Snoring is a problem not for the patient, but for others. However, snoring can be a symptom of a serious illness. What are the causes of snoring and how to get rid of it?
General information about snoring
Snoring is a sound phenomenon during sleep caused by the vibration of the soft tissues of the upper respiratory tract in conditions of limited inspiratory flow. In most cases, it occurs during the inhalation phase, although it can also occur during exhalation. Regardless of when snoring occurs, it is caused by the opening and closing (you might call it flutter) of upper airway structures, including the soft palate and the root of the tongue. Also, snoring is promoted by mucous secretions due to chronic inflammation.
According to modern concepts, snoring is divided into two types: habitual and isolated. Habitual is most often combined with obstructive sleep apnea in combination with complaints of daytime sleepiness, fatigue. In the event that a polysomnography was performed and no other respiratory disorder was found, such snoring is called isolated. Also, isolated snoring is not associated with metabolic syndrome and cardiovascular disease.
What is apnea?
The word “apnea” is translated from Greek as “no breath”. Sleep apnea is a stoppage of breathing during sleep that lasts for a few seconds. There are three types of this disorder: central, obstructive and mixed. Obstructive sleep apnea is a pathology characterized by repeated episodes of cessation or reduction of airflow during sleep due to obstruction (i.e. overlap) of the upper airways, accompanied by a decrease in blood oxygen saturation.
Central sleep apnea, unlike obstructive sleep apnea, is not accompanied by airway blockage. With this pathology, there are no ventilation impulses generated by the respiratory center of the brain.
Apnea symptoms are as follows:
constant snoring at night;
pauses in breathing during sleep;
feeling of suffocation at night;
increased motor activity during sleep;
Diagnosis of respiratory disorders
The main diagnostic task is to distinguish between isolated snoring and snoring, which is combined with pauses in breathing during sleep. The objective assessment in this study is the measurement of snoring (graphic, quantitative), which is based on the use of special devices (during respiratory monitoring or polysomnography in the sleep laboratory).
The choice of diagnostic method depends on the clinical picture of the disease. Polysomnography is a rather expensive method. Its use will be justified if there are indications of respiratory arrest, complaints of daytime sleepiness, fatigue, insomnia. And also, if the patient has concomitant diseases, such as metabolic syndrome, arterial hypertension and heart rhythm disturbances.
In addition to the above examinations, in the diagnosis of respiratory disorders, the following are used: cardiorespiratory test, EEG (electroencephalogram), ECG (electrocardiogram), measurement of the flow of inhaled and exhaled air.
Causes of snoring and sleep apnea
The causes of snoring and sleep apnea are varied. Predisposing factors are: male gender, overweight, older age, large tonsils or tongue, gastroesophageal reflux (or GERD), snoring and sleep apnea in relatives. The causes of snoring also include deformity of the nasal septum, chronic rhinitis, sinusitis, edema caused by an infection of the respiratory tract, and the appearance of polyps in the nose.
Treatment and prevention of snoring and sleep apnea
Treating snoring is quite difficult. Currently, there are many different snoring remedies available without a prescription, but almost all of them have limited effectiveness. Usually these are nasal dilators, various moisturizers for the mucous membrane of the nose and throat, nutritional supplements, special pillows. More reliable treatments for snoring include lifestyle modification, mouthpieces, nasal septum surgery, and non-invasive mechanical sleep ventilation (CPAP).
Lifestyle modification, first of all, is weight loss, refusal to drink alcohol, smoking cessation. Oral devices can also be used to treat snoring in the presence of a healthy bite. Surgical treatment of snoring can be performed in its isolated form, but only in cases where an anatomical substrate is identified that contributes to the development of snoring.
Continuous positive upper airway pressure (CPAP) therapy is commonly used to treat patients with sleep apnea. But it is also known that CPAP therapy successfully fights snoring. The device is a portable compressor that, under constant positive pressure, delivers air into the patient’s airways, thereby preventing upper airway obstruction during sleep. A mask is attached to the breathing circuit (there are various modifications, including mouth, nasal and nasal masks), through which air is supplied. To achieve a clinical effect, it is recommended to use therapy for at least 5 hours during sleep for at least 70 nights.
The most common side effects of CPAP therapy are local irritation of the skin under the mask, dryness of the nasal and pharyngeal mucosa, nasal congestion or discharge from it, conjunctivitis. However, these violations may be associated with the incorrect use of masks or the wrong choice of the device operation mode.
Speaking about the prevention of respiratory disorders, again I would like to note the importance of a healthy lifestyle. Or rather, the normalization of body weight, the cessation of alcohol and smoking cessation. Patients with position-dependent variants of apnea and snoring should avoid positions during sleep (usually on the back) that cause sleep apnea.