Sleep crisis: “snoring” is a manifestation of apnea
Case 1: Pharaoh, 62 years old, has frequent chest tightness and belching for 3 months at night.
Doing dynamic electrocardiogram examination found frequent premature beats, and more often during sleep at night, and even 5 cardiac arrests up to 8 seconds.
The family was frightened; it was possible to “sleep to death” in the evening at any time.
Pharaoh usually does not have other diseases, that is, the snoring is particularly severe. Examination revealed that there is severe OSAS. Since his arrhythmia occurs mostly at night, doctors highly suspect that it is related to OSA.
Case two: Xiao Zhang, 40 years old, has an overweight body. Since he was found to have high blood pressure six months ago, he has used three antihypertensive drugs. His blood pressure has not been able to drop, far from reaching the ideal standard.
The doctor inadvertently inquired and found that he had severe snoring at night, and recommended that he conduct polysomnography, and found that there was severe obstructive sleep apnea syndrome (OSAS).
After 1 month of treatment, Xiao Zhang’s blood pressure was significantly controlled, and gradually began to reduce the use of antihypertensive drugs.
People often hear ambulances whizzing at night or in the early morning, which is related to the high incidence of sleep-related heart events at night.
On this year’s World Sleep Day, attention will be focused on the connection between sleep and the heart.
Experts point out that sleep is closely related to heart disease, and a large number of clinical studies have confirmed that the incidence of high blood pressure and heart disease will increase if long-term lack of sleep or poor sleep. If sleep is accompanied by apnea, it will be more harmful to the heart.”It’s worse.”
The long-term insomnia heart rate fluctuates greatly. Everyone knows that no matter whether asleep or awake, the heart is always “working” hard, delivering blood to the whole body.
Professor Li Taoping, director of the Southern Hospital’s Sleep Medicine Center, said, “Few people know that even during sleep, the brain also participates in the regulation of cardiac homeostasis and plays the role of” commander. ”
During the cycle transition between wakefulness and sleep, dynamic changes in brain parameters affect heart rate, blood pressure, cardiac blood supply, breathing, etc. Such fluctuations increase the risk of arrhythmias, myocardial ischemia and myocardial infarction in patients with heart disease.
According to Professor Pan Jiyang, director of the Department of Psychiatry and Sleep Center of the First Affiliated Hospital of Jinan University, if he lacks sleep every day 6.
At 5 hours or more, the incidence of cardiovascular disease increases.
A survey of 120,000 nurses aged 30-55 years in the United States found that sleeping too long or too short will increase the risk of coronary heart disease, with less than 6 sleeps per day.
At 5 hours, the incidence of cardiovascular disease increased by 15%, and the incidence of coronary heart disease increased by 23%. Those who sleep more than 9 hours per day (mainly refer to people with poor sleep quality, such as those with sleep apnea syndrome), have cardiovascular diseaseWill increase by 63%.
The survey also showed that 7-8 hours of sleep are the best for health and the lowest risk of coronary heart disease.
“This situation is even more common. People often hear ambulances whizzing at night or in the early morning, which is related to the high incidence of sleep-related heart events at night.
“Li Taoping said.
Pan Jiyang explained that long-term sleep disorders can cause repeated stress, anxiety, irritability, agitation, and anxiety, and cause the cerebral cortex to excite-inhibit imbalance, which will cause small arterial blood vessels to contract and increase blood pressure in the surrounding blood vessels to increase blood pressure, Lipid metabolism disorders, resulting in cardiovascular disease.
”Snoring” is an important manifestation of apnea. If there is apnea during sleep, it is even worse for the heart.
Pan Jiyang said that during sleep apnea, hundreds of central or obstructive apnea can occur every night, which may have serious adverse consequences on cardiopulmonary activity.
It is now known that sleep apnea is associated with various cardiovascular events such as hypertension, coronary heart disease, arrhythmia, and heart failure.
Studies in recent years have shown that sleep apnea-hypopnea syndrome (OSAHS) itself is one of the causes of nocturnal arrhythmias, especially bradycardia.
OSA patients account for 59% of patients who need pacemaker implantation. Therefore, relevant guidelines recommend that doctors conduct a systematic review of patients who are preparing to install pacemakers. If OSA is diagnosed and there is significant nocturnal arrhythmia, OSA should be targeted first.For treatment.
In 2008, the American Heart Association and the American Cardiology Foundation jointly issued the Scientific Statement on Sleep Apnea and Cardiovascular Diseases. In 2009, China issued the Expert Consensus on Sleep Apnea and Cardiovascular Diseases; it aims to promote the comprehensiveness of clinicians.A deep understanding of the relationship between sleep apnea and cardiovascular disease and the current status of treatment.
