Snoring and sleep apnea

Definition of snoring

Snoring is medically known as a sound from a person during breathing when he goes to sleep. It is usually associated with inhalation, but it may occur with exhalation sometimes, and there are people who suffer from snoring in wakefulness as well. Statistics show that about 45% of adult adults have occasional snoring, about 25% of adults suffer from it permanently, and that snoring increases with age.

Snoring is a partial obstruction of the airway in the nasal pharynx, pharynx, and the back of the tongue. As the air passes during breathing in this part, there is a fluctuation in the soft tissue of the roof of the throat and larynx. The sound of snoring may occur … Sometimes a complete cessation of breathing may occur.

Inhalation is caused by a total obstruction of the respiratory tract for at least ten seconds. It may be partially blocked and cause snoring during sleep, but it may be dangerous in some cases. When this disorder occurs, a person wakes up from sleep or sleeps very little. Each pause stops breathing for ten seconds, twenty seconds or more.

Breakout periods can occur twenty or thirty times in one hour. The most common type of obstructive sleep apnea is sleep apnea. This means that the sleeper can not get enough air through the mouth and nose. When this happens, the amount of oxygen in the blood can drop. Natural breathing is associated with the snoring and the sound.

People with sleep apnea snore loudly. But not everyone who suffers from snoring has a problem with sleep apnea. A person does not get enough sleep when his sleep is interrupted all night, which makes him sleepy all day long. Persons with sleep apnea are more likely to be injured by traffic accidents, work injuries and other medical problems. If you have this disease it is important that you get proper treatment.

• If the circumference of the neck is more than 17 inches (43 centimeters), that person is more likely to have sleep apnea
• Smoking Smoking may cause inflammation and swelling of the duct tissue. This may be a reason for smokers to experience sleep apnea more than non-smokers. Some people with mild sleep apnea can treat their injuries after stopping smoking and drinking alcohol
• Age is more common among people over the age of sixty-five. But sleep apnea may affect people regardless of their age, even children. The shape of the neck and throat and their dissection may cause sleep apnea. Man inherits these traits from his parents as he inherits the size of the nose and ears. If a person’s cramps are narrow, he is more likely to have sleep apnea.
• Men have more sleep apnea than women. Sometimes the tonsils and lymphocytes swell, causing partial obstruction in the airway during sleep. Doctors may recommend surgery to remove inflamed tonsils or fleshy in people with sleep apnea.

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

• Weakness in the muscles of the tongue and the pharynx of the pharynx: There is a deep relaxation in this area during deep sleep (sleep after severe stress or sleep).
• Enlargement in the size of the tongue, which may strain the muscles of the course during constriction and incontinence during the sleep of the person, and thus lead to frequent self-break and force him to wake up frequently during the night
• Increase the density of the tissues surrounding the pharyngeal cavity, such as enlargement of the tonsils and gonads (nasal pharyngeal), which occurs in children,
• Excessive weight gain in adults.
• Elongation and soft palatine tissue.
• Organic nose obstruction: such as nasal deflection, inflated nasal cornea, nasal or nasal growths, and nasal tumors.
• There are some diseases that can lead to increased tissue density surrounding the oral pharyngeal cavity such as thyroid dysfunction, which leads to weight gain and accumulation of fat.
• There are rare neurological causes of apnea, including polio, Thalamus-related diseases such as stroke, and spinal cord diseases.

• Intermittent sleep at night leads to drowsiness 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 sleepiness causes hundreds of thousands of traffic accidents every year and is often fatal. Patients with severe sleep apnea who have not received treatment are more than twice as likely to have two or three times as many accidents.
• Poor sleep deprivation may cause some changes in the personalities of people with sleep apnea, including irritability, forgetfulness, mood swings, anxiety and depression.
• Sleep apnea may cause impaired mental capacity due to forgetfulness and inability to concentrate.
• Children with sleep apnea often suffer from attention deficit disorders.
• The heart makes more effort to give the body 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 that may cause death

• Sleep apnea may cause sexual dysfunction in men due to poor circulation, fatigue and personality changes. Sexual impotence is the lack of an erection. People with sleep apnea may feel more sensitive to hypnotics, especially those that are used in anesthesia. This excessive anesthesia may threaten the life of the patient, so it is very important that the person with sleep apnea informs his / her doctors that he or she may have sleep apnea. Sleep apnea affects those who sleep apnea in their bedroom. The husband or wife or those who have sleep apnea in their bedroom often notice a loud, sudden snoring sound during the night, which prevents them from sleeping even if they do not move to another room. Sleep apnea may cause tension between the couple.
• Drying the throat because of breathing through the mouth and keep the mouth open for a long time.
• Depression and difficulty concentrating.
• Insomnia disorders.
• Severity of breathing disorders.

