Snoring: causes, treatment
Content:
- Snoring development mechanism
- Causes of snoring
- Features of snoring
- Snoring diagnostics
- Snoring treatment
The specific low-frequency vibrating sound made by a person or an animal when breathing during sleep is called snoring. The pathological process that causes snoring is due to the excessive relaxation of the muscles of the uvula, the palatine-lingual arch, the soft palate, and other structures of the pharynx.
More than 30% of adults suffer from snoring, and in people over 60, the frequency rises to 60–65%. This is a very common phenomenon, known to almost everyone. More often, snoring sufferers suffer from snoring, in whom the process of falling asleep is disturbed, various neurological disorders develop. In rare cases, a sharp vibrating sound interferes with the person himself, he wakes up from him. In addition to problems for others, snoring is dangerous for snoring, because during sleep his body loses oxygen, as a result all organs, especially the brain, suffer from hypoxia.
The appearance of loud sounds accompanying breathing in a dream is a precursor to the development and the main symptom of a serious illness called obstructive sleep apnea (OSAS). This pathology is characterized by the sudden cessation of pulmonary ventilation during sleep. The duration of respiratory arrest varies from 10 to 30 seconds, less often in severe cases, up to 2–3 minutes. Sometimes this syndrome leads to death.
Snoring development mechanism
The basis of the pathogenesis is the pathological relaxation of the muscles of the oropharynx — the palatine-articular arms, the uvula, the soft palate — or the obstruction of the airway due to some kind of obstruction. The passing air stream, instead of directly passing into the lungs, twists, causing the vibration of the soft structures of the pharynx. This is accompanied by an unpleasant sharp rattling sound. Further changes in the walls of the respiratory tract leads to the development of OSA.
Causes of snoring
The following factors may impede airflow:
- Thornwald cyst;
- swelling of the pharynx and tongue with allergies - hives or angioedema;
- inflammation and swelling of the nasal mucosa in rhinitis, including allergic;
- polyps in the nose;
- tonsillitis; hypertrophy of tonsils;
- adenoids ;
- curved nasal septum due to injury;
- congenital anomalies of the upper respiratory tract:
- underdevelopment of the upper or lower jaw;
- narrowed lumen of the pharynx;
- elongated uvula;
- macroglossia is an abnormally enlarged language.
- malignant or benign tumors of the nasopharynx;
- pathological displacement of the jaw due to injury;
- the deposition of fat in the walls of the pharynx, observed with obesity;
- hypertrophy of the vocal cords, larynx, tongue with acromegaly;
- an increase in language in Down syndrome.
Causes of pharyngeal muscle hypotonia:
- the use of alcohol and alcohol-containing beverages;
- smoking;
- addiction;
- aging of the body;
- taking certain medications;
- muscle relaxants - drugs that relieve muscle spasms;
- tranquilizers - psychotropic drugs;
- narcotic analgesics;
- hypnotic drugs.
- hypothyroidism , in which the muscles of the pharynx relax against the background of general muscular hypotonia;
- myasthenia gravis, myodystrophy, and other neuromuscular diseases;
- peripheral nerve injury, for example during surgery;
- diseases involving damage to the cranial nerves and brain, for example hydrocephalus, stroke, brain edema.
Features of snoring
Rare weak snoring in a dream is observed in almost everyone and is a variant of the norm that does not require treatment. As a rule, the snorer himself does not hear the sounds he makes. Snoring becomes a problem when it begins to disturb others, and later on, to the person himself, who snores in his sleep. According to statistics, snoring suffer more often than men. Sometimes the vibrating sounds are so loud and annoying that they wake up not only the spouse sleeping next to them, but also the rest of the family members who are in the apartment.
Insomnia begins with relatives: they cannot fall asleep in the evening and at night, but in the morning and during the day I feel sleepy. Himself the culprit of insomnia also complains of daytime sleepiness. If the relatives do not sleep due to snoring sounds, then the snoring person falls asleep normally, but, nevertheless, his body does not fully rest due to the frequent awakenings of the brain, necessary to resume breathing. Such a mechanism is characteristic of sleep apnea syndrome, which is a serious, life-threatening consequence of snoring.
Throughout the night, the snorer can experience up to 500 short stops. Snoring suddenly stops, the ensuing silence indicates cessation of breathing. After a few seconds, the brain wakes up to command the throat and pharynx muscles to tighten. A loud jerky snort speaks of renewed breathing.
