July 2, 2012
Snoring ranks high among the most annoying causes of divorce. We tell you what snoring is, why people snore and why it is dangerous.
Among the most annoying reasons for divorce, banal snoring ranks high. It is not surprising, because loud noises at night lead to chronic lack of sleep for spouses, stress and conflicts with household members. However, the snoring person himself experiences serious inconveniences, ranging from feelings of guilt to health problems. Let's figure out what snoring is, why do people snore and why is it dangerous?
What is snoring?
Snoring is noisy breathing during sleep. Normally, a person does not snore
: for him it is not physiological. The annoying sounds called snoring are based on the vibration of weakened structures of the nasopharynx and oropharynx: the soft palate and uvula. Most often, snoring occurs during inhalation, but sometimes a person snores while exhaling. All people snore from time to time, but not everyone has snoring as a constant problem. According to various sources, among people aged 30 to 60 years, 44 percent of men and 28 percent of women snore.
Snore
Allergy
9714 June 16
IMPORTANT!
The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Snoring: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.
Definition
Snoring is a specific low-frequency vibrating sound made by a person when breathing during sleep. It occurs in 5-10% of children and approximately 30% of adults. Mild snoring can occur in anyone and does not require treatment. Loud snoring is often a sign of obstructive sleep apnea syndrome (OSA) - repeated short-term cessation of breathing.
When a person is awake, the muscles of the pharynx, soft palate and tongue are in good shape, the lumen of the upper respiratory tract remains free, breathing is light and silent. During sleep, muscle tone decreases, the muscles of the soft palate and the walls of the pharynx gradually relax, and the lumen of the pharynx narrows slightly. If there are predisposing factors leading to excessive relaxation of the muscles of the pharynx and/or its narrowing, then when breathing and the passage of a stream of air, its walls begin to vibrate and create a characteristic sound (snoring).
In the deep sleep phase, there is a further decrease in muscle tone in the lower part of the nasopharynx and oropharynx (soft palate, root of the tongue, epiglottis), which can lead to complete collapse of the pharynx and the development of an acute episode of suffocation.
As a result, the organs begin to experience oxygen starvation, in response to this the brain restores control over the pharyngeal muscles and the airways open again. The person snores loudly and takes several deep breaths - normal oxygen levels are restored in the body. This cycle can be repeated many times during the night (up to 400–500 stops of breathing of varying duration).
The size of the lumen of the upper respiratory tract at the level of the pharynx depends on:
- from the initial internal diameter of the pharynx,
- on the degree of pressure reduction in the lumen during inspiration,
- from the tone of the pharyngeal muscles during sleep.
Frequent episodes of suffocation with a decrease in oxygen concentration in the blood cause drowsiness throughout the next day, headaches, decreased potency, sweating and frequent urination at night, the development of cardiovascular, metabolic, endocrine, neurological and mental disorders.
Acute and chronic lack of oxygen during sleep significantly increases the risk of hypertension, heart rhythm disturbances, myocardial infarction, stroke and sudden death during sleep.
Severe sleep apnea in children leads to severe attention deficit hyperactivity disorder and delayed physical and mental development.
Types of snoring
Doctors distinguish several types of snoring depending on the severity of its development and possible consequences:
- isolated or uncomplicated snoring:
- episodic - can be observed in all people during a cold, as well as as a result of severe fatigue, alcohol consumption;
- constant – occurs at least three times a week;
Possible causes of snoring
The most common causes of narrowing of the airways at the level of the pharynx in adults are:
- fat deposition in the walls of the pharynx in obese patients (fat deposits in the area of the soft palate, uvula, lateral arches narrow and compress the lumen of the pharynx);
- enlarged tonsils, adenoids, nasal polyps;
- deviated nasal septum;
- congenital anomalies of the upper respiratory tract, underdevelopment of the upper or lower jaw;
- malignant or benign neoplasms of the nasopharynx;
- enlarged tongue (Down syndrome, congenital tumors, endocrine disorders, amyloidosis);
- rhinitis, occurring with inflammation and swelling of the nasal passages;
- elongated uvula;
- Thornwald cyst (congenital cyst-like formation located on the posterior wall of the nasopharynx);
- deformations of the facial skeleton after injury;
- hypertrophy of the vocal cords, larynx, tongue with acromegaly, etc.