There are many ways to diagnose and usually ask the patient’s partner in the room and methods and the best test of sleep called polysomnography

There are two types of testing:

• Night test that measures brain waves during sleep, muscle, eye movement, breathing process, blood oxygen level as well as sounds released as snoring.

• The second type is a device to be given to the patient and with specific instructions from the specialist and then analyze the computer information the next day.

Non-surgical methods:

• To treat the mild degree of obstructive sleep apnea, doctors first recommend some lifestyle changes, including:

• Avoid alcohol
• Avoid hypnotism
• Weight loss
• stop smoking
• Sleep on one side

• In some sleep apnea, doctors recommend using a mouthpiece to keep the airway open during sleep. The dentist or orthodontist makes the oral instrument. The oral instrument adjusts the jaw and tongue position to keep the airway in the larynx open. Some people with sleep apnea have oral damage, but they may cause long-term damage to the teeth, gums and mandible. There are also some help devices that can pull the tongue forward to prevent it from sliding backwards during sleep.

• C-PAP can be connected to the mouth and nose region immediately before sleep. This device pumps the air into the airway in a continuous pressure manner, by continuous positive air pressure in the patient’s nose which helps keep the airway open. There are several models of airflow machines with constant positive pressure, but many have a face mask before sleeping. The continuous positive pressure airflow machine has been very successful in treating sleep apnea and is now the most widely used treatment method. If the patient wants to test the ventilator by continuous positive pressure, he or she should give the treatment two weeks or more before observing the results. He also has to learn how to put the mask properly without pressing his face.

Surgical methods

• Treatment of congenital malformations that affect the breathing process, such as in the case of warping of the nose, which leads to obstruction in the respiratory tract and also when the small size of the lower jaw than normal or when the small opening at the end of the throat. As well as when treating sore throat or inflammation of tonsils or large size and remove the growth behind the nose, especially in children also help to get rid of the problem
• The surgical procedures that are used in the advanced cases or when the patient’s request because of non-compliance with the aforementioned devices, and is diverse and depends on the case and causes and need to see a doctor specialist and from them

• Removal of a part of the lumbar and lifting the roof of the throat: a process in which the surgeon removes the larynx is an excess of diet related to the last pharynx and throat, and lifting the roof of the throat in proportion to the patient and his condition

• Laser Assisted Uvuloplasty (LAUP): Laser surgery or cosmetic surgery is the most common treatment for snoring. The doctor should be specialized in the operation of this type of surgery.

• The lifting of the throat cap (Pillar Procedure), a process designed to raise the throat by planting a substance within the muscle tissue with the roof of the throat (soft palate) and lead to tighten the roof of the throat naturally and without resorting to surgery and thus prevent snoring and obstruction of the soul during sleep, and It is one of the most modern and safest methods in the world and proven to be 90% effective. It can be performed in the clinic under local anesthesia and the patient is referred to practice his life immediately after the disappearance of local anesthesia without pain. It is the most common currently among the surgical methods performed by the specialist nose, ear and throat

• There is also a type of treatment in the therapeutic methods by surgery and depends on the radiation that occurs in the shrinkage of tissues that cause obstruction in the respiratory tract

At the end of the talk should be sure to diagnose carefully to know the cause of respiratory disorders and thus find appropriate treatment

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

• Snoring is high with shortness of breath

• Intermittent cessation of breathing during sleep

• Sudden loud snoring or sleep during sleep

• Daytime drowsiness

Sleep apnea treatment helps to enjoy deep sleep, which will rejuvenate during the day. It will also prevent heart disease and high pressure diagnosis right by discussing the problem with the doctor, because there are many solutions that can help the patient and make his life and those who love better.

Dr.. Ahmed Mahmoud Alyan