Treatment of snoring and sleep disorders - sleep apnea
About
Snoring is a sound phenomenon caused by the vibration of the soft tissues of the oral cavity and pharynx during sleep.
Treatment of snoring is complex and long-term. We distinguish between occasional snoring, chronic or habitual snoring without pathological apnea and snoring as a concomitant sign of obstructive sleep apnea (OSA). Stopping breathing during sleep – sleep apnea – for a few seconds is a normal occurrence during REM sleep.
Sleep apnea lasting 10 seconds or more in adults or >3 seconds in young children is a warning sign. An apnea frequency of 10 or more during one hour of sleep (apnea index >10) or >30 during a 7-hour sleep is considered pathological.
Obstructive sleep apnea (OSA) is a much more dangerous health condition than snoring.
With it, the flow of air in the nose and pharynx stops, the pharynx is closed for the passage of air due to the weakness of the muscles, which the body tries to overcome with the increased effort of the abdominal wall and chest.
Obstructive apnea can last longer than 2 minutes and is typically accompanied by snoring after re-establishment of breathing.
Candidate
Symptoms of OSAS are exhaustion, continuous fatigue and sleepiness during the day, morning headache, waking up with a dry mouth or sore throat, attention problems, irritability. Patients often suffer from overweight, high blood pressure, typically have a short, wide neck with a narrowed and swollen pharynx, enlarged ends and palatine villi. Smoking, consumption of alcohol and various drugs significantly increase the risk of OSAS. OSAS must be treated because the long-term presence of elevated blood pressure, coronary insufficiency and heart rhythm disorders inevitably leads to sudden cardiac death.
Preparation
We treat snoring by adhering to general measures and lifestyle, which helps reduce symptoms in milder cases. This includes: reducing body weight, avoiding sleeping pills, alcohol, carbonated drinks and nicotine, avoiding sleeping on your back, using the side position, maintaining nasal patency - inhalation of saline solutions or short-term nasal decongestants.
Treatment
Surgical treatment of snoring consists of: extraction of the third tonsil and tonsil, surgery of the nasal septum, nasal shells and sinuses, uvulopalatopharyngoplasty UPPP (tightening of the soft tissues of the palate and pharynx), Pilar method for the treatment of the soft palate, reduction of the base of the tongue by laser and correction of the lower jaw. Treatment of severe OSAS is carried out using a CPAP (Continuous positive airway pressure) mask, which supports breathing with continuous positive pressure. It is a device that blows air into the airways through a mask placed over the nose or over the mouth and nose that the patient wears while sleeping. Air is blown under a pressure of 4-20 cm H2O and thus prevents airway collapse.
Result
The purpose of surgery for snoring is to establish good nasal passage and tighten the loosened mucous membrane of the pharynx, which causes snoring with its vibrations.
Precautions
The assumption that a patient could successfully use a CPAP mask is the patency of the nose and pharynx. If the patency is insufficient, before using the mask it will be necessary to perform one of the surgical procedures described above that improves nasal breathing or widens the pharynx.
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