Snoring and sleep apnea

Written By The HealthMeth Team - Updated On Saturday, March 13, 2021 6:00 PM

Definition of snoring

Snoring is known medically as the sound that a person makes during breathing when falling asleep. It usually accompanies inhalation, but it may happen with exhalation sometimes, and there are people who suffer from snoring while awake as well. Statistics indicate that about 45% of adult people suffer from the problem of snoring sometimes, and that about 25% of adults suffer from it permanently, and that the incidence of snoring increases with age.

What is the difference between snoring and respiratory depression

Snoring is a partial blockage of the airway in the nasopharynx, oropharynx, and the back of the tongue, with the passage of air during breathing in this part, fluctuation occurs in the soft tissues of the roof of the throat and uvula, causing the sound of snoring ... and sometimes a complete interruption of breathing may occur.

As for apnea, it is caused by a total obstruction of the airway for a period of not less than ten seconds, and this may be partial obstruction and cause snoring during sleep, but it may be dangerous in some cases. When this disturbance occurs, a person wakes from sleep or sleep becomes very deep. Each pause in breathing lasts ten seconds, twenty seconds, or more.

Interruptions can occur twenty or thirty times in one hour. The most common type of this condition is obstructive sleep apnea. This means that the sleeper is unable to get enough air through the mouth and nose. When this happens, the amount of oxygen in the blood can drop. Restoring normal breathing is accompanied by the sound of snoring and hissing.

People with sleep apnea also snore loudly. However, not everyone who snores will have sleep apnea. A person does not get enough sleep when his sleep is interrupted throughout the night, and this makes him sleepy throughout the day. Also, people with sleep apnea are more vulnerable to traffic accidents, work injuries, and other medical problems. If you have this disease it is important that you get proper treatment.

Factors associated with sleep apnea and snoring

  • Weight gain and if the neck circumference is more than seventeen inches (43 cm), then that person is more likely to have sleep apnea
  • Smoking Smoking can cause inflammation and swelling of the airway tissue. This may be the reason smokers have more sleep apnea than non-smokers. Some people with mild sleep apnea can treat their condition after stopping smoking and drinking alcohol
  • Old age is three times more common among people over the age of sixty-five than among others. But sleep apnea can affect people regardless of their age, even children. The shape and anatomy of the neck and throat may be the cause of sleep apnea. A person inherits these traits from his parents just as he inherits the size of the nose and ears. If a person's trachea is narrow, then he is more likely to have sleep apnea than others.
  • Men have more sleep apnea than women. Sometimes the tonsils and adenoids enlarge, causing a partial blockage of the airway during sleep. Doctors may recommend surgery to remove enlarged tonsils or polyps in people with sleep apnea.

It is necessary to remember that there is a non-obstructive type of sleep apnea, which is the type caused by the failure of the brain to send signals to the body to breathe. (It will be discussed in another topic)

Organic causes of snoring and apnea

  • Weakness in the muscles of the tongue and the oropharynx cavity: severe relaxation occurs in this area during deep sleep (sleeping after extreme stress or staying up late).
  • An enlargement of the tongue, which may put pressure on the muscles of the stream during contraction and extension while a person sleeps, and thus leads to frequent shortness of breath and forces him to wake up repeatedly during the night
  • Increased density of tissues surrounding the oropharyngeal cavity, such as enlarged tonsils and adenoids (nasopharyngeal polyps) that occurs in children,
  • Excessive weight gain in adults.
  • Elongation of the soft palat.
  • Organic nasal obstruction: such as a deviated septum, enlarged nasal corneas, presence of nasal growths or polyps and nasal tumors.
  • There are some diseases that can lead to an increase in the density of tissues surrounding the oropharyngeal cavity, such as laziness of the thyroid gland, which leads to weight gain and the accumulation of fat.
  • Central neurological causes for respiratory failure are rare, including polio, diseases related to the visual thalamus in the brain (Thalamus) such as stroke, and diseases related to the spinal cord.

Complications of snoring and obstructive sleep apnea

  • Interrupted sleep at night leads to a feeling of sleepiness throughout the day, which negatively affects the quality of life of the patient and limits his mental and physical abilities.
  • People with sleep apnea are more prone to accidents, especially traffic accidents, because they feel tired and sleepy all the time. Driver drowsiness cause hundreds of thousands of traffic accidents every year and are often fatal. Patients with severe cases of sleep apnea who do not receive treatment are two or three times more likely than those without a road accident.
  • Deprivation of good sleep can cause some personality changes in sleep apnea sufferers, including irritability, forgetfulness, mood swings, anxiety and depression.
  • Sleep apnea may impair mental abilities, cause forgetfulness and an inability to concentrate.
  • Children with sleep apnea often have ADHD.
  • The heart works harder to provide the body with the oxygen it needs in people with sleep apnea. Therefore, the patient may suffer from heart disease and circulatory problems in the long term. Sleep apnea may lead to:
  • Hypertension
  • Increased risk of heart attacks and strokes, which may cause death
  • Sleep apnea may also cause impotence in men due to poor circulation, fatigue, and personality changes. Impotence is the lack of an erection disease. People with sleep apnea may feel more sensitive to hypnotics, especially strong ones that are used in anesthesia. This increased anesthesia may threaten the patient's life, so it is very important for a person with sleep apnea to inform their doctors of the possibility of sleep apnea. Sleep apnea affects those who have sleep apnea share their bedroom. Usually the husband or wife or someone who shares sleep apnea notices in his bedroom the loud and sudden sound of snoring during the night, which leads to depriving him of sleep also if he does not move to another room. Sleep apnea can strain the relationship between spouses.
  • Dryness in the throat due to breathing through the mouth and keeping the mouth open for a long time.
  • Depression and difficulty concentrating.
  • Bedwetting disorders.
  • The severity of breathing disorders.

