To do this, use a special device consisting of a control unit and a humidifier in the form of a mask for sleeping. Thanks to the device in the throat, positive pressure is created, which eliminates the stopping of breathing in a dream. Note that CPAP therapy is the most effective way to treat apnea at home.
  • Quitting smoking and alcohol. Cigarette smoke and alcohol relax the muscles of the pharynx and disrupt the breathing process.
  • Humidificationin the room. Maintaining the proper humidity in the bedroom reduces the frequency of apnea. Humidity is regulated by a special device, which can be purchased at a fairly modest price.
  • Using special cap for snoringfixing the jaw in the correct position.

Characteristic symptoms

When breathing stops, noticeable anxiety appears. A man begins to twist his head, roll over. Frequent waking is characteristic of him, during which he immediately begins to draw in air.

There are other symptoms that show breathing problems while drowning,

  • alternating snoring with periods of sudden silence,
  • palpitations during night awakenings due to the sensation of suffocation,
  • sweating
  • difficulties in continuing to sleep after anxious waking up,
  • the appearance at night of the need to empty the bladder.

After awakening, the following conditions are characteristic signs of frequent respiratory arrest:

  • headache,
  • lack of feeling of rest after sleep,
  • daytime drowsiness, which reduces working capacity,
  • dry mouth
  • chronic irritability
  • memory impairment, decreased attention span,
  • the possibility of developing impotence.

Such a complex of negative effects on the body should motivate people who have sleep apnea syndrome, be more careful while driving, control themselves when doing responsible work, learn how to restrain negative emotions during personal communication.

Doctor's sleep apnea treatment

If treating sleep apnea at home has proven ineffective, consult somnologist. An experienced specialist after talking with you will prescribe a suitable therapy that will help to avoid complications of this disease.

In some cases, the help of a surgeon is needed to treat apnea.And usually it is associated with plastic soft tissue of the pharynx.

As a rule, treatment of apnea in specialists includes:

  • Medications. When apnea is usually prescribed drugs to stimulate breathing, for example, aminophylline.
  • Uvulopalatopharyngoplasty (UPFP). The operation to remove the palatine tongue, tonsils and part of the palate facilitates the patient's breathing with apnea.
  • Plasticity of the palate. With the help of the operation, part of the palatine tissues is corrected, which also improves air patency in the upper respiratory tract. The operation is performed by cryo- or laser therapy.
  • Changing the shape of the nasal septum. Facilitates the passage of air in the nasopharyngeal region.

Diagnostic Methods

If there is a suspicion of respiratory arrest, a diagnosis is performed that includes several directions.

  • Visual observation, survey

The doctor at the initial stage reveals the presence of signs of nocturnal apnea. The evidence of other family members who may have observed restless behavior during sleep helps clarify the picture.

Indirect symptoms are taken into account, which include fatigue, drowsiness, irritability.

During the examination, respiration parameters are measured, the patency of the nasal passages is checked, the possible presence of pathological changes in the upper respiratory tract is detected. A blood test is performed.
Important information can be obtained by connecting to a device that registers the necessary parameters throughout sleep. Such a procedure, if necessary, is carried out in the clinic. A patient may be given a portable device for examination at home.

Treatment methods

Since respiratory arrest during falling asleep can be a provoking moment for serious pathological conditions, one cannot ignore the recommendations of doctors on the treatment of apnea. There are several successfully tested and showing good results treatment methods.

1. Lifestyle changes

Knowing some of the factors that trigger the appearance of night apnea can be a leading motive for their eradication. This approach is effective in the presence of a mild degree of the disease.

For obesity, you will need to turn to specialists and choose a safe method for getting rid of extra pounds. It is necessary to quit smoking, minimize the amount of alcohol (it is advisable to start a completely sober lifestyle).

2. CPAP (CPAP) - therapy

The essence of this progressive therapeutic technique is the use of a specially designed device with which it is possible to normalize breathing in a dream. An indication for this method is the development of moderate or severe apnea.