Nevertheless, the whole society, whether doctors or patients attach great importance to sleep and breathing disorders, is far from being as high as it should be.
What kind of disease is sleep apnea?
Zhang Tao, Director of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Jinan University, introduced that OSAHS is a disease. Due to some changes in body structure, breathing is not smooth during sleep. The patient’s thorax and abdomen move with breathing during sleep, butNo air flow through the mouth and nose.
It can be counted once every 10 seconds, and sleep more than 30 times every 7 hours every night.
Therefore, the patient does not sleep soundly, the actual brain does not rest, that is to say, from the nose to the trachea, any link: nasal, throat, tongue root, trachea infarction, OSAHS can occur.
Professor Li Taoping pointed out that people commonly call “snoring” and “snoring” is an important manifestation of sleep apnea.
I used to think that “snoring is a good night’s sleep”, but now I find that this is a misunderstanding.
People who snore often feel “not enough sleep” because they don’t sleep well, and can fall asleep anytime, anywhere, and are mistaken for “good sleep.”
In fact, snoring is a manifestation of airway stenosis. To a certain extent, snoring will cause breathing to stop during sleep, which will lead to hypoxia and awakening. Repeated occurrence will lead to poor sleep quality and fragmentation, which will affect the entire system of the body in the past., Especially the cardiovascular system.
It’s easy to see that fat people are more likely to snore.
Obesity caused by a poor lifestyle is an important cause of OSA.OSA is also an aging disease. As people age, many people who did not have OSA will develop OSA, especially in postmenopausal women.
The course of OSA develops slowly, occurs during sleep, and is often often ignored initially, only to show up when other problems occur.
Because it has some concealment and great harm, it should be paid more attention to, and the disease should be treated before it happens.
Professional ratings should be done before surgery. Currently, OSAHS medications are ineffective.
Zhang Tao said that to do sleep monitoring, through imaging and respiratory manometry, determine which part of the nose, throat, tongue, and trachea has an infarction.
OSAHS can develop from birth to old age, and each age has its own treatment strategies and methods.
This problem is common in children with tonsil hypertrophy, adenoid hypertrophy, or abnormal throat development.
For OSAHS, the most commonly used oropharyngeal angioplasty is not surgery can solve all problems, the previous surgical indications were too wide, but people with maxillofacial deformities, the results are not good.
Pharyngopharyngoplasty is indicated for patients with tonsil hypertrophy and pharyngeal stenosis.
Most need to do continuous positive nasal pressure breathing therapy, that is, wearing a ventilator for life.
There are standards for OSAHS surgery in Germany: one is not too old, it is not recommended to be over 45 years old, followed by excessive obesity is contraindicated, and body mass index over 30 is obese.
After the pharyngeal surgery, the local area was swollen and fractured, and the severity was greater than before the surgery.
In addition, the professional rating of the hospital is needed to determine whether it is suitable for surgery.
Stopper has no effect There are a large number of therapeutic products for snorers on the surface. Is it as useful as a stopper?
Zhang Tao and Pan Jiyang both said that they have no effect. The principle is to stimulate the acupuncture points during the process of falling asleep. However, there is no evidence-based medicine to prove the efficacy of the stopper.
For less severe OSAHS, patients are still encouraged to control their weight, eat lightly, do not eat supper before going to bed, do not drink, do not smoke, and sleep on the right side.
Because of the diameter of the pharyngeal cavity in many patients, when lying down, the muscles of the pharynx and the root of the tongue will fall back, which will cause the hypopharyngeal stenosis.
When sleeping on the side, falling down can be avoided, while lying on the right side, the heart is on the top, the heart is no longer compressed, the heart function is not in conflict, and the stomach on the right side is in the vertical direction, which is beneficial to gastric emptying.
Some people with snoring OSAHS snoring, but others only snoring, but the next day work is completely drowsy.
It’s not called OSAHS, it’s called hysteria.
But also intervene because it will progress to OSAHS.
Because snoring is that the airflow passes through the pharyngeal cavity, but the flow is not smooth, and the soft palate has a snoring sound for the airflow, that is, it has been distorted.
You should quit drinking, don’t eat a greasy diet, don’t get full before going to bed, don’t smoke, and control your weight.
Consistent with light OSAHS processing.
How to determine OSAHS daytime excessive sleepiness has many common causes: 1.
Causes narcolepsy 3.
People with fatal limb dyskinesia must be tested for sleep, and then identified as a series of problems.