The diagnosis

There are many ways to diagnose, and usually the patient's partner in the room is asked, and one of the best methods is a sleep test called polysomnography.

There are two types of test:

  • A nighttime test that measures brain ripples during sleep, muscles, eye movement, breathing process, oxygen level in the blood as well as sounds such as snoring.
  • The second type is a device that is given to the patient and with specific instructions from the specialist, and then the computer information is analyzed the next day.

treatment

Non-surgical methods:

  • To treat the mild degree of obstructive sleep apnea, doctors first recommend some lifestyle changes, including:
  • Avoid alcohol
  • Avoid hypnotics
  • Weight loss
  • stop smoking
  • Sleep on one side
  • In some cases of sleep apnea, doctors recommend using an oral instrument to keep the airway open during sleep. The dentist or orthodontist makes the oral instrument. The oral instrument repositioned the lower jaw and tongue to keep the airway in the larynx open. An oral tool is useful for some people with sleep apnea, but it may cause long-term damage to the teeth, gums and lower jaw, and there are also some assistive devices by which the tongue can be pulled forward to prevent it from sliding backward during sleep.
  • The (C-PAP) device can be connected to the mouth and nose area immediately before sleeping, as this device works to pump air into the airway in a continuous pressure method, by continuously positive pressure the air in the patient's nose, which helps to keep the airway open. There are several models of CPAP machines, but many have a mask that you put on the face before bed. The continuous positive pressure airflow machine has been very successful in treating sleep apnea and is today the most popular treatment method. If the patient wants to try the CPAP machine, give treatment two weeks or more before seeing results. He also has to learn how to apply the mask correctly without putting pressure on his face.

Surgical methods

  • Treatment of congenital anomalies that affect the breathing process, as in the case of a crooked nose that leads to a blockage in the airway and also when the size of the lower jaw is smaller than the normal range or when the opening at the end of the throat is small. As well as when treating sore throats or tonsillitis operations or enlarging their size, and removing the growths behind his nose, especially in children, also helps to get rid of the problem
  • The surgeries that are resorted to in advanced cases or upon the request of the patient due to lack of commitment to the aforementioned devices, and they are varied and depend on the condition and its causes and require the opinion of a specialist doctor.
  • Removing part of the soft palate and raising the roof of the throat: It is a process in which the surgeon removes the soft palate, which is a fleshy appendix attached to the end of the throat and larynx, and raises the roof of the throat in proportion to the patient and his condition
  • Laser Assisted Uvuloplasty (LAUP): It is a laser-assisted surgery or cosmetic surgery of the uvula and is the most common treatment for snoring, and the doctor must be a specialist in this type of operation.
  • Pillar procedure is a procedure that aims to raise the roof of the throat by implanting a substance inside the muscle tissue of the roof of the throat (soft palate) and leads to naturally stretching the roof of the throat without resorting to surgery, thus preventing snoring and obstruction of breath during sleep, and It is one of the modern and safest methods in the world and its effectiveness has proven to be 90%. It can be performed in the clinic under local anesthesia and the patient returns to his life immediately after the disappearance of local anesthesia and without pain. And it is currently the most prevalent among the surgical methods that are performed by an otolaryngologist
  • And there is also a type of treatment in the therapeutic methods by surgery and depends on the radiation that shrinks the tissues that cause obstruction in the respiratory tract.

At the end of the conversation, an accurate diagnosis must be made to find out the cause of breathing disorders and thus find appropriate treatment

If the husband or wife tells her that she is suffering from one or more of the following symptoms, the first to consult a doctor to confirm sleep apnea:

• Loud snoring with shortness of breath
Intermittent pauses in breathing during sleep
• sudden loud snoring or gasping during sleep
Continuous sleepiness during the day

The sleep apnea treatment helps the sufferer enjoy a deep sleep, which will restore his feeling of energy during the day. It will also prevent heart disease and hypertension for a proper diagnosis by discussing the problem with the doctor, because there are many solutions that can make the patient happy and make his life and the one he loves better.


Dr.. Ahmed Mahmoud Elyan