Sleep apnea: causes, symptoms, consequences and remedies

What specifically is sleep apnea? What are the causes? And are there any remedies?

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Sleep apnea is a chronic disease that compromises the quality of sleep with various consequences. What are the causes? Do's and Don'ts? How to prevent them and what are the foods and remedies that can favor or counteract it?





A real syndrome capable of causing breathing interruptions during sleep. What happens is basically a total or partial narrowing of the respiratory tracts in the phase of sleep where the lungs do not receive air and normal breathing movements stop. Hence loud snoring and a lowering of oxygen levels in the blood. But what specifically is sleep apnea? What are the causes? And are there any remedies?

For sleep apnea to be diagnosed in a person, they must occur at least 10 or 15 suspensions in one night. Even children can suffer from it. In all cases, only a specialist can assess the situation and recommend the use of certain therapies.

Breathing is always normal, but the frequency of sleep apnea and, consequently, the frequent lowering of oxygen in the blood, can cause the release of stress hormones and related pathologies.

Index

What is night apnea

Sleep apnea is the momentary interruption of breathing during sleep, a real one breathing block due to a temporary stop of the passage of air in the upper airways, which are located just behind the nose and mouth.

These interruptions can recur many times in a night, but because it is medically diagnosed, at least 10 or 15 suspensions must occur per night.

If the airways in the sleep phase narrow, it also means that the lungs are not receiving air. A number of causes that can then lead to snoring and a sudden drop in oxygen levels in the blood. If these levels drop too low, ours brain sends nerve impulses to stiffen the neck and upper respiratory tract muscles.



Frequent lowering of oxygen in the blood can cause the release of stress hormones and therefore to: an increase in heart rate, the risk of arterial hypertension, stroke, myocardial infarction.
Sleep apnea must be treated and to do this it is essential to distinguish the two types.

Central sleep apnea

It is caused by a disorder of the nerve centers which control the automatism of breathing and therefore by alterations of the stimulus to breathe, in the absence of an obstruction of the airways. This means that there may be cases in which the nerve impulse that must move the respiratory muscles from the brain stops in the true sense of the word.

These are rare forms, which can appear in the presence of some neurological pathologies, such as central lesions, or neuromuscular diseases, such as muscular dystrophy and lateral sclerosis. But also in the presence of congestive heart failure.

The most well-known form of central sleep apnea is "Undine Syndrome", the congenital central hypoventilation syndrome.

Obstructive sleep apnea

It is practically the mechanical blockage of the respiratory tract during sleep and is characterized by episodes of partial or complete closure of the upper airways leading to respiratory interruption.
In this way, the concentration of oxygen in the blood is reduced, the quantity and quality of sleep are compromised.

Sleep apnea: causes, symptoms, consequences and remedies

Obstructive Sleep Apnoea Syndrome (OSAS) is the most common form of the disease, with an incidence of 2% of the female population and 4% of the male.

Causes

When we talk about sleep apnea, therefore, in general we speak of the obstructive form. Risk factors can be obesity, aging or family history. Very young children can suffer from enlarged tonsils resulting in sleep apnea.



Common causes of obstructive sleep apnea syndrome include:

  • adeno-tonsillar hypertrophy
  • postmenopausal state
  • drinking alcohol or sedatives
  • neuromuscular pathologies
  • Down syndrome or other genetic syndromes
  • smoke
  • asthma and allergic rhinitis
  • craniofacial anatomical alterations
  • epistaxis
  • cancerous forms of the thyroid gland
  • metabolic syndrome

Additionally, sleep apnea is often associated with chronic diseases such as arrhythmias, heart failure, stroke, diabetes, gastroesophageal reflux, and hypothyroidism.

Sleep apnea: causes, symptoms, consequences and remedies

Symptoms

If there are no particular symptoms in the case of central sleep apnea (it is mostly asymptomatic), other than restless sleep and long breathing pauses, in the case of obstructive sleep apnea the symptoms are different and can occur during sleep , upon waking or even during the day.

First of all, in the presence of sleep apnea there is a tendency to snore at night, even at intervals, to gasp and pant. Snoring is often interspersed with sudden awakenings (of which the patient has no memory) with a sense of suffocation and labored breathing.

In general, the main symptoms of sleep apnea are:

  • drowsiness
  • respiratory acidosis
  • arrhythmia
  • asthenia
  • dry mouth or throat
  • atrial fibrillation
  • mood disturbances
  • insomnia
  • decreased sexual desire
  • cyanosis
  • headache
  • dyspnea
  • shortness of breath
  • white patina on the tongue
  • yellow tongue
  • lethargy
  • myoclonus (a short, involuntary contraction of a muscle)
  • nocturia (needing to interrupt sleep in order to get up to urinate several times during the night)
  • sleepwalking
  • night sweats

In addition, during the course of the day, one may suffer from agitation, fatigue, difficulty concentrating, morning headaches and excessive daytime sleepiness.

Consequences of sleep apnea

Sleep apnea: causes, symptoms, consequences and remedies

If sleep apnea is not treated promptly and appropriately, in the long term it can result in:

  • the development of arterial hypertension
  • cardiovascular diseases
  • respiratory failure
  • metabolic disorders
  • diabetes and obesity
  • heart failure
  • heartbeat abnormalities and arrhythmias
  • accidents in the workplace or driving vehicles

Driver's license

Precisely regarding the last point, art. 2 of the decree of 22 December 2015, which governs the assessment of fitness to drive, includes obstructive sleep apnea among the diseases that must be carefully evaluated when renewing or issuing the driving license.

"The driving license must neither be issued nor renewed to candidates or drivers suffering from severe neurological diseases of a degree that is incompatible with driving safety".

According to the law, therefore, those who suffer from sleep apnea will be able to obtain or renew their driving license only if precise conditions exist, as sleep apnea "causes severe and incoercible daytime sleepiness", which increases the risk of incurring road accidents.

In this regard, the decree of 3 February 2016 of the Ministry of Health, relating to the rules to be followed to ascertain the fitness to drive for people affected (or suspected to be affected) by OSAS, defines the cases of suspected OSAS. and the need for a further assessment to define the risk profiles for road traffic.

Remedies for sleep apnea

What needs to be done if sleep apnea is suspected is to consult a specialist immediately. He will make a diagnosis based on the symptoms and on the basis of some sleep tests, such as polysomnography and respiratory polygraphy.

Treatment is directed first at controlling risk factors, then at specific sleep apnea episodes. Traditionally, continuous positive pressure is applied to the airways so that they do not collapse during sleep (CPAP), or to the application of oral appliances or airway surgery, in case of presence of anatomical alterations or intractable disease.

Continuous positive pressure ventilator

This is the most common therapy for moderate to severe sleep apnea in adults, using a mask that covers the nose and mouth, or just the nose.

Orthodontic appliances

There are custom-made plastic appliances to treat sleep apnea, aimed at putting the jaw and tongue back in place and helping to keep the airways open during sleep.

Surgical intervention

It consists of widening the airways, removing removed, stiffening or shrinking excess tissue in the mouth or throat, or rearranging the jaw.
For children in some cases, tonsil removal surgery is useful.

Lifestyle

Sleep apnea can be cured by changing your lifestyle, with a few simple steps:

  • keep the line
  • no smoking, no alcohol
  • avoid medications that can cause drowsiness, as they cause difficulty in keeping the throat open during sleep
  • sleep on your side rather than on your back
  • for the night, if useful, use nasal sprays or allergy medications (not vasoconstrictors), on the advice of your doctor only

Germana Carillo

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