As a result, night sleep becomes shallow. During the day, brokenness, cephalalgia, irritability, inability to concentrate on something, reduced performance, attention, memory appear. There is an overwhelming desire to fall asleep. Lack of oxygen (chronic hypoxia) in the body can lead to hypertension, stroke or heart attack, ischemia of the heart muscle, heart rhythm disturbance.
Moreover, he himself snoring during episodes of short-term cessation of breathing does not wake up and is unaware of the development of his sleep apnea syndrome. Close people who unwittingly witness the cessation of breathing should be on their guard, report the problem to the snoring person, convince him to consult a doctor to determine and eliminate the cause of the pathology.
Snoring diagnostics
To clarify the factors provoking snoring, you should contact the otolaryngologist, as well as a somnologist. Consultations and treatment from other specialists - a nutritionist, an orthodontist, a cardiologist, an endocrinologist, and a neuropathologist - are not excluded.
Stages of complex diagnostics:
- The conversation with the doctor , during which he collects and systematizes the patient's complaints, asks about the features of snoring, conducts testing. A survey of relatives is important to determine the frequency and approximate duration of respiratory arrest, if any.
- Visual objective examination of ENT doctor helps identify the deviation of the nasal septum, swelling of the mucous membrane of the nasal cavities, macroglossia, malocclusion, underdevelopment or abnormalities of the jaws, hypertrophy of the tonsils, the presence of adenoids or neoplastic process, general obesity or fat deposition in the neck area, many other pathologies contributing the occurrence of snoring.
- Functional tests to assess breathing through the nose and movement of the lower jaw.
- Polysomnography is considered the “gold standard” in the diagnosis of sleep disorders. This is a comprehensive computer study of the patient during sleep. A person is connected to the devices, after which he falls asleep, and the computer registers the parameters:
- airflow;
- the volume of snoring;
- movements of the various sections of the abdominal wall and chest during breathing;
- saturation (saturation) of blood with oxygen;
- electroencephalogram;
- electromyogram;
- electrocardiogram;
- electrooculogram;
- sleep video recording with recording of movements of the limbs and the position of the body under study.
- Radiography of the facial skull . Conducted to clarify the features of the deformations of the bones of the nose, jaws.
- Computed tomography or magnetic nuclear resonance . If a tumor is suspected, to determine its exact location, size, structure.
- Laboratory tests are necessary to identify inflammatory processes in the nose, pharynx, pharynx. Assign a clinical and biochemical examination of blood, bacteriological analysis of a smear from the nose and throat, cytological and histological examination of the biopsy of the tumor.
Snoring treatment
Depending on the severity of snoring and its causes, the optimal way to eliminate the pathology is chosen. Several treatments have been developed:
- Intraoral cap . A special device that is inserted during sleep, which shifts the lower jaw forward and fixes it in this position. The lumen of the pharynx increases, eliminating the contact of the walls with each other.
- Sticker Breathe Right . It is glued to the wings of the nose before bedtime, it expands the nasal passages, facilitating nasal breathing.
- The device "Extra-Law" - a design of a polymeric material with a regulator. It is indicated for the prevention and treatment of uncomplicated forms of snoring.
- Pap therapy . It provides for sleep with a special compressor worn in the form of a mask, which, by supplying air, creates a constant pressure in the airways, which causes the throat walls to flatten and prevent their subsidence. There are several types of this treatment:
- CPAP therapy. Air is supplied continuously in one mode.
- avtoSIPP-therapy. The principle of operation is similar to the CPAP method, the only difference is that the device adapts to the exhalation and inhalation of a person.
- BIPAP-therapy. The two-level mode of the device with a fixed air supply, oriented to inhale and exhale.
- avtoBIPAP-therapy. Automatic mode in two levels.
- TriLeve-therapy. Three-level mode.
- Weight loss with obesity .
- Cryoplasty and laser plastics of the sky . The principle of getting rid of snoring lies in a thermal or laser burn of the mucous membrane of the soft palate, which provokes inflammation of this area. During tissue regeneration, the volume and density of the palate and uvula decreases. As a result, vibration vibrations of the structures of the soft palate during sleep are significantly reduced.
- Surgical elimination of obstacles to the normal flow of air. Operations aimed at increasing the lumen of the pharynx, restoration of nasal breathing. Surgical removal of adenoids, malignant tumors, restoration of the physiologically correct position of the nasal septum, etc. In severe cases, uvulopalatopharyngoplasty is performed with surgical removal of the tonsils, uvula and part of the soft palate.