Snoring and Sleep Apnea

What is Snoring?
The sound in the form of noise that occurs when the airway behind the mouth and nose is narrowed. snoreis called.

Snoring and Sleep ApneaWhat is Sleep Apnea Disease?

Obstructive sleep apnea is when breathing stops for a while during sleep and the body makes excessive effort to breathe during this time. (Sleep Stuffing, Breathless and Oxygen Deprivation) . In this disease, which is the most severe form of snoring, severe snoring is interrupted by a period of breathlessness. At this time, breathing completely stops. While the person is sleeping, if the breathing stops and starts again for more than 5 seconds per hour or longer than 10 seconds, many systems of the body, especially the heart and brain, are adversely affected and the risk of death increases.

Causes of Snoring and Sleep Apnea

During sleep, structures such as the nose, soft palate, uvula and tongue root forming the upper respiratory tract (swallow) , together or separately, can narrow or block the airway. During sleep, the narrowing of the airway in the pharynx increases the airflow velocity. Air passing through a narrow passage rapidly destroys the unsupported tissues of the upper airway. (such as soft palate, uvula) vibrates, making loud noises (snoring). It can be said that the narrowing and obstruction of the airway is the main cause of sleep apnea and snoring. Anatomical factors are very important in sleep apnea and snoring.

1- Loosening and sagging of anatomical soft tissues

In most cases, this narrowing and/or obstruction occurs at the base of the tongue; When the tongue slides towards the pharynx, obstruction or narrowing occurs. Loose muscles cannot prevent the tongue from slipping towards the back of the throat when lying on the back. This event can also occur with the loss of muscle control in the sleep of someone who has been relaxed by taking alcohol or drugs. In some people, snoring may also occur due to relaxation in the deep phase of sleep.

2- Excessively large tissues in the throat

Large tonsils and adenoids are the most common cause of snoring in children. Thick neck tissue can be shown as the cause in obese people. Cysts and tumors can also rarely cause snoring. Excessively drooping and long soft palate and uvula narrows the airway towards the throat and causes snoring.
3- Congenital narrow throat in some people

4- Other factors

All problems that narrow the upper airway from the nose to the vocal cords (allergic flu, curvatures in the nasal bone, sinusitis, structural abnormalities in the lower and upper jaw) can cause snoring. The person with nasal congestion creates an excessive vacuum in the nasal cavity to get the air. This vacuum pulls collapsible tissues in the throat towards the airway. Thus, snoring begins to be seen in the person who does not snore while the nose is open. This explains why some people snore only during allergic periods or when there is flu or sinusitis. Nasal deformities are known as the causes of this type of nasal congestion. Deviation is defined as the protrusion of the middle part of the nose to the sides. It is the most common of the intranasal deformations. Tonsils being larger than normal and having adenoids are the cause of sleep apnea, which is mostly seen in children; however, it can sometimes be responsible in adults as well. In children, unlike adults, attention deficit and hyperactivity are seen instead of sleepiness and lack of energy. Because ADHD (Attention deficit and hyperactivity disorder)All children diagnosed and scheduled for drug treatment should be evaluated for sleep disorders. ADHDof children diagnosed 25%The main underlying problem is sleep breathing disorders, periodic arm and leg movements and restless legs syndrome.

Incidence Frequency
Normal adult people at least 45% He snores from time to time. 25% snore constantly. men over the age of 35 35% Snores intermittently or depending on the lying position. It is more likely to be seen in individuals who are overweight, have a short-thick-wide neck and strong chewing musculature, are over middle-aged, and use cigarettes and alcohol. The neck circumference, that is, the shirt collar number, greater than 43 cm in men and more than 40 cm in women creates a risk for sleep apnea. Snoring and sleep apnea are about twice as common in men than women. The reason for this is that in men, fat accumulation is in the upper part of the body, especially in the neck area, and in women, it is mostly in the lower part of the body. However, it is known that sleep apnea and snoring can develop in individuals with normal weight. The use of alcohol, tranquilizers, and sleeping pills can cause the throat muscles to relax and sag during sleep. Its incidence increases in women in the postmenopausal period. Although it is mostly seen over the age of 40, it should be kept in mind that it is a problem that can be encountered at any age from infancy.