Applying treatment with CPAP devices, it is possible to ensure a full sleep. Also, this method is the prevention of stroke and heart attack.

Some side effects are taken into account:

  • discomfort at the stage of getting used to the mask,
  • nasal congestion
  • headache,
  • difficulty in nasal breathing
  • pain in the ears
  • stomach pain, flatulence.

With the constant occurrence of such reactions, specialist advice will be required.

3. Mandibular splint

A tire made of rubber-like material is put on the teeth, firmly securing the lower jaw. With moderate severity of sleep apnea, treatment with this device is effective and brings significant relief. The main condition is a competent selection of size, so you need to contact a dentist who owns skills in this direction.

4. Surgery

If it is impossible to cure night apnea with the help of special devices, surgical intervention may be indicated in the following cases:

  • curvature of the nasal septum,
  • small lower jaw
  • hypertrophic tonsils.

If often in a dream it stops breathing, then apnea treatment can take the form of the following types of operations.

  • Tracheostomy.With complete blockage of the upper respiratory tract, a special tube is inserted into the trachea through the hole, allowing air to flow freely into the lungs.
  • Uvulopalatopharyngoplasty. During the operation, the excess tissue of the soft palate is removed. If necessary, a tongue can be removed. Such surgery is often practiced in adult patients.
  • Adenoidectomy If adenoids interfere with breathing freely in a dream, they must be removed.
  • Tonsillectomy. During such an operation, hypertrophic tonsils are removed.
  • Pillar system. To make the soft palate more stable and rigid, thin implants made of dense material are inserted.
  • Bariatric surgery. If severe obesity is identified as a key cause of night apnea, it may be necessary to suture the stomach or reduce its volume by installing a special balloon.

What type of operation will be most effective is decided individually in each individual case.

Folk remedies

Even a brief respiratory arrest during sleep is dangerous, especially for a weakened body. The therapeutic complex may include drugs made according to the recipes of traditional medicine.

  • Fighting respiratory dysfunction caused by excess mucus will allow nightly washing of the nasal passages with sea salt (a teaspoon) dissolved in preheated boiled water (200 ml).
  • White cabbage juice (200 ml) will be beneficial, in which honey (a teaspoon) is added immediately after squeezing and drunk before bedtime.
  • With severe nasal congestion, 4 drops of pharmacy sea buckthorn oil are dripped an hour before falling asleep.
  • To strengthen the body, treat the cardiovascular system, remove mucus from the lungs, use black cumin seeds. For infusion, pour a tablespoon of raw material in 200 ml of boiling water and hold for insisting under the lid for 15 minutes. Drink before a meal twice a day. Course duration is 2 months.
  • In severe cases, it is advisable to prepare a mixture of several plants. It will take 100 g of sage, horsetail (grass), burdock (leaves), hawthorn (berries). Also included in the collection is 50 g of Cinquefoil (root). After grinding all the components, they should be mixed. In the morning, prepare a decoction, pouring in 500 ml of water a tablespoon of the mixture. After boiling, cook for 5 minutes. then the broth is filtered and cooled. Drink a day 4 times in a glass.

There are many recipes from the assortment of folk wisdom, so without effort you can choose the right option.

Effects

It is important for every person to understand what night apnea is and how this disease can be dangerous if left untreated.

Among the negative consequences of frequent delays during breathing sleep, the following pathological conditions are noted:

Neurological disorders may develop, type 2 diabetes may occur. For men, impotence becomes an unpleasant consequence. People with high severity apnea are at risk because of the possibility of sudden cardiac arrest.

Apnea treatment with folk remedies

The treatment of apnea at home involves the use of folk remedies. However, these funds are ineffective in the fight against the disease. In any case, before starting such therapy, consult with your doctor.

