Medical Centre Promed

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About snoring and sleep apnoea

The treatment of snoring and sleep apnoea is a relatively young field of research. The rise and development of the non-invasive methods of tracing the physiological processes which take place during sleep caused a development of the whole branch of medicine in the past 20 years.

Breathing disorders during sleep can occur in many illnesses, e.g. in chronic obstructive lung illness, chronic heart failure, neurological illnesses, neuro-muscular illnesses, endocrinological illnesses, asthma, interstitial lung fibrosis. Obstructive sleep apnoea (OSA) is a serious, life-threatening illness which occurs in 4% of men and 2% of women. OSA is a disorder in which the upper respiratory tract collapses repeatedly, which stops the air inflow to and from the lungs, i. e. apnoea. An apnoea usually lasts from a few to more than ten seconds. Such interruptions at night can happen even a few hundred times. The interruptions are accompanied by loud and irregular snoring, which is a typical symptom of the illness. Throat patency depends on the balance of two factors: the scale of negative inspiratory pressure, which brings the throat walls close to one another, and on the other factor which counteracts the process – the tension of the aggrandizing muscles. Tumefaction of the palate, cion, and mucous membrane of the throat walls caused by snoring can coarct the throat. The throat lumen is coarcted also in the case of obesity.

Loud, irregular snoring is a typical symptom of OSA. Apnoea causes immediate, deepening hypoxia and hypercapnea, which induces sub-conscious awakenings. The structure of sleep is disturbed and the sleep itself is restless.

Among the symptoms of the illness there are tiredness, excessive somnolence, memory disorders, attention deficit disorder. They all cause work inefficiency, which may result in a job loss. Emotional state disorders (depression, fear, irritability) may cause conflicts in your family and professional life. People suffering from OSA fall asleep easily in inappropriate places and situations. They often cause accidents in the streets and at work. OSA causes problems with sexual potency as well as night urinating, dysponoea, itensified sweating, cardiopalmus. Men who experience breathing disorders in their sleep often suffer from erection problems.

In 1990, there was published a study of erectile disorders in the United States. The research was conducted on 1025 patients and shows that more that 80 % of them suffered from breathing disorders during sleep. Over 50% of patients with OSA were diagnosed with erectile disorders! About 50% patients with OSA have arterial disorders. Heart rate disorders can also occur during sleep, which may sometimes be dangerous. In cases of intensified hypoxemia there were found ventricular heart rate disorder in the shape of premature contractions, ventricular tachycardia, and even ventricular fibrillation. Moreover, hypoxia connected with apnoea can increase malperfusion of the cardiac muscle and cause coronary attacks. Coronary attacks and brain strokes happen more often to people with OSA than to people with similar risk factors but without OSA.

OSA causes hormone secretion disorders: testosterone and somatotropin secretion are impaired, atrial natriuretic peptide secretion grows. This is connected with impotence, nycturia, growth disorders (children). 50% of obese men suffering from insulin-resistant diabetes were diagnosed with OSA.

The most characteristic symptom of the illness is permanent, loud snoring. OSA is unlikely if snoring does not occur. People who have apnoeas, episodes of choking and suffocating at night should be examined in the direction of OSA. Such information can be usually gained from the person who sleeps with the patient, or from other family members. Obesity, especially of the upper part of the body is also a risk factor and influences the course of the illness. The body mass of the ill is usually over 120% of the due mass. The circumference of the neck is over 43 cm (men) and over 41 cm (women). The constriction of pharyngonasal cavity caused by the deviation of the nasal septum, nasal polyps, the hypertrophy of the palatine amygdala, long cion, big tongue and small, receding lower jaw bone predisposes to the illness.