The main causes of snoring and the formation of obstructive sleep apnea syndrome in children are adenotonsillar hypertrophy of allergic or inflammatory origin, obesity and rhinitis.
Constant breathing through the mouth leads to the formation of a vertically elongated face in a child, a small lower jaw shifted back, and “crowded” teeth. Secondary hypertrophy of the palatine tonsils develops. If chronic nasal obstruction is not treated, by the age of 10–12 years a child may develop developmental defects of the facial skeleton, which in themselves will be risk factors for the development of snoring. By the age of 25–30, moderate and severe forms of obstructive sleep apnea syndrome develop.
Patients with hypothyroidism (low thyroid function) are predisposed to weight gain and swelling of visceral tissues, as well as decreased muscle tone. As a result, there is a tendency to snore.
With acromegaly in adults, there is a disproportionate growth of individual organs, including the tongue, which leads to a narrowing of the lumen of the pharynx at the level of the root of the tongue and increases the risk of developing OSA.
Neuromuscular dystrophic processes (aging, neuromuscular diseases, amyotrophic lateral sclerosis) cause disruption of the muscles, including those responsible for maintaining the lumen of the airways open during sleep. This increases the risk of collapse of the pharyngeal walls and the development of obstructive sleep apnea syndrome.
Alcohol and drugs have a muscle relaxant effect (relaxing effect on muscles), inhibit brain activity and contribute to snoring.
Smoking has a negative chronic irritant effect on the upper respiratory tract - as a result, tissue swelling is formed, leading to narrowing of the airways and causing sleep disordered breathing.
The risk of developing snoring in smokers is 2 times higher than in non-smoking patients.
Which doctors should I contact if I snore?
If you snore, you should consult an otolaryngologist or somnologist (a specialist who deals with sleep problems). Consultations and treatment with other specialists may be recommended - nutritionist, orthodontist, , , .
Diagnostics and examinations for snoring
Polysomnography is a long-term instrumental method for diagnosing sleep disorders, which is carried out to assess the functioning of the body during sleep, identify abnormalities in brain activity, breathing, cardiac activity and determine the cause of sleep disorders. About 18 sensors are installed on the patient, which are attached to the head, torso and limbs. During sleep, sensors record breathing indicators, blood oxygen saturation, respiratory movements of the chest and abdominal wall, body position and movements of the lower extremities, electrocardiogram, electroencephalogram (electrical activity of the brain), electrooculogram (eye movements), electromyogram (mental muscle tone), snoring . Video cameras above the bed record a person's reactions during sleep. Then the doctor deciphers the received data.
Computer somnography is a method for diagnosing sleep-disordered breathing. The device is placed on the wrist, and two external sensors are installed on the finger (to record blood oxygen saturation and pulse) and on the chest (to record snoring episodes, body position, chest movement). The result is processed by the computer.
Cardiorespiratory monitoring is a hardware method for recording air flow passing through the nose and mouth, movement of the chest and abdominal wall, snoring, and blood oxygen saturation. In addition, an electrocardiogram is taken.
Respiratory monitoring is a hardware method for recording respiratory flow, snoring, oxygen content in the blood, and pulse parameters. The device is attached to the wrist, and the cannula coming from it is installed in the nose.
X-rays of the facial part of the skull, computed tomography or MRI are carried out to clarify the characteristics of deformations of the bones of the nose and jaws; determining the exact location, size, structure of the tumor: x-ray of the paranasal sinuses, x-ray of the skull, MRI of the brain, CT of the brain and skull, CT of the paranasal sinuses.
Causes of snoring
Snoring has many causes.
The most common of them are the anatomical features of the structure of the nasopharynx, diseases affecting the upper respiratory tract, as well as age-related decreases in muscle tone. In the latter case, weakened muscles leave the airways open during sleep. Snoring can also be caused by narrowing of the airways. This type of snoring is usually associated with high blood pressure and heart disease. Such dangerous excess weight
The dangers of excess weight are not limited to short-term cessation of breathing during sleep. Read about how to lose weight correctly and reliably.