As a rule, treatment of apnea with folk remedies includes:

  • Eating Baked Carrots. Bake the carrots in the oven until cooked. Then, take one carrot at bedtime.
  • Gargling with Olive Oil. Dilute 1 tbsp. a spoonful of oil in a glass of warm water. The resulting solution daily gargle to prevent the occurrence of apnea.
  • Reception of cabbage juice with honey. Using a juicer, squeeze the juice from fresh cabbage. After, strain it all through a sieve and add 1 tbsp to the juice. a spoonful of honey.Pour half a glass of boiled water there. Take the finished product 1-2 tablespoon before bedtime. The duration of apnea treatment in this way is 1 month.
  • Nasopharyngeal lavage with sea salt. Take a small syringe and draw water into it with the addition of sea salt. After that, rinse your nose 3-4 times. Salt water moisturizes the nasopharynx, reducing the risk of apnea.
  • Reception of a decoction with mint, yarrow and lemon balm. After preparation, the drink is cooled and taken half a cup daily 15 minutes before bedtime.

Treating snoring and apnea

In addition to apnea, snoring treatment should also be addressed. Recommended for this sing out loud. Singing strengthens the vocal cords and trains the muscles of the pharynx, which in turn reduces the likelihood of snoring and night apnea.

If you don’t feel like singing, read aloud regularly. Reading in the voice is effective for treating snoring and sleep apnea. In addition, reading aloud, you not only reduce the risk of respiratory arrest in a dream, but also get useful information. As a bonus, reading books or articles aloud trains memory.

Mild apnea can be eliminated with yoga or auto training. Both that, and another is aimed at restoration of physiological processes in an organism thanks to which it is possible to cure an illness.

Apnea Exercise

The treatment of apnea at home also includes special exercises that train the muscles of the pharynx and jaw. Such gymnastics relieves the sufferer of snoring and reduces the frequency of respiratory arrest.

The set of exercises is as follows:

  • Move the jaw back and forth while pressing the chin into the area under the lower lip. When doing the exercise, you should feel the resistance created by pressing your hand. To begin, make 10-15 of these movements. Then, over time, increase the number of repetitions to 30-40. This exercise trains the jaw muscles, which reduces the frequency of snoring.
  • Press the thumb with your thumb for 30-60 seconds. The pressure should be palpable, but do not press too hard so as not to damage the oral mucosa. To achieve a therapeutic effect, take 2-3 of these approaches. Exercise corrects the muscles of the palate, which also reduces the frequency of respiratory arrest in sleep.
  • Stick your tongue forward as far as possible. Then pull it towards the nose, chin, and also towards the left and right cheeks. Hold the tongue for 5 seconds in each position. Make 20-30 such movements.
  • Move your tongue to the side of the throat and back. The mouth should remain closed. Perform 50-100 of these movements.
  • Move your jaw clockwise and then counterclockwise. Make 10 movements in one and the same amount in the other direction.
  • Tighten your neck and say 10 times loudly all the vowels of the Russian alphabet.

Note that for maximum effect, exercises should be performed regularly. Moreover, it is advisable to conduct such training 2 times a day: during the day and before bedtime.

Exercises for proper breathing with apnea

You can get rid of apnea and snoring using the right chest and abdominal breathing. Sit or lie down in a comfortable position before starting. After, take a deep breath through the nose, while protruding the stomach. Exhale slowly and pull the stomach back. Take 7 such breaths.

The next stage is chest breathing, in which the "bloat" should not be the stomach, but the chest. While in the same comfortable position, take a deep breath through your nose. During inhalation, by filling the lungs with air, expand the chest, being careful not to protrude the stomach. Exhale and inhale 6 more times.

Another exercise for training proper breathing is larynx gymnastics. To do this, lie on the bed and lay a pillow under your head. Then, press your chin to your chest and exhale forcefully with your nose.When performed correctly, breathing should be noisy. The exercise is performed no more than 5 minutes.

