Sleep apnea occurs when breathing stops for at least 10 seconds while sleeping. Depending on whether there is respiratory effort or not, apneas can be classified as:
- Obstructive : when there is respiratory effort.
- Central : when there is no respiratory effort.
- Mixed : when they start as central and end up as obstructive.
Causes of sleep apnea
While you are sleeping, it relaxes all body muscles, even those muscles that are concerned with keeping the airway open. When the upper throat muscles relax while we sleep, breathing can be stopped for a few seconds, resulting in sleep apnea. When this area of the throat is narrow or small, the medical picture is worse if sleep apnea occurs.
There are many cases of people who suffer from sleep apnea and snore. Snoring on these occasions occurs when the air tries to pass through the narrow or blocked airway. However, not all people who snore suffer from sleep apnea.
- Age : as the years go by, the muscle tone of the upper airways is less.
- Sex : It is more common in men than in women.
- Hormones : the airway is favored by estrogen and progesterone. Menopause and androgens increase the risk of sleep apnea.
Anatomical features of the palate or upper airway that cause it to collapse more easily:
- Tonsils and large adenoids in children that can block the airway.
- Short neck.
- Dentofacial deformities: small jaw, maxillary deficiency.
- Large tongue that can retract and block the airway.
- Big bell.
- Neurological alterations affecting the airways and the respiratory regulating center.
- Sleeping posture: lying down or lying on your back favors the posterior displacement of the tongue and soft palate, reducing the diameter of the upper airways.
- Percentage of body fat.
- Toxic habits
Diagnosis of sleep apnea
- Clinical history and complete physical examination: mouth, neck and throat.
- Specialized questionnaire.
- Sleep study or polysomnography.
The treatment aims to keep the airways open so that the breathing does not cease while sleeping. Continuous airway pressure in the airways is usually the most common treatment, given by a machine with a tight face mask. Some patients may need dental devices inserted into the mouth at night to keep the jaw forward.
Surgery may be indicated in some cases:
- Uvulopalatopharyngoplasty (UPPP): involves removing excess tissue in the back of the throat.
- Orthognathic surgery : to correct abnormal structures of the face.
- Surgery on the nose and sinuses .
- Sleep hygiene.
- Weight control.
- Do not drink alcohol or smoke at least 6 hours before bedtime.
- Minimize the consumption of central nervous system depressant drugs.
- Sleep on the side and the headboard at 30º.