Appointment with a somnologist people often come with complaints of snoring and the appearance of respiratory arrest during sleep. The latter is usually reported to them by concerned relatives. If breathing pauses in sleep last more than 10 seconds, this makes a person suspect one of two serious diseases: either obstructive sleep apnea syndrome (OSAS for short), or central sleep apnea syndrome (abbreviation – CSAS). What are these violations and how dangerous are they for health?

Obstructive sleep apnea: causes of respiratory arrest during sleep

During sleep, muscles relax, including the muscles of the pharynx. Therefore, in a sleeping person, the lumen of the respiratory tract is always less than in a person in the waking state. If, for some reason, the patient’s pharynx is narrowed more than normal, in a dream there may come a moment when it closes completely. Because of this, breathing in a dream stops.

The most common causes of OSA are:

• Excess body weight – in this case, fatty tissue, like a clutch, envelops the pharynx from all sides, slightly squeezing it;
• Violations in the structure of the facial skeleton, in particular, a small lower jaw in adults. In the presence of this feature during sleep, the tongue falls back, becoming a mechanical obstacle to the flow of air.
• Adenoids or enlarged tonsils are the main factors in the development of sleep apnea, they create an obstacle to the passage of air at the level of the pharynx.
• Problems with normal breathing through the nose. Curvature of the septum, polypous formations in the nose, runny nose with acute respiratory infections, rhinitis of an allergic nature – all this can provoke snoring and OSAS.
• Taking alcohol, muscle relaxant drugs, and sleeping pills are common reasons why adults stop breathing during sleep. All of these substances reduce the tone of the muscles of the pharynx, provoking the collapse of its walls and their adhesion to each other.

Now back to the patient with sleep apnea. What happens to the sleeping person at the moment when he has an obstruction (closing) of the lumen of the pharynx? He reflexively tries to take a breath, but it doesn’t work. The oxygen content in the blood drops, the body experiences acute oxygen starvation. At some point, a protective mechanism is triggered – the brain partially or completely awakens. He gives a signal to the muscles of the pharynx, they come into tone, the lumen of the pharynx becomes passable, and the person takes a noisy breath. There is a loud snoring . And then the sleeper continues to snore until the moment when his muscles relax again, and he again has a pause in breathing.

Watch this video: a patient talks about the symptoms he experienced before being treated for sleep apnea. Do you have similar symptoms?

You can also learn about the symptoms and diagnosis of obstructive sleep apnea from the video of this lecture:

Causes of central sleep apnea

In central sleep apnea syndrome , disorders that lead to respiratory arrest do not occur at the level of the respiratory tract, but in the respiratory center of the brain. It is his disorders that cause inhalation pauses in patients to sleep.

There are many reasons for SCAS. Respiratory arrest can occur in people taking opioid drugs (morphine, heroin, methadone), and sleep apnea is also detected in people with severe kidney and heart failure. Similar problems can appear in healthy people who find themselves in the highlands. Very rarely, central sleep apnea occurs in patients receiving CPAP therapy for obstructive sleep apnea. It is not known what causes the development of apnea in such patients, but it has been found that this phenomenon in people who are on CPAP therapy is temporary.

Why does a child stop breathing in a dream

If your child stops breathing intermittently during the night, it’s important to see a sleep specialist, pediatrician, or otolaryngologist.

The cause of apnea in a child is most often adenoids or chronic tonsillitis, which manifests itself as an increase in the palatine tonsils. In such situations, small patients are most often indicated for surgery.

In other cases, the cause of respiratory arrest in children is allergic rhinitis and other problems with nasal breathing. Obesity and anomalies in the development of the jaws can provoke respiratory arrest in a child.

Sleep apnea treatment

Treating patients with OSA and CAAS is not an easy task. If surgery helps with normal uncomplicated snoring in 80% of cases , then surgical treatment is contraindicated for OSA and SCAS, since it is simply ineffective.

To help his patients, the doctor finds out in detail the symptoms of the disease and the reasons why there was a cessation of breathing in a dream. Further, the specialist selects a treatment aimed at eliminating one, and more often several causes of apnea at once.

If breathing through the nose is disturbed, the help of a surgeon may sometimes be required. In other cases (for example, with allergic respiratory disorders), Nasonex hormonal drops are prescribed , which are allowed from the age of two.

For patients with a small or posteriorly sloping lower jaw during sleep, intraoral devices that push the jaw forward may be recommended.

For people who abuse alcohol, drugs and sleeping pills, as well as smokers, the doctor will recommend that you stop taking these drugs and stop smoking.

Everyone, without exception, will benefit from gymnastics for training the pharyngeal muscles, as well as following recommendations regarding sleep hygiene. For example, you need to sleep with an elevated headboard, and choose an orthopedic pillow for sleep. The advice not to sleep on your back is easy to follow if you sew a tennis ball into your pajamas in the back area.

Most patients with sleep apnea syndrome (starting with moderate severity) are shown CPAP therapy . Its essence is as follows: before going to bed, the patient puts on a face mask connected by a soft hose to a special apparatus. The main unit of the device, under low pressure, supplies air to the hose. The air stream, getting into the pharynx, straightens the airways on inhalation and exhalation, so pauses in breathing stop. In patients suffering from central forms of apnea, CPAP therapy is usually not used, as it does not give the desired effect.