Complications of Apnea

If you do not treat apnea, the disease can lead to dangerous complications. Among them are:

  • Cardiovascular diseases - heart attack, stroke, coronary heart disease, hypertension, cardiac arrhythmias, etc.
  • Diabetes. With apnea, the production of insulin, a hormone that regulates blood glucose, is impaired.
  • Impotence. Holding your breath in a dream reduces the concentration of testosterone in men. As a result, this reduces sexual desire and prevents the appearance of an erection.

To avoid complications, treatment of apnea should be taken in time. Moreover, treatment should not be limited only to alternative methods. In most cases, it is extremely important to consult a doctor who will select the right treatment program for you.

Good night to you!

Video on how to treat apnea at home:

Causes of Apnea in Children

In newborns, respiratory arrest in a dream is quite common. This is due to the fact that the respiratory system has not yet fully developed. As a rule, a few weeks or months after birth, nocturnal apnea in infants pass by themselves. Many parents are afraid that this ailment may lead to sudden infant death syndrome. However, there is no scientific evidence that these things are related.

Causes of OSAS in newborns:

  • congenital narrowed airways,
  • improperly developed muscles of the larynx
  • upper airway obstruction,
  • improper development of the jaw, retraction of the tongue back, cleft palate.

The causes of SCAS in newborns can be:

  • traumatic brain injury during childbirth,
  • increased blood oxygen immediately after birth,
  • skull hemorrhages, brain hematomas,
  • abnormal brain development.

If the child’s fingers or face turn blue, the pulse slows down to 90 beats per minute, when picked up, the baby’s body feels no tone, the arms and legs sag, the baby refuses to breast — an ambulance should be called immediately.

At an older age, adenoids, enlarged tonsils or problems with nasal breathing: allergies or rhinitis can be causes of apnea in children. Also, the child may have a violation of the structure of the facial skeleton or obesity, which interferes with the normal circulation of air in a dream. If you suspect apnea, you must visit a pediatrician or otolaryngologist.

CPAP therapy will help children with syndromic apnea.

Elimination of the cause of pathology

In 85-90% of cases, the main factor in the occurrence of obstructive sleep apnea is obesity. With an increase in body mass index of more than 30, it is necessary to carry out measures to reduce weight. In most cases, after a decrease in BMI to 20-25, the symptoms of the disease disappear on their own.

At the moment, the market for pharmaceuticals is full of "diet pills", private clinics offer various options for operations, and on the Internet there are schemes of strict diets bordering on fasting. For the vast majority of people, all these methods will not bring benefits, but only additionally harm their health.

Rational weight loss can be achieved by regularly observing the following conditions:

  • Refusal from the use of alcohol and nicotine (including cigarettes, smoking mixtures, vapes, etc.). Permissible is a single use of strong alcoholic drinks not more than 50 g. Not more than 2 times a week,
  • The right diet. You should not give up all types of food and starve - these measures are effective only for a short period of time. To reduce weight, just change your diet as follows:
    • Refuse any confectionery, including chocolate, cookies, cakes, pastries and others. These products are sources of digestible carbohydrates that the body does not have time to use for its needs.As a result, they are stored in fatty tissue throughout the body, including in the internal organs (liver, pancreas, heart, blood vessels, etc.),
    • Exclude fatty foods: various products cooked in oil / margarine, fatty meats (veal, lamb, pork, beef), sausages and others,
    • Give preference to protein foods - poultry and cereals,
    • Be sure to include fruits and vegetables in the diet, as a source of fiber and activators of the intestines.
  • Adequate daily exercise is a prerequisite for losing weight. This paragraph does not mean that a person should go to the gym every day and practice for several hours. Enough light running, brisk walking, visiting the pool or doing exercises at home. The main thing is regularity physical exercises.

For most patients, these recommendations are enough to gradually reduce BMI to acceptable values ​​over several years. The main thing is not to deviate from these principles and adhere to the described scheme. Rebuilding your lifestyle is quite difficult, so often people neglect simple methods, being in search of a “magic pill” or other means. Unfortunately, at the moment there is no safe and effective means that would allow to reduce weight without human effort.

