Sleep apnea occurs when breathing stops for at least 10 seconds during sleep. Depending on whether or not there is respiratory effort, apneas can be classified as:
- Obstructive: when there is breathing effort.
- Central: when there is no respiratory effort.
- Mixed: when they start as central and end as obstructive.
Causes of sleep apnea
During sleep, the entire musculature of the body relaxes, including those muscles involved in keeping the airway open. When the upper throat muscles relax during sleep, breathing can stop for a few seconds, leading to sleep apnea. When this area of the throat is narrow or small, the medical picture is worse if sleep apnea occurs.
There are many cases of people who suffer from sleep apnea and snore. Snoring on these occasions occurs when air tries to pass through the narrowed or blocked airway. However, not all people who snore suffer from sleep apnea.
Risk factors
- Age: as the years go by, the muscle tone of the upper airways decreases.
- Sex: it is more common in men than in women.
- Hormones: the airway is favored by estrogens and progesterone. Menopause and androgens increase the risk of sleep apnea.
Anatomical features of the palate or upper airway that cause it to collapse more easily:
- Large tonsils and adenoid vegetations in children that can block the airway.
- Short neck.
- Dentofacial deformities: small mandible, maxillary deficiency.
- Large tongue that can retract and block the airway.
- Large bell.
- Neurological disorders affecting the airway and the respiratory regulatory center.
- Sleeping posture: lying or lying on the back favors posterior displacement of the tongue and soft palate reducing the diameter of the upper airway.
- Percentage of body fat.
- Toxic habits
Diagnosis of sleep apnea
- Complete medical history and physical examination: mouth, neck and throat.
- Specialized questionnaire.
- Sleep study or polysomnography.
Treatment
Treatment aims to keep the airway open so that breathing does not stop during sleep. Continuous air pressure in the airway is usually the most common treatment, which is administered by means of a machine with a tight-fitting face mask. Some patients may need dental appliances inserted into the mouth at night to keep the jaw forward.
Surgery may be indicated in some cases:
- Uvulopalatopharyngoplasty (UPFP): involves removing excess tissue in the back of the throat.
- Orthognathic surgery: to correct abnormal structures of the face.
- Nose and sinus surgery.
General recommendations
- Sleep hygiene.
- Weight control.
- Do not drink alcohol or use tobacco at least 6 hours before sleeping.
- Minimize the consumption of drugs that depress the central nervous system.
- Sleep on the side and the head of the bed at 30º.