What is sleep apnea 1

Sleep apnea syndrome

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Obstructive sleep apnea syndrome is a chronic sleep disorder. Breathing stops, breathing pauses and breathing pauses during sleep can lead to an insufficient supply of the organs with vital oxygen. This undersupply triggers subliminal wake-up reactions.

What happens with obstructive sleep apnea syndrome?

Normally, muscles, bone and cartilage structures mechanically keep the airways from the nose to the windpipe open. There are no supporting anatomical structures between the base of the tongue and the entrance to the larynx. If there is an obstructive sleep apnea syndrome, the pharynx walls suck towards each other during inhalation and this leads to a narrowing (obstruction) of the airways and a reduced or completely interrupted air flow.

What examinations are required?

If sleep apnea is suspected, a so-called polygraphy is first carried out at home. In addition, the patient is given a small monitoring device ("sleeping suitcase") to take home with them, which they put on themselves when they go to bed. The device records breathing, blood oxygen levels and heartbeat while sleeping.

In order to find out whether a breathing disorder is also affecting the quality of sleep, it is sometimes necessary to check the depth of sleep and the quality of sleep more closely at the same time as measuring breathing and oxygen. A very similar investigation is carried out for this, the so-called Polysomnography, in which the brain waves are also measured. In the past, this examination was only possible in a sleep laboratory. Today it can usually be done at home.

Before a diagnosis of sleep-related breathing disorder is made, an ear, nose and throat examination should be carried out to determine whether there are any obstructions in the respiratory tract, nose and upper throat. Very enlarged tonsils are also more frequently the cause of persistent snoring and obstructive sleep apnea syndrome.

One differentiates in

  • Respiratory arrest during sleep (apnea)
  • Decrease in airflow (hypopnea)

Both apnea and hypopnea cause an insufficient supply of oxygen to the body. This can be demonstrated by the reduced oxygen saturation. The oxygen shortage, known as hypoxia, triggers an alarm reaction in the body, which in turn initiates the wake-up reaction. If apneas or hypopneas occur repeatedly during the night, the recovery of the body is disturbed during sleep. In addition, hormone stimulation (adrenaline) that is also triggered can disrupt blood pressure regulation, which in the long term can lead to heart attacks and strokes.

Five or fewer respiratory arrests per hour are not considered to be pathological. An obstructive sleep apnea syndrome is present when breathing stops occur more than 5-10 times per hour, clinical symptoms of disturbed sleep at night or, if necessary, accompanying diseases such as high blood pressure are present. The severity levels of obstructive sleep apnea syndrome are defined as follows:

  • Apnea / hypopnea <5 per hour: normal findings, no treatment necessary
  • Apnea / hypopnea 5-10 per hour: limit value range, treatment for clinical complaints or relevant concomitant diseases makes sense
  • Apnea / hypopnea 10-20 per hour: slight disturbance, treatment recommended
  • Apnea / hypopnea 20-30 per hour: moderate disorder, treatment recommended
  • Apnea / hypopnea> 30 per hour: Serious disorder, treatment required

Guiding symptoms obstructive sleep apnea syndrome

  • loud, irregular snoring
  • pronounced daytime sleepiness
  • Breathing pauses (breathing pauses)

Other symptoms:

  • restless sleep
  • Changes in personality
  • Irritability, lack of concentration, cognitive deficits (mental performance decreases)
  • morning headache
  • (Loss of libido or impotence, weight gain, night sweats and alcohol intolerance possible)

Risk factors obstructive sleep apnea syndrome

  • Obesity: the higher the body mass index (BMI), the more severe the sleep apnea syndrome. The syndrome can also occur in people of normal weight, but it is usually a mild apnea syndrome. Therefore, if a sleep apnea syndrome is suspected, the examinations of the lungs also include a determination of the BMI.
  • Smoke
  • high blood pressure
  • Diabetes mellitus
  • Lipid metabolism disorders
  • Sedentary lifestyle
  • Heart disease such as coronary artery disease, heart muscle disease, cardiac arrhythmia

In the therapy In sleep apnea, general measures such as maintaining adequate sleep hygiene and, in the case of overweight, reducing body weight are in the foreground. The most effective therapy is the so-called CPAP therapy. During inhalation and exhalation, air is continuously pumped into the throat through a nasal mask so that it is kept open from the inside. In the case of mild sleep apnea, operations or the use of a specially made dental splint that pushes the lower jaw forward a little (lower jaw protrusion splint) are sometimes useful.

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