Is snoring dangerous to your health?
What is obstructive sleep apnea syndrome (OSA)? How does apnea differ from simple snoring, what danger does sleep apnea pose to a person and how to treat it? Somnologist and endocrinologist Ekaterina Mikhailovna Kalinina spoke about this and much more on the live broadcast of the Apteka.ru website.
You can watch the broadcast on the Apteka.ru channel on YouTube.
Snoring in itself is not a diagnosis. It occurs as a result of beating and vibration of tissue in the nasopharynx, since there is no cartilaginous frame there. Muscles relax during sleep and vibrations occur. But sometimes the walls of the pharynx and palate collapse, as a result, air does not enter the lungs, but breathing efforts are maintained.
The man tries to breathe, but cannot. Sleep fragmentation, decreased oxygen levels, and daytime sleepiness occur.
It's called "sleep apnea", obstructive sleep apnea (OSA - obstructive sleep apnea syndrome) - and this is serious. It should be noted that apnea is defined as stopping breathing for more than 10 seconds.
How common is this syndrome?
5–7% of people over 30 years of age suffer from this pathology. Thus, more people suffer from OSA than from diabetes (3%) and bronchial asthma (5%).
A severe form of the disease occurs in 1-2% of people over 30 years of age, but the older a person gets, the more common this syndrome is.
After 60 years of age, up to 20% of men and women suffer from OSA. Women are more protected due to their hormonal levels.
Risk factors for OSA
Who suffers from this disease? Men suffer more often than women: for every ten men there is one woman.
The older the person, the higher the likelihood of the disease.
In addition, most people with OSA are obese. Endocrine diseases can also lead to this syndrome.
Alcohol abuse aggravates OSA.
Disturbances in the structure of the ENT organs and changes in the structure of the facial skeleton - for example, a small jaw pushed back - can also cause a severe form of OSA.
And lastly, the use of sedatives and hypnotics can lead to OSA, so caution should be exercised.
Why is obesity a major factor?
Fat tissue is deposited not only on the waist, but also around internal organs, including around the throat.
In an obese patient, the lumen of the pharynx is narrower, which is reduced by fat pads. The muscles relax at night and collapse easily.
Therefore, obese patients are more likely to suffer from this syndrome. In addition, as a result of sleep problems, obese people have difficulty losing excess weight. Question from a viewer: Does alcohol become a risk factor only immediately after consumption or does it have a longer lasting effect? Is it possible to experience sleep apnea by drinking alcohol once a month?
A risk factor is chronic alcohol consumption. There is a very high probability of developing OSA in people who drink alcohol daily, but occasional consumption (once a week, once a month) is dangerous, it can lead to the development of mild OSA or worsen the situation if the syndrome already exists.
How does OSA lead to significant disturbances in the body?
As a result of falling asleep, muscle tone decreases and the airways collapse, breathing stops, which leads to a decrease in blood oxygen saturation.
The body immediately reacts to any fluctuations in oxygen. This is stress for the body: increased levels of adrenaline and other hormones can lead to increased blood pressure. The heart rhythm may be disturbed, which can even cause the heart to stop.
OSA can cause a stroke or heart attack during sleep.
Due to OSA, patients experience morning headaches and erythrocytosis (blood thickening due to increased production of red blood cells, a reaction to lack of oxygen).
Due to lack of oxygen, the brain has to constantly wake up the patient, due to which the patient is unable to enter the deep stages of sleep.
Why is snoring dangerous?
Snoring means that the nose or windpipe is partially blocked. The more the airways are blocked, the worse the oxygen supply to the entire body. In addition, snoring increases the risk of developing carotid atherosclerosis, a narrowing of the blood vessels that supply the brain. According to scientists, the vibrations that occur during snoring damage the carotid arteries and lead to an increased risk of the formation of atherosclerotic plaques in them. People who snore often also suffer from apnea
- periodic stops in breathing that can last up to ten seconds or more. Physiologically, apnea is similar to snoring. However, with it, the muscles relax so that they cause not partial, but complete closure of the airways.