Principles for addressing other causes

If apnea is not associated with the development of obesity, you must find the cause of the disease and try to eliminate it. In most cases, this can be done with special therapy or a little surgery.

Various diseases have their own characteristics of treatment. For each patient, the doctor individually determines the most optimal approach, depending on the state of his body and the type of respiratory disturbance. Below are the general principles for eliminating pathologies that can cause apnea, and especially the tactics of a doctor in various diseases.

Surgical - the elimination of pathology is carried out mainly by surgical intervention.

Adenoidectomy - removal of excess tissue of the nasopharyngeal tonsil. Currently, it is performed without additional incisions - the surgeon performs all manipulations through the nasal passage, using special (endoscopic) instruments.

In addition to surgical treatment, otolaryngologists recommend a course of therapy that eliminates the cause of the disease and prevents the recurrence of the disease. The classic scheme includes:

  • Antimicrobials in the form of sprays and nasal drops,
  • Saline solutions (Aqua Maris, Physiomer, Sea water, etc.) for washing the nasal passages,
  • Physiotherapy
  • Spa treatment in a warm marine climate.

Endoscopic polypectomy - removal of tumor formations through the nasal passage.

Relapse prevention is carried out with local glucocorticosteroid preparations (in the form of a spray). Preparations - Nasobek, Tafen nasal, Budesonide and others.

Adenoid growths of the pharyngeal tonsils (Adenoids)
The presence of polyps in the nasal cavity
Nasal septum curvatureRhinoseptoplasty is an operation to restore the correct shape of the nasal septum and patency of the nasal passages.
Conservative - improving the patient's well-being can be achieved with the help of pharmaceuticals.Chronic rhinitis (vasomotor, allergic, occupational, etc.)Treatment of this group of diseases should be comprehensive. The classical scheme of therapy, regardless of the pathology option, necessarily includes the following points:

  • Elimination of contact with a factor provoking an increase in the common cold (allergen, industrial dust, stress, etc.),
  • Flushing the nose with sea water solutions,
  • Local anti-inflammatory therapy (glucocorticosteroid sprays).

If necessary, general recommendations are supplemented with specific preparations necessary for a particular patient. The main thing is to achieve control over the disease and maintain patency of the upper respiratory tract.

HypothyroidismSubstitution therapy with thyroid hormone analogues (L-thyroxine).
Diabetes as a risk factor for obesity and disorders of the innervation of the muscles of the pharynxBlood sugar control can be achieved in three main ways:

  • Diet
  • Antiglycemic drugs (the best option for most patients is Metformin),
  • Insulin preparations.
Drug overdose, alcohol / drug intoxicationThe principles for eliminating body poisoning are as follows:

  • Stopping the use of a toxic substance,
  • Waiting for the removal of the toxin from the body,
  • In severe cases, hospitalization of a person in a hospital is indicated for intravenous infusions and the introduction of an antidote (if any).

Treatment of "oxygen starvation"

With a long course of pathology, a lack of air can persist in the blood even after adequate therapy. Since the body "gets used" to a certain concentration of gas in cells and tissues, it continues to maintain its deficiency. As a result, a person has symptoms, despite the excellent airway patency.

To saturate the body with oxygen, American scientists have developed a new technique, called "non-invasive ventilation." Its principle is extremely simple - a mask is put on a person’s face or respiratory tubes are put on a nose, after which a special device starts supplying gas under a certain pressure. This procedure is performed during sleep, and all treatment for apnea occurs at home.

There is only one drawback of this method - the price. For therapy, special equipment necessary for daily use is necessary: ​​CPAP apparatus or BiPAP apparatus. Their cost in Russia ranges from 40 thousand to 200 thousand, when ordering from American sites - half as much. Not every patient can afford such expensive equipment that limits its use.

