Sleep Apnea

What is it?

It's a chronic and progressive debilitating desease with high mortality and morbidity and a high incidence in the population. It's a complex situation that often requires an inter-relationship of various medical areas,

What is and what causes it?

It is a disorder characterized by respiratory arrest lasting more than 10 seconds, repeated overnight. Occurs when the tissues of the pharynx (throat) approach and prevent the entry of air, closing the airway during sleep. A patient with sleep apnea falls asleep, stops breathing and wakes, breathing resumes, sleep, breathing stops again and so successive periods throughout the night. Thus, this situation leads to a fragmentation of sleep during the night, causing a poor quality of sleep.

What are the complaints?

Patients with sleep apnea are often obese, with a very heavy snoring and breathing pauses to watch a restless sleep. Have hypersomnolence during the day, falling asleep with ease even when driving or at work. They can also refer to fatigue, difficulty concentrating, irritability, memory loss, sexual impotence and morning headaches.
They may also have hypertension. The Snore corresponds to a noise caused by vibration of the tissues of the throat during the passage of air. Not all people who snore have sleep apnea, but all people who suffer from apnea snore.

What consequences might be?

In addition to lowering the quality of life caused by the complaints mentioned above, there is an increased risk of car accidents and work. There are also risks for the night: each time breathing stops, the low level of oxygen, forcing the heart to work harder and can lead to an increased risk of cardiovascular disease and even sudden death during sleep.

How is it diagnosed?

When there is suspicion of this situation the patient should seek medical advice and should be accompanied by his partner, because it is important to know what goes on during the night when the patient thinks he is sleeping well..
The doctor may recomend to make a polysomnogram witch is a recording made during sleep witch allows to assess the severity of the disease.

What is the treatment?

The recommended treatment depends on the clinical status of each patient and includes:
Loose weight;
Avoid alcoholic beverages (alcohol depresses breathing by making more frequent and severe apneas);
Avoiding sleeping pills (for the vast majority exacerbates sleep apnea);
Use medications to relieve nasal congestion, if any;
Sleep-side (the apnoeas are more frequent when lying on back)

Nasal continuous positive airway pressure (CPAP) is the application of a nose mask at night. This unit has a continuous air pressure forcing air to pass through the airway, leaving the apnea occurs and allowing the individual to breathe normally without sleep is disturbed.

Intraoral appliances, which allow a better opening of the upper airway with anterior projection of the jaw, tongue and soft palate.
Surgical procedures to correct physical changes that affect breathing during the night. These include enlarged tonsils or adenoids, nasal polyps, a deviated nasal septum, and malformations of the jaw or soft palate.

The uvulopalatopharyngoplasty (UPPP) and laser-assisted uvulopalatopharyngoplasty (UPPL) are techniques in which the surgeon removes excess tissue at the back of the throat (uvula and part of the soft palate) that may be blocking the airway during sleep. In addition to these surgeries, in the most serious cases it may be necessary to resort to other surgical techniques more differentiated as the maxillomandibular and mental. In other extreme cases, with a very severe sleep apnea may be necessary to perform a tracheotomy.