Symptoms

  • severe snoring
  • Heart complaints and high blood pressure
  • morning headache
  • Psychological problems, depression
  • waking up tired
  • Insomnia, being constantly tired during the day
  • Excessive sweating during sleep
  • Waking up with dry mouth and sore throat
  • Excessive and rapid weight gain
  • waking up with breathing difficulties
  • Loss of sexual desire
  • Daytime sleepiness, poor performance
  • difficulty concentrating
  • Irregular and uncomfortable sleep
  • Frequent urination, dehydration
  • Observation by others of respiratory pause during sleep

Snoring and Sleep Apnea

According to the International Sleep Foundation’s 2002 survey results, the most common complaint of sleep apnea patients is fragmented sleep, characterized by excessive daytime sleepiness, heavy snoring, and frequent awakenings. In the morning of such a sleep, patients often complain of headaches, pain and nausea in the jaw muscles and jaw joint due to clenching and grinding of the teeth, which lasts through the night. Other complaints include intellectual deterioration, distraction, less brain functioning, irritable behavior, a tendency to argue with people around them, to gluttony, depression and severe distress, pessimism. Occupational accidents, adverse effects on work performance and decreased productivity are other recorded complaints. Restlessness and involuntary leg movements are also present during sleep. While all this is going on during sleep, the person may enter the deep sleep phase in a very short period of his sleep. Since real rest is only possible in the deep sleep phase, the daytime without rest becomes sleepy, tired and unproductive. During the day, napping is seen at every opportunity. These types of people usually fall asleep in a sitting position during lunch breaks. There may be distraction and drowsiness while doing work that requires attention, especially since there will be difficulty in concentration. Therefore, the risk of having an accident while driving is very high, and frequent traffic accidents are among the common symptoms of the disease. As it can be understood from this, snoring and sleep apnea is a disease that involves hidden risks not only for the person himself and his sleep friends, but also for other members of the society.

Adverse Effects

For the health;

  • Cerebral Palsy -Alzheimer’s
  • High Blood Pressure -Tachycardia
  • Blood Vessels Damage – Cancer Risk
  • Arrhythmia -Chronic Chest and Respiratory Diseases
  • Heart Failure -Sleep Cardiac Arrest and Sudden Death
  • Male Impotence – Female Urinary Incontinence
  • Depression and Psychological Disorder
  • Recurrent and Persistent Upper Respiratory Infections

The importance of sleep apnea and snoring is that the decrease in blood oxygen level during apnea may lead to hypertension, heart diseases and lung diseases in the long term or pose a greater risk. The decrease in the blood oxygen level during the shortness of breath increases the heart rate. As the low oxygen level continues, the pulses get faster. This increase in blood pressure causes damage to the inner surface of the walls of blood vessels on both sides of the neck. Adhesion of cholesterol, fat, and calcium to the damaged areas and the buildup of calcified plaques begin to block blood flow to the brain. In the long term, severe damage such as paralysis may occur during sleep. The oxygen level in the blood drops and the heart has to pump more blood. As a result, since the load of the heart has increased, after a while, the heart rhythm deteriorates. (arrhythmia), High blood pressure and an enlarged heart can occur over the years. Air passage is disrupted in individuals with sleep apnea and snoring. Anxiety develops, a condition in which less air enters the lungs. Since the patient cannot get oxygen, carbon dioxide reaches dangerous blood values. In other words; A decrease in blood oxygen values ​​causes an increase in blood carbon dioxide levels. This increases chest effort. Thus, it causes the lung to be forced in the long term and to tire quickly in the short term. It causes respiratory irregularities and upper or lower respiratory tract disorders. As the immune system is suppressed by the decrease in oxygen intake, opportunistic bacteria, viral and parasitic infections (for example, patients have more frequent and severe cold, flu and flu infections) greater susceptibility. Oxygen deficiency also precedes larger ailments such as life-threatening cancer. Because diseases such as cancer and many other infections cannot survive in oxygen-rich environments.

Socially;

  • Brain Underwork – Insomnia
  • Absence from Work – Risk of Losing Job
  • Concentration Difficulty -Sexual Reluctance
  • Loss of Work Efficiency and Labor -Decrease in Production
  • Accident Losses (Work Accident, Traffic Accident)-Medical Expense
  • Depression and the Tastelessness of Life
  • Spousal Problems and the Destruction of Happy Marriages
  • Deterioration and Regression in Social and Psychological Relationships

The most dangerous is the problems experienced while driving in traffic. These people cannot drive for a long time without sleeping. They suffer greatly, especially when driving in the evening and at night. Sleeping at the wheel is one of the leading causes of traffic accidents. Snoring and Sleep Apnea Is A Serious Disease! It is a vital disease that requires urgent treatment.

Snoring and Sleep Apnea Test
one)If you are told that you snore some nights
2)If you are said to snore at night when you are tired
… you may be in the initial stage of the disease. You can avoid the disease with simple precautions.