The Curse of Ondine

The article described many causes that can cause sleep apnea. However, in some people, the disease can occur without any reason. How does this happen? Against the background of complete health, a small child or adult has snoring with episodes of respiratory arrest. These episodes can be much longer than with the classic course of the disease. In some cases, they end in death by strangulation.

This option is called Undina’s Curse Syndrome or idiopathic hypoventilation. The reliable reason for its occurrence is not known to date. Scientists suggest that the syndrome is associated with congenital underdevelopment of the respiratory center or damage to the nerves that are responsible for the work of the respiratory muscles. Most often, it manifests itself in newborns or young children, however, there are cases of late debut of the disease (in 30-40 years).

The legend of Ondine.In German mythology, there is a story about the beautiful mermaid Undine, who lived on the shore of a raging sea. A knight passing by her hut was amazed by the beauty and singing of the girl. Vowing her with his morning breath, he conquered Undine's heart and married her. Over time, the knight forgot about his love and found a new object of sighing. Seeing this, Ondine cursed her husband, depriving him of the ability to breathe while sleeping, retaining only his “morning breath”.

The Curse of Ondine is a diagnosis of exclusion. It can be installed only after all other possible causes are excluded. A distinctive feature of this pathology is the absence of any symptoms, except for respiratory arrest and snoring.No diagnostic method can confirm its presence, therefore, laboratory and hardware methods are needed only to exclude other reasons.

It is impossible to completely get rid of this disease. In severe cases, the patient has to fight for his whole breath all his life, since all respiratory movements are made by willpower. Existing methods of treatment do not affect the cause of hypoventilation syndrome and do not allow to get rid of it. The only way to maintain a decent quality of life for these patients is with CPAP devices for BiPAP therapy.

Nocturnal apnea in children

The principles of treatment and diagnosis of this disease in a child practically do not differ from those in an adult. However, the causes and manifestations of the pathological process have certain characteristics at a young age that you need to know. This will allow you to suspect the disease earlier and timely proceed to confirm the diagnosis.

Apnea in children rarely develops due to tumor processes, lesions of the nervous system and obesity. According to the frequency of occurrence, the following conditions come first in young patients:

  • Ingestion of foreign bodies in the respiratory tract. Various options are possible - the subject can pass from the larynx to the bronchial tree. In this case, a diagnosis can only be made using x-ray examination,
  • Adenoid growths (enlarged nasopharyngeal tonsils),
  • Anomalies in the structure of the airways (deformation of the septum, atresia of the choan, hypertelorism, etc.) or the upper jaw,
  • Chronic rhinitis, often allergic in nature,
  • Acromegaly is the rarest option.

In addition to the classic symptoms, apnea in newborns and young children (up to 14 years old) is manifested by a number of additional disorders. All of them are associated with a lack of tissue nutrition and a constant lack of air. These include:

  1. Growth retardation and physical development. Apnea in newborns can be manifested by a slower increase in mass, compared with normal values. With a long course of pathology, for small patients, the characteristic signs are low growth, weakness of the muscle apparatus and fast fatigue,
  2. Decrease in mental and cognitive functions. In preschool age, it is manifested by distracted attention and difficulties with learning the skills of reading, counting, orientation in time, etc. In schoolchildren, this disease can cause poor performance and discipline in the classroom,
  3. Inhibition / hyperactivity in the daytime.

A separate group of patients are children born earlier than scheduled. With a slight deviation from the norm (for 1-2 weeks), the child may not have respiratory disorders. However, premature birth at an earlier date often causes apnea in premature babies.

The diagnosis, in this situation, rarely causes difficulties. Since the child is not discharged from the perinatal center until his condition is normalized, airway obstruction is promptly detected by a neonatologist and successfully treated in a medical facility. With the late “debut” of the pathology, it is also not difficult to detect it - the mother quickly detects periods of lack of breathing that occur in her sleep, and turns to the pediatrician for medical help.

