Obstructive Sleep Apnea (OSA)

                       Obstructive Sleep Apnea (OSA)

What is OSA?

Obstructive sleep apnea generally refers to more than 30 episodes during an adult's 7 hours of sleep per night. During each episode, the airflow through the mouth and nose stops for 10 seconds or more, and is accompanied by blood oxygen saturation. decrease, etc.

What are the causes of OSA?

When breathing normally, the key to gas exchange is the upper airway above the larynx, so that the gas can enter the tracheobronchial unobstructed. If for some reason, this airflow is blocked, snoring or obstructive sleep apnea will occur.

Risk factors for obstructive sleep apnea

  1. Gender: Men are about two to eight times more likely to get the disease than women. However, after menopause, women have the same chance of getting the disease as men. ​​
  2. Age:With age, upper airway muscle tone decreases, making it more prone to collapse.
  3. Obesity: People who are more than 120% of their ideal body weight are more dangerous.
  4. Neck Circumference: Greater than seventeen inches (43 cm) for men and fifteen inches (38 cm) for women.
  5. Anatomical Abnormalities: Too little space in the back of the tongue or in the posterior urn, too large tongue, hypertrophic tonsils, too much soft tissue in the mouth and nasopharynx, too high soft palate, receding jaw, too small jaw, or facial deformity.
  6. Special congenital disorders: eg Down syndrome.
  7. Endocrine diseases: such as hypothyroidism, acromegaly.
  8. Drinking alcohol, tranquilizers, or sleeping pills can make the condition worse by reducing muscle tone in the upper airways.

 

Warning signs of obstructive sleep apnea:

  1. Loud snoring that can be heard by people (even neighbors) across several rooms.
  2. The type of snoring is special, the snoring will be interrupted due to the stop of breathing, and then gasping, indicating that the person stops breathing and then starts breathing again.
  3. Daytime sleepiness, for example: at work or while driving.
  4. Inattention, forgetfulness, irritability, anxiety or depression.
  5. Headache in the morning, frequent urination at night, decreased libido, men will complain of impotence, women will have menstrual disorders.

These problems often develop slowly over several years, and some symptoms go unnoticed. Family members, bosses, or colleagues may first notice the patient's drowsiness and changes in mood or behavior. Anyone who finds these symptoms in others should encourage them to seek medical attention. .

Have you ever suspected that you have OSA?

Snoring is a very common phenomenon, but if you really suffer from sleep apnea, you need to go to a professional institution for a sleep test. OSA can not be generally regarded as an annoying sound in social life that affects the rest of others, but a clinical disorder that needs careful examination, which can cause many serious complications;

Diagnostic checks:

A polysomnographic test should be performed in patients with OSA. Over the years, sleep research centers have been established in qualified units, and the diagnosis and treatment of OSA is one of its main research contents. Patients at the research center can receive continuous sleep observation, monitoring and automatic recording throughout the night. In addition to pulmonary function tests and cardiac monitoring, electroencephalogram, electrooculogram, electromyogram (digastric muscle, pharyngeal muscle, mental muscle, etc.), ear oxygen saturation, etc. are also included. Through the above tests, we can understand the changes of the patient's body during sleep, as well as the nature (type) and degree of sleep apnea.

Treatment plan:

  1. Non-surgical treatment is mainly aimed at some patients with mild snoring, and there are many methods.

(1) Adjust the body position during sleep, and change from supine to side lying, which may reduce or eliminate snoring.

(2) Lose weight. Various methods can be used, such as applying drugs, controlling diet, strengthening activities, etc., in order to lose weight, and can often achieve certain results.

(3) Drug treatment. Taking an antidepressant, protriptyline 30mg, at bedtime may work. CNS depressants such as alcohol and sleeping pills should be avoided before going to bed.

(4) Use continuous positive pressure ventilation and non-invasive ventilator while sleeping. Air flow was introduced through the mask, and the pressure was maintained between 5-15cmH2O.

  1. Surgical treatment In principle, appropriate measures should be taken to remove the pathogenic factors;
  2. Psychological counseling

OSA patients are often accompanied by loud snoring at night, which seriously affects the sleep of sleepers and spouses in the same room, and can lead to interpersonal tension and disharmony between husband and wife. Some patients may cause negative emotions such as inferiority complex and anxiety. The spouse's lack of health awareness and medical knowledge will also directly affect the patient's treatment, and the spouse's lack of understanding and opposition will also cause the patient to bear a lot of psychological pressure. Therefore, both patients and their spouses should receive more medical knowledge about OSA and conduct appropriate psychological interventions for patients.

Positive airway pressure therapy (CPAP Therpay) has been the treatment of choice for sleep apnea. The home ventilator provides a continuous pressure to the upper airway during sleep, so that the blocked or collapsed airway is opened to play a therapeutic role, which acts like an "air stent". Non-invasiveness and high efficiency are the biggest advantages of ventilator therapy. Most studies show that ventilator therapy can greatly reduce sleep apnea, correct nocturnal hypoxia, improve symptoms, and improve sleep quality.