Snoring - symptoms and treatment
Behavioral techniques are the basis for the treatment of both uncomplicated snoring and sleep apnea syndrome.
To get rid of snoring it is recommended:
- reduce body weight;
- avoid sleeping on your back;
- Avoid alcohol and sleeping pills before bedtime;
- stop smoking.
There are special exercises and even simulators that, with regular use, can increase tone and strengthen the muscles of the oropharynx and upper respiratory tract, helping to reduce the intensity of snoring.
There are studies confirming that snoring and obstructive sleep apnea syndrome are reduced by singing and regular playing of the didgeridoo , an Australian Aboriginal wind instrument [27][32].
Special intraoral devices , which are installed on the upper and lower teeth and allow the lower jaw to move forward during sleep. Typically, such devices are custom-made by an orthodontist, but there are also cheaper devices made from thermoplastic plastic that are similar in appearance to a boxing mouth guard. Moving the jaw forward helps to increase the lumen of the oropharynx and reduce snoring.
Snoring can also be reduced by facilitating nasal breathing with the help of nasal sprays (only as prescribed by an otolaryngologist!), humidifiers in the sleeping area, and strips to widen the nasal passages.
Orthopedic pillows can help relieve the symptoms of snoring. When you sleep on a pillow that is too low, your head falls back; when you sleep on a pillow that is too high, your neck muscles become tense. In both cases, snoring intensifies. Using an orthopedic pillow relaxes the muscles of the neck and chest, and the symptoms of snoring are reduced. You can also raise the head of the bed by 15 cm to prevent your tongue from sinking.
It is useful to do a set of exercises in the morning and before bed, for example, try to open your jaws 25-30 times, interfering with your hands.
Surgical methods
In the treatment of isolated snoring, uvulopalatoplasty surgery , which involves excision of the enlarged uvula and palatine arches, is effective. There is also a more advanced version of the operation - uvulopalatopharyngoplasty, which consists of excision of the uvula, palatine arches and tonsils. It is indicated for their hypertrophy. Determining the indications and performing the surgical intervention itself should be carried out by an experienced operating otorhinolaryngologist.
In recent years, due to low morbidity, selective laser and radiofrequency interventions on the soft palate have become widespread. Their principle of operation is that scars are applied to the soft palate using a laser or radio frequency, which leads to its hardening over time. It should be noted that these operations are not effective enough for sleep apnea syndrome.
One of the types of minimally invasive surgical treatment for snoring and sleep apnea syndrome is the introduction of Pillar palatal implants into the soft palate, which leads to its compaction and, accordingly, to a decrease in the intensity of snoring. Implants are inserted for life. The operation is contraindicated in case of inflammation in the oral or nasal cavity.
In cases where snoring is a manifestation of obstructive sleep apnea syndrome, treatment measures are aimed primarily at correcting the underlying disease, that is, sleep apnea syndrome. The main treatment method in this case is “PAP” (Positive Airways Pressure, English - positive pressure in the upper respiratory tract), sometimes the term “CPAP” is used. The method involves using a special device that creates positive pressure in the patient’s upper respiratory tract, which prevents it from collapsing and stopping breathing. The selection of the device, mask and mode of operation of the device is carried out by a somnologist. CPAP is not a treatment for snoring and is described in detail in the article about sleep apnea syndrome.
In conclusion of the review of methods for treating snoring, it is necessary to mention that many original and even curious ways to get rid of this disease are now being proposed, which have no evidence of effectiveness. Among them are various dietary supplements, clips, magnetic bracelets and even special anti-snoring insoles. It should be understood that all this does not bring real benefit.
Several myths about snoring
Healthy, sober sleep
Even moderate doses of alcohol drunk at night reduce the number of sleep phases during which a person truly rests.
Remember, sleep and alcohol are not friends. Myth:
Bogatyr snoring is a sign of good health.
Fact:
Loud snoring indicates that the “hero” has already developed sleep-disordered breathing.
Myth:
Only men snore.
Fact:
About 40 percent of men and about 30 percent of women snore.
