Snoring
Introduction
Introduction Snoring (medical terminology, snoring, sleep apnea syndrome) is a ubiquitous phenomenon of sleep. Most people think that this is commonplace, and it is not taken for granted. Others regard snoring as sleepy. which performed. In fact, snoring is a big enemy of health. Because of snoring, sleep breathing is repeatedly suspended, causing severe hypoxia in the brain and blood, forming hypoxemia, and inducing hypertension, brain heart disease, arrhythmia, myocardial infarction, and angina pectoris. A nighttime apnea of more than 120 seconds is prone to sudden death in the early hours of the morning.
Cause
Cause
In medicine, snoring is called "sleep breathing termination syndrome." According to statistics, the problem of snoring is more serious for men, and the ratio of male to female is 6 to 1. On the other hand, male snoring begins earlier, and may occur after about 20 years of age. Women are later than men, and most occur after age 40. In medical theory, snoring is caused by the following three reasons:
1. Caused by central diseases.
2, caused by obstructive diseases.
3. Caused by mixed diseases.
In general, adults are most likely to have mixed symptoms, and children have the most obstructive problems.
The medical profession believes that snoring is also likely to be caused by other causes of the body. The current medical research report shows that patients with hypertension and cardiovascular disease have a higher chance of snoring, and those who are more obese than normal people are more prone to snoring. In addition, patients with chest problems, diabetes, rheumatoid arthritis and other diseases There are more common problems with snoring.
Examine
an examination
Related inspection
Otolaryngology CT examination of brain CT examination
Polysomnography is the "gold standard" for the diagnosis of snoring and has an irreplaceable role in other methods of examination. Through various sensors and electrodes placed on the snorer, the polysomnography can trace the electroencephalogram, electrocardiogram, nasal and nasal airflow, blood oxygen saturation, snoring, posture, eye movement, chest and abdomen breathing of the snorer's sleep. A graph of multiple parameters such as exercise and limb movement, which is a polysomnography. Polysomnography can analyze the snorer's sleep (distinguish between sleep and wakefulness, determine sleep depth), breathing and heart condition, and make a definitive diagnosis of snoring and hypoxia; according to apnea indicators, apnea can be judged Types, such as obstructive, central, and mixed; can also be judged to be simple snoring or snoring, and to assess the severity of snoring.
The diagnostic criteria for snoring are:
Hysteria can be divided into two types: simple snoring and obstructive sleep apnea syndrome. Simple snoring is a partial obstruction of the upper respiratory tract during sleep, resulting in snoring during sleep, but apnea and hypoxia are rare, have little effect on health, and do not sleep during the day. Obstructive sleep apnea syndrome may occur if the nose and mouth breathing frequently stops and suffocates due to periodic full obstruction of the upper respiratory tract during sleep. If the upper airway airflow is blocked and the respiratory airflow stops for more than 10 seconds, it is called an apnea. If the apnea occurs more than 5 times during 1 hour of sleep, it can be diagnosed as obstructive sleep apnea syndrome, that is, snoring.
Diagnosis
Differential diagnosis
According to the clinical manifestations and monitoring results of the multi-channel sleep recorder, these types of sleep-disordered breathing can be clearly diagnosed, and sometimes differentiated from other diseases such as pulmonary heart disease and sleep-disordered breathing.
It should be noted that although healthy people's REM sleep phase is relatively regular, it can be seen at the beginning of sleep that a few minutes of respiratory instability disappears after stable sleep. The apnea seen during this period did not have respiratory movements, and obstructive sleep apnea was also likely to be mistaken for healthy people with asymptomatic CSAS. However, usually less than 20 times per night, only mild arterial oxygen saturation is reduced. If the phase occurs during REM sleep, the arousal response is weakened, which may lead to a significant decrease in arterial oxygen saturation.
In addition, there are two types of apnea-like phenomena that are easily confused with sleep apnea syndrome:
1 Epilepsy: mild epilepsy without tension can also have apnea, such as when it occurs during sleep or after the onset of sleep-like episodes can be confused with sleep apnea can be identified by EEG.
2 Chen-Shi's breathing: can be seen in patients with reduced cardiac output or prolonged circulation, as well as various neurological diseases affecting the respiratory center and some elderly people are difficult to distinguish from central apnea, and both can coexist but Chen - The change in respiratory amplitude of Shi's breathing is moderated from small to large and then reduced to apnea apnea. The shorter central apnea tends to occur suddenly, often with a wake-up response longer than 60 s. In addition, Chen-Shi's breathing can continue to be awake, while central apnea does not occur when awake, and often worsens during REM sleep.
OSAS can also co-exist or independently occur with CSAS obesity hypoventilation syndrome upper airway resistance syndrome, but simple OSAS patients usually have no hypercapnia in awake state, while obesity hypoventilation syndrome often occurs even during daytime PaCO2 Above 45mmHg.
Patients with chronic obstructive pulmonary disease may have significant respiratory and gas exchange functions during sleep. Deterioration is mainly due to severe arterial oxygen saturation reduction and transient specific respiratory abnormalities such as apnea and hypopnea during REM sleep. The mechanism is still unclear and may be related to abnormal breathing activity associated with this sleep. In addition, when these patients are awake, there is a chemical ventilatory response to slow sleep, which can further aggravate the ventilatory response. Whether this condition is diagnosed with sleep-disordered breathing and how to name it is not consistent.