Simple Precautions for Adult Snorers

  • To gain good muscle tone, a sporty lifestyle should be chosen
  • Weight should be lost
  • Sleeping pills, sedatives and allergy medications called antihistamines should not be taken before sleep.
  • Avoid drinking alcohol 4 hours before sleep
  • Avoid heavy meals 3 hours before sleep
  • Avoid excessive fatigue
  • Sleeping on your back is preferable to lying on your side (an old recommendation is to sew a tennis ball to the back of your pajamas, which is still a useful way to avoid sleeping on your back.)
  • The bed should be raised approximately 10 cm so that the head of the bed is higher (For this purpose, it would be appropriate to place a brick under one side of the bed)
  • People who do not snore at home should be given time to fall asleep before… these precautions are valid for people with mild snoring and position-dependent snoring.

3)People around you say that you snore loudly at night and sometimes you hear your own snoringbr /> 4)If you wake up by yourself some nights choking
5)If your partner says that you are choking at regular intervals while you sleep, you can’t breathe and you struggle in bed
6)If you have trouble getting up in the morning and feel like you haven’t slept at all
7)If you have a headache, a bitter taste in your mouth and an upset stomach when you wake up in the morning
8)If you are sleepy during the day, falling asleep all the time
9)If you feel a general reluctance and restlessness during the day
10)Effort (strength)If you feel a tightness in your chest and shortness of breath when you do work that requires
… or if you are experiencing other symptoms and negative effects described at the beginning of the article, you may have snoring syndrome and sleep congestion.

Diagnosis
Especially if we cannot breathe through our nose during sleep and therefore we have to sleep with our mouth open, snoring will be inevitable. Keeping our nose open and mouth closed is the golden rule for a healthy sleep. The most important step for a definitive diagnosis is a detailed ear, nose and throat examination. If deemed necessary after the examination, the patient may stay overnight in the Sleep Laboratory. (in hotel setting)During sleep, the parameters necessary for diagnosis are measured.

According to the results of the sleep laboratory, it is determined whether the person’s snoring poses a threat to his life and the treatment is planned by using some values.

The general aims in the treatment of sleep disorders are to eliminate social problems and stop the progression of the disease, reduce the person below the risk of death, increase life expectancy, reduce health hazards, improve sleep quality, reduce fatigue throughout the day, reduce or eliminate morning headaches, hypertension and other It is to control or improve related health problems, to improve memory, to correct impotence problems, to reduce the risk of motor vehicle accidents, and to increase the quality of life and the joy of life accordingly.

Treatments
People who snore in any position “heavy snorer” is named. These people need more help than the simple measures above.
one-Elimination of simple factors that may cause disease
Excess weight, use of alcohol and sedatives…
2- Drug therapy
Periodic allergies, sinusitis, throat infections…
3- Surgery
moving tissues (soft palate, uvula, tongue root)fixation – stretching and further widening of the airway (uvulopalatopharyngeoplasty surgery – UPPP; laser – LAUP)stretching of the uvula and soft palate that obstruct the airway (radiofrequency surgery – Somnoplasty),tonsil, adenoid, deviation
4- Extra-oral appliances
They can be preferred in addition to surgical intervention in patients whose general condition is not suitable for surgery, who cannot undergo surgery due to another disease, or who are too advanced to benefit from surgery. in america FDA There are nearly 300 patented devices and drugs used in the treatment of snoring, some of which are really effective. However, most of the time, these methods prevent snoring but do not provide a comfortable sleep for the person. Even devices that work with excessive snoring and wake up the person and thus save their sleeping companions from the sound of snoring have been produced, but all of these have not gone beyond making the snoring patient even more sleepy.

a) CPAP and BiPAP In cases where surgery is too risky or not desired by the patient, it is a mask that is placed on the mouth or nose during sleep and gives compressed air to the throat. Sleeping while wearing a mask during the night causes social and physical discomfort for the patient.

b) Snoring clip It is not intended to be used for the diagnosis or treatment of sleep apnea or any disease. It is effective as long as it is used. It is inserted into the nose 10-15 minutes before going to bed and remains in the nose during sleep. It is an apparatus that reduces the frequency and sound level of snoring and makes it disappear completely in some people.

5- Snoring ProsthesisIt is the only alternative to surgery that can provide effective results in all stages of Snoring and Sleep Apnea disease caused by moving tissues (soft palate, uvula, tongue root) partially or completely closing the airway.

As a resultSnoring is a disease and this disease carries serious risks in terms of one’s own health, apart from its social dimension that disturbs the environment.

People who snore should not be ashamed of this situation and should take a step towards treatment. People who start to stop breathing and have the first signs of serious health problems should undergo an Ear Nose and Throat examination immediately before the disease progresses further.

Remember!

Snoring and Sleep Apnea is a Serious Problem.
Snoring and Sleep Apnea is dangerous cessation of breathing.
Snoring and Sleep Apnea is not funny, it is not hopeless at all.

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