The term “breathing disorder in a dream” means a number of conditions that cause a breathing disorder during sleep.
The most common of these is sleep apnea. Apnea means a temporary cessation of breathing. Despite the fact that there are other types of sleep apnea, the term “sleep apnea” is usually meant a syndrome of obstructive sleep apnea (OSA), in which the patient for a short time lose the ability to breathe due to temporary obstruction of the airways in the throat called pharynx. In patients with OSA, such cases can occur several hundred times during a single night’s sleep. In patients with OSA, such cases can occur several hundred times during a single night’s sleep.
During sleep, our muscles relax. In some people, relaxation of the tongue and some muscles in the larynx can lead to a narrowing of the airway, leading to impaired and temporary cessation of breathing. In this case, the brain produces a short partial awakening, in which the airway opens up again and breathing resumes. Repeated waking up during the night can seriously affect the quality of sleep and lead to excessive daytime sleepiness.
In addition, each case of apnea is accompanied by fluctuations in heart rate and blood pressure. Ultimately, high blood pressure (hypertension) also continues after waking up, as a result of which the risk of a heart attack or an angina attack increases.
Patients with OSA tend to snore. Noise from snoring occurs when the tissues of the larynx vibrate, which indicates an unstable condition of the respiratory tract and increases the likelihood of squeezing during sleep. However, OSA is observed only in a minority of snorers.
Symptoms of OSA may occur both day and night.
- Increased sleepiness
- Lack of concentration
- Headache in the morning
- Mood Swings
- Dry mouth
- Impotence or decreased sexual desire
- Restless sleep
- Temporary stop breathing
- Awakening from choking
- Realistic dreams
- Night polyuria (night urination)
- Salivation and teeth grinding
The prevalence of sleep apnea increases with age to 60 years.
Any cause that leads to a narrowing of the throat increases the likelihood of developing OSA.
The main risk factor is moderate or severe obesity, since it is accompanied by an increase in adipose tissue around the larynx. Obesity was found in 60% – 90% of patients with OSA and is the most common risk factor in adults.
Smoking and drinking also increase the prevalence of snoring and sleep apnea.
In some people, sleep apnea develops due to their genetic predisposition.
Sleep apnea is more common in men than in women.
Certain types of structure of the facial bones of the skull cause a narrow larynx, which increases the likelihood of developing SOAS; The most common is a chin chin. Certain genetic diseases, such as Down syndrome, also provoke the development of OSA in a patient.
OSA also develops in children, and the most common contributing factor is enlarged tonsils. In some children and adults, severe nasal congestion may worsen the disease.
Diagnosis and treatment
The diagnosis of OSA is often made on the basis of symptoms and clinical examination, but in most cases, records made at night are necessary to confirm. For a detailed study of sleep, called polysomnography, an electroencephalogram is made, muscle activity, eye movements, heart activity, chest movements, nasal air flow, and oxygen content in the blood (oximetry) are recorded.
This detailed study is carried out in sleep laboratories, but for most people who are suspected of having OSA, it is possible to conduct a simpler study using portable equipment, often at home with the patient. With some devices, you can record various combinations of oxygen in the blood, chest movements, air flow, and heart rate.
To assess daytime sleepiness, fill out a simple questionnaire, which is called the Epworth Sleepiness Scale. In this questionnaire, the patient is asked to assess the probability of falling asleep in various daily situations. It is also recommended that the bed partner give information about the symptoms of sleep apnea, such as snoring and apnea, confirmed by a witness.
The most effective treatment for apnea is to maintain a positive continuous airway pressure (PNDD), which is a simple and economical method. This treatment method requires the use of a device that directs the flow of air through the mask into the nose (or into the nose and mouth) with the pressure necessary to keep the larynx open and overnight. To achieve positive results, this equipment must be used every night. Other treatment options include using a device that is inserted into the mouth to extend the lower jaw or, if necessary, to have tonsil surgery.
On the moment not exists pharmacological treatment.
- In developed countries, according to reports, apnea is observed in 3% – 7% of middle-aged men and 2% – 5% of women.
- Sleep apnea increases the risk of developing hypertension andcardiovascular diseases, depressions and insomnia-related accidents.
- Patients who do not treat apnea are at 1.2 – 2 times the risk of road accidents.
- The pre-hospitaldiagnosis of sleep apnea is associated with medical costs per person, which are 50% – 100% higher than the average
- It is necessary to raise awareness of this condition and its consequences in the absence of treatment.
- Health authorities and transport authorities should be aware of the impact of insomnia caused by OSA on driving vehicleswith the goal of taking measures to reduce the risk of driving for individuals and the general public.
- Are required additional efforts to simplify research conducted in order to diagnose this disease.
- Centers for the treatment of apnea need to be expanded, as waiting time for evaluation and treatment is a serious problem in Europe.
- To increase the effectiveness of therapy, it is necessary to better understand which treatment is most effective for different groups of patients.