Myth:
You can fight snoring with “folk” remedies (tying up your lower jaw, sewing a ball on the back of your pajamas, wearing special bracelets).
Fact:
None of these methods have been shown to be effective in clinical trials. The above methods of prevention, as well as surgical treatment, can be considered effective. Its necessity is determined by an ENT doctor.
Why snoring is dangerous and how to deal with it
You may not even know it, but there's a good chance you snore. If you do not live alone, then you have probably already been informed about this. If so, this is bad news for both you and those around you. The good news is that snoring can be treated at the Doctor ENT family clinic. Why can a sweet heroic dream be dangerous, and what to do about it?
Snore. Is he dangerous? Let's figure it out together with ENT doctor A.V. Sviderskaya.
Snoring is vibration of the soft tissues of the larynx and pharynx. During sleep, the muscles relax, and the flow of air during breathing vibrates the tissues with a characteristic sound. These sounds depend on each person's specific anatomy, and the sound can range from almost imperceptible to powerful snores.
Why does a person snore?
The “origin” of your snoring may vary. For example:
- Nose injuries and impaired nasal breathing
- Overweight
- Bad habits
- Malocclusion
- Wrong position in which you sleep
- Individual anatomical features or age-related changes in the throat and pharynx
It is a common belief that snoring is just a household inconvenience for those who are trying to sleep next to a noise source. But is everything so harmless?
Why is snoring dangerous?
It has long been believed that powerful snoring indicates that a person is strong and healthy. But the sound prevents spouses from sleeping in the same bed, and if there is nowhere to hide from the noise, people around them have problems sleeping, as a result of which they do not get a full night’s rest.
Have you ever woken up from your snoring? Many people believe that a person cannot hear his own snoring, but in reality this is not the case. Often a person simply does not remember his micro-awakenings, and during the day they suffer from drowsiness and lack of concentration of thoughts, because the brain and body are not rested. Therefore, not only those around him suffer, but also the person himself.
Finally, snoring is highly likely to be a symptom of diseases or unhealthy conditions in the body, the most dangerous of which is sleep apnea syndrome (or, scientifically speaking, obstructive sleep apnea syndrome, OSA).
Apnea - the silent killer of snorers
"A silent killer
During sleep, the relaxed muscles around the respiratory tract not only vibrate under the influence of the air flow, but can become so close during inhalation that they completely block breathing. If you have observed the dream of a snoring person, then you probably remember a frightening moment - the snoring is replaced by complete silence with a cessation of breathing, then the sleeper changes his position or moves his arms and legs and takes a sharp deep breath.
During the night, patients with apnea syndrome can have up to 300-400 such stops, with a total duration of up to 4 hours. Each of them is stress for the body, disrupting normal blood pressure, the functioning of the hormonal system, heart rate, and even fatal consequences. In addition, under conditions of a lack of oxygen in the body, the processes of lipid peroxidation occur more actively, and this is the main “sponsor” of aging.
What to do if you snore?
Don't panic! It is not at all necessary that your particular case indicates a mortal danger. However, if you have the following symptoms: regular snoring, sleep apnea, nocturnal asthma attacks, frequent night urination, morning headache, daytime sleepiness, then you are at risk for OSA. It's time to go to the doctor and cure your snoring!
Heal - and sleep without fear
Treatment for snoring is possible at the Doctor ENT clinic
Yes, snoring can really be cured! Tell your loved ones this news and make them happy! A modern painless operation in 15 minutes will tone the soft palate and stop their long-term suffering.
The worst thing about this operation is its name: uvulopalatoplasty. Under local anesthesia, a micro-incision is made using a laser in the tissues of the soft palate, as a result of which a small scar is formed and the tissues are pulled upward. They will no longer interfere with the free movement of air during breathing.
Laser uvulopalatoplasty is no longer exotic. We at the Doctor ENT clinic have performed hundreds of similar operations. We note improvements in the well-being of our patients - they sleep better, the load on the heart decreases, and other health indicators increase.
Good health to everyone - and good night!
Sviderskaya A.V.
Chief physician of the clinic "Doctor ENT"
ENT doctor, candidate of medical sciences.
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