TOP 5 misconceptions about sleep apnea

There are many articles on the Internet describing this problem. It must be remembered that when reading any information, you need to be critical of it and, first of all, consult your doctor. When analyzing various resources and medical portals, the most common errors of the authors were identified.

Here are our TOP 5 misconceptions about sleep apnea:

  1. Menopause is a risk factor for apnea.To date, scientists have not found a connection between the amount of female sex hormones and the pharyngeal muscle tone. There are no studies or clinical guidelines to support this risk factor. Otherwise, the main contingent of patients with this disease would be women older than 50 years. However, almost 90% of patients are men 30-40 years old,
  2. ARVI can cause the disease. Not a single acute illness causes nocturnal apnea in children. Of course, they can lead to difficulty in nasal breathing, but this violation persists in daytime. This pathology is a consequence of chronic respiratory failure, lasting more than 2 months,
  3. Mandibular splint is an effective treatment. At the moment, European and domestic doctors recommend treating night apnea without using the above methods. Since the tires do not affect the tone of the pharynx, they cannot improve nasal breathing or the work of the respiratory center, their use is not justified,
  4. Tracheostomy and bariatric surgery are good methods for eliminating the disease. A tracheostomy (creating an incision in the larynx and installing a tube in it) has only one indication - a life threat due to complete obstruction of the upper respiratory tract. This method is never used to treat sleep apnea.
    Bariatric surgery (for weight loss) is also a last resort in the treatment of obesity, which should not be widely used. Most of the patients with apnea are people who are not bothered by anything. In this case, the risk / benefit ratio of surgical intervention is not comparable - the consequences of such operations may be a hospital infection, adhesive disease, laryngeal stenosis, etc. Conservative therapy should be preferred.
  5. Bronchodilators and sedatives can treat apnea syndrome. These groups of drugs are not used in therapy. Bronchodilators are substances that expand the bronchi and improve air conduction through lower parts of the respiratory tract. They do not affect the condition of the nasal cavity and pharynx. The main indications for their use: bronchial asthma, COPD, an attack of bronchospasm. With these diseases, breathing can be disturbed not only at night, but also in the daytime.

Sedative pharmacological preparations also do not have a positive effect on the course of the disease. On the contrary, some of them increase the symptoms of central apnea and increase the risk of complications. This fact can be found in the "contraindications" section, with careful reading of the instructions.

Examples of bronchodilatorsExamples of sedatives
  • Salbutamol,
  • Formoterol,
  • Fenoterol,
  • Salmeterol,
  • Berodual, etc.
  • Relanium,
  • Diazepam
  • Sibazon,
  • Lorafen
  • Noofen, etc.

FAQ

At the moment, scientists recommend counting the number of “interruptions” in breathing during sleep, based on which the severity of the condition is determined.

The number of respiratory arrestsSeverity of pathology
5-9Easy
10-19Average
More than 20Heavy

Reducing the depth or frequency of respiratory movements, leading to the accumulation of carbon dioxide in the blood. It is quite difficult to detect hypopnea during a routine examination, so this symptom is rarely used in the diagnosis.

Yes, since the relaxation of the muscles of the pharynx begins to occur already at the stage of falling asleep. In this case, further examination is necessary in order to identify pathology.

This pathology occurs with prolonged respiratory failure, only during sleep. Therefore, acute conditions, such as acute respiratory viral infections or the body’s response to vaccination, cannot cause sleep apnea.

The principles of therapy do not differ from those in the adult population. The main thing is to determine the cause of the violations, after which you can begin to eliminate it and combat air shortages.

The diagnosis is the responsibility of the therapist / pediatrician.Any competent specialist will be able to suspect a violation, prescribe a further examination and, if necessary, consult other specialists.

Watch the video: Laryngospasm: Sudden, Terrifying Difficulty Breathing (February 2020).

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