Causes and consequences of sleep apnea
More and more often I hear from the circle of friends and acquaintances that nocturnal respiratory murmurs - ie sleep apnea - are becoming more and more of a topic in recent times. Sleep apnea must be treated as it affects the health, as well as the professional and private life of the person affected.
How does sleep apnea become noticeable?
Lead daytime sleepiness with a tendency to falling asleep, difficulty concentrating, reduction in mental capacity, the feeling of having hardly slept at all, listlessness, dryness in the mouth, impotence, aversion and sluggishness may indicate apnea.
Sleep is disturbed; This creates a chronic unnoticed sleep deficit, which is noticeable by daytime sleepiness. Those affected become forgetful, often suffer from anxiety and mild depression, often experience headaches.
Daytime tiredness leads e.g. in motorists to an up to seven-fold increased accident probability due to unconcentrated driving, up to life-threatening microsleep.
The risks of apnea:
- high blood pressure
- heart failure
- Circulatory disorders of the heart muscle up to the infarction
- Arrhythmia
- arteriosclerosis
- stroke
But what happens?
During the night, the muscles in the pharynx become slack, the tongue falls back and blocks the respiratory tract. The breath stops, at worst for minutes, at worst several times a night.
Respiratory arrest lasts between 10 and 120 seconds and occurs up to five times per hour's sleep.
There are three types of sleep apnea:
- OSAS = Obstructive sleep apnea
- ZSAS = Central Sleep Apnea
- Mixed sleep apnea,
Obstructive sleep apnea is the most common. Men of older age are more often affected, women are usually spared until menopause.
In obstructive sleep apnea blockage of airflow to the lungs occurs due to blockage of the upper airway, in the nose or throat.
The possible cause of a blockage, for example, is that the muscles relax too much during sleep, thus preventing adequate airflow.
The central sleep apnea usually develops in older age due to her- circulatory diseases.
Possible causes of apnea:
Causes of sleep apnea are predominantly
- too high a body-measure index (overweight)
- the age
- the use of sedatives and sleeping pills
- Diabetes mellitus
- Nicotine and alcohol consumption
- heart failure
- Sleep in the supine position
but also (rather rare):
- rheumatism
- Hypothyroidism
- enlarged almonds
- Nasal polyps and fatty and connective tissue at the entrance of the respiratory tract
Reason for common sequelae:
In respiratory arrest, oxygen saturation in the blood decreases, which means that the brain and all organs are no longer adequately supplied with life-sustaining oxygen. The brain detects the acute emergency and causes the wake-up reaction, which is not noticed by the affected person in most cases.
The cause of the blockage of the upper respiratory tract is z. For example, the weight of the neck narrows the airways, the muscles relax too much in the sheep and prevent the flow of air (in the form of central sleep apnea - ZSA - for example, the airways are open, but there is no air flow of the lungs. This condition is often not recognized, because those affected rarely snore).
If there is even the slightest suspicion that you have a sleep apnea, it is urgently necessary to see a doctor immediately. He will prescribe a training in a sleep laboratory, in which on average two nights, the sleep behavior is examined. Usually it is enough to arrive in the evening in the sleep laboratory of the hospital and spend only the night / nights there. The evaluation is then sent to the family doctor or pulmonologist, further steps are discussed and prescribed.
This includes a CPAP therapy using a nasal / breathing mask, which keeps the airways open with overpressure. Breath loss is prevented and deep sleep (REM) is achieved again. Individually, there are other options, such as minor complaints and non-obese patients. an operation or dentist-adapted lower jaw splint.
Ventilation therapy is helpful in all cases of apnea if it is done consistently and consistently. The little effort to thoroughly clean the mask and tube daily is out of all proportion to the benefits of the therapy.
However, it is not enough to treat sleep apnea solely by CPAP therapy:
It would make more sense to eliminate the cause of apnea, ie to eliminate obesity, hypertension and disturbed lipid metabolism.
The costs of the CPAP mask (Continuous Positive Airway Pressure) are taken over by the health insurance companies.
