Breathing Disorders During Sleep: Symptoms, Causes And Treatment
The human being breathes continuously, in a semi-automatic way, throughout his life. Breathing allows us to obtain the oxygen that our cells need to survive, and the absence of this process for long enough causes death (in fact, for a long time the moment when we stop breathing was considered the moment of dying). It is something so essential that it is necessary even when our level of consciousness is altered, and even when we sleep.
But sometimes during sleep some alterations occur that make it difficult for us to carry out this vital process, even for a few seconds. So, we can encounter different respiratory disorders during sleep We will talk about this type of health alterations in this article.
Sleep respiratory disorders are understood to be those set of alterations that occur during the sleep period in which insufficient ventilation or breathing occurs or a change in breathing rate. Mostly, these are disorders in which apneas appear, or brief periods in which the patient stops breathing for at least ten seconds and which usually generates a partial awakening of the subject to be able to inhale and receive oxygen. There is also another associated concept, hypopnea, in which although the subject does not stop breathing at any time, the amount of air that enters the body is greatly reduced as breathing becomes more superficial.
These disorders tend to cause frequent nocturnal awakenings (mostly not consciously perceived), and are usually linked to the appearance of snoring. They usually have consequences, perhaps most visible being the difficulty in maintaining continuous and restorative sleep, which can result in the appearance of daytime sleepiness, fatigue and concentration difficulties. It can also lead to problems at a relational level, such as discomfort and conflicts with bed partners.
Breathing disorders during sleep are seen by the majority of the population as something mild that does not cause complications, and in some cases this is true, but in reality the presence of a breathing disorder during sleep can have a series of serious health consequences if it is not treated correctly.
And they can have very harmful effects on our cardiovascular system: in fact, this type of disorder is a risk factor for suffering from heart disease. And the obstruction of the passage of air generates pulmonary hypertension and an overload in the right ventricle of the heart (which is the part of the heart responsible for sending blood to the lungs for reoxygenation) that can lead to a greater probability of arrhythmias, angina pectoris and even heart attacks.
Likewise, it can have cognitive effects, since it makes the maintenance and rhythmicity of sleep cycles difficult and, in addition, the presence of repeated micro-anoxias. can cause the death of groups of neurons In children, it can also cause delays in growth and development, as well as greater insulin resistance or other metabolic problems. It has also been observed that they are detrimental to diabetic patients and patients with neuromuscular disorders.
Guys
There are very diverse phenomena that could be considered sleep breathing disorders and that have different levels of impact on the subject who suffers from them. Below are some of the most common ones.
1. Obstructive sleep apnea
Perhaps the best-known sleep breathing disorder, obstructive apnea is an alteration in which the subject who suffers from it suffers during sleep. obstruction of the upper airways, despite continuing to breathe This causes the respiratory rate to increase as an attempt to receive the air that does not arrive.
Non-conscious awakenings and micro-awakenings are frequent during sleep, although the subject ends up waking up due to the contraction of the muscles linked to breathing, in search of oxygen. This can occur cyclically several times during the night.
One of the most frequent symptoms is the presence of irregular, high-intensity snoring, in addition to awakenings caused by our body’s search for air. It is not uncommon for vivid dreams and high levels of night sweats to appear. During the day they usually suffer from fatigue, lack of strength, memory problems and a lower sexual appetite. Arrhythmias frequently appear and can facilitate the onset of severe heart problems.
2. Central sleep apnea
Central sleep apneas are those types of apneas that occur when the person’s airways are not obstructed but allow the correct passage of air, but there is nevertheless a decrease in respiratory flow. The problem itself is that the body does not make the effort to breathe normally. In other words, there is an interruption of air flow due to a reduction or absence of respiratory effort.
It is a problem derived from a heart or brain disorder, and there may be numerous possible causes behind it. Unlike other apneas and sleep disorders, snoring is not common and may not even be detected directly. What is perceived is the presence of daytime fatigue, nocturnal awakenings caused by the sensation of suffocation and sometimes fear of sleeping due to these sensations.
3. Mixed sleep apnea
It is a respiratory disorder during sleep that combines the characteristics of the previous two: the respiratory problem begins with central apnea in which the effort to breathe is greatly reduced, but when it returns to normal rhythms, a real obstruction of the respiratory tract appears. the respiratory tract that usually generates the awakening of the subject.
4. Upper Airway Resistance Syndrome
Syndrome of less severity than the others in which there is no decrease in the oxygen levels received This disorder is characterized by the presence of awakenings during sleep, without an episode of apnea appearing. The problem in this case seems linked to an increase in the effort made to inspire. Intense snoring usually appears as a result of this effort. It also tends to cause daytime sleepiness.
5. Hypoventilation syndromes
These syndromes are characterized because, unlike what happens with apneas, there is no period of time in which a complete cessation of breathing occurs. These are syndromes in which the subject who suffers from them has some type of deficiency in the respiratory system that causes a sufficient level of air to not reach the body, generally being superficial breathing. Less oxygen reaches the brain and there is an increase in carbon dioxide levels in the blood.
It is not uncommon for snoring to appear, and like the previous ones, it usually causes fatigue, memory problems and some nocturnal awakenings. We talk about syndromes because there are several that could be included in this category, such as Ondina syndrome (caused by congenital alteration of respiratory control).
Causes of the appearance of these disorders
The reasons for some type of breathing disorder to appear during sleep can be multiple, both genetic and environmental.
Alterations of a biological and genetic nature are found in the presence of cranial malformations or hypertrophies of organs such as the tongue or tonsils or in different syndromes and diseases, both genetic and acquired.
One of the most relevant controllable risk factors is obesity: increased fatty tissue especially around the throat It can exert weight and pressure on the airways that makes it difficult for air to pass through. Likewise, the obstruction and deterioration of these pathways can contribute to generating or maintaining a respiratory disorder during sleep, such as tobacco consumption. Allergies are also a possible reason for its appearance.
They can also be linked (as occurs in the case of central apneas) or derive from the presence of heart disease or brain injury which can be derived from infections, cardiovascular or cerebrovascular accidents, tumors, respiratory diseases or traumatic brain injuries.
Treatment
The treatment of breathing disorders during sleep can be carried out in multiple ways depending on the needs and abilities of the patient, as well as their personal characteristics.
One of the available options involves carrying out a plan to lose weight in the case of obstructive apnea, along with avoiding substances that irritate the airways.
Different drugs can be used in the treatment, although they are not usually very effective. The exception may occur if we are dealing with a patient whose obstruction is allergic or derived from different specifically expressed diseases. In these cases The disease or disorder that causes or facilitates altered breathing during sleep must be treated
A common mechanism for treatment is the use of continuous positive airway pressure or CPAP equipment. It is a mechanism that provides continuous pressure through a mask placed over the nose and/or mouth, allowing continued lung functionality by keeping the airways open. It is applied to those patients in whom nocturnal breathing problems are very frequent and do not respond to sleep hygiene and other treatments, and aims to achieve the cessation of apneas and limitation of respiratory flow.
In some cases surgical intervention is required, for example when hypertrophies occur in the tonsils or even the tongue. Alternatives such as the use of dental prostheses or mandibular advancement devices can also be used.
