You can have sleep apnea without snoring

Sleep apnea

Sleep apnea: description

Snoring is a common phenomenon that increases with age. Almost every second person produces the nocturnal noises - but breathing does not stop.

Sleep apnea is one of the sleep-related breathing disorders, abbreviated to SBAS, by sleep specialists. They occur exclusively or primarily during sleep. The term "sleep apnea" comes from the Greek: "A-Pnoe" means something like "without breath". Sleep apnea disturbs sleep and ensures that a person with sleep apnea syndrome does not wake up refreshed in the morning. This often also applies to the person next to you who is disturbed by the particularly loud and irregular snoring. Sleep apnea is dangerous because the pauses in breathing during sleep can develop into a long-lasting, threatening respiratory standstill.

There are no precise figures on how often sleep apnea actually occurs - not everyone who snores goes to the doctor. It is estimated, however, that around two to four percent of the total adult population between the ages of 30 and 60 are affected by sleep apnea. The frequency increases with age. Overweight people are particularly affected: around 80 percent of patients with sleep apnea syndrome are too fat.

Obstructive Sleep Apnea (OSAS)

Obstructive sleep apnea syndrome is the most common type of sleep apnea. During sleep, the muscles of the soft palate, located between behind the uvula, relax and the tongue falls back. This partially or completely closes the airways and the sleeper gets too little or no air at all.

The lack of breathing reduces the oxygen content in the blood (hypoxemia) and there is an insufficient supply of the tissue. As a result, the body starts a "wake-up reaction". It abruptly activates the breathing muscles of the diaphragm and chest, the heart also increases its performance and the blood pressure rises. The sleeper usually wakes up briefly. Doctors call this awakening caused by sleep apnea "arousal". If breathing then starts again, several deep breaths usually follow. The respiratory arrest can last ten seconds to two minutes and occur up to 100 times a night. The person concerned can usually no longer remember the next morning that he woke up at night due to a lack of oxygen.

Central sleep apnea

The second form of sleep apnea is central sleep apnea. This form is triggered by a malfunction in the central nervous system (CNS). The upper airways remain open here, but the breathing muscles of the chest and diaphragm do not move sufficiently. Central sleep apnea mainly affects the elderly. This type of breathing disorder is often harmless and usually does not need treatment. Unless it occurs in combination with a weak heart or nervous system - then you should consult a doctor.

Sleep apnea: symptoms

Typical symptoms of sleep apnea are repetitive Breathing pauses in sleep. The respiratory arrests last between 10 and 120 seconds and occur more than five times an hour. Phases of excessive breathing (Hyperventilation) as well as loud and irregular snoring (when the patient is breathing hard). In addition to snoring, partners and relatives often notice pauses in breathing at night while the person concerned is not aware of them.

Sleep apnea has consequences. In general, sleep is disturbed and people with sleep apnea suffer from chronic sleep deficit and daytime tiredness. They are also forgetful and have trouble concentrating. This also increases the risk of accidents on the road. Some people with sleep apnea also have anxiety or depression. In part, the breathing disorder leads to headaches (especially in the morning hours) and decreased sexual desire. Erectile dysfunction can occur in men.

Obstructive Sleep Apnea Syndrome (OSAS) can also affect children. According to experts, the breathing disorders may also play a role in sudden infant death syndrome. Older children with OSAS often appear sluggish and clumsy. They often stand out in school because of their poor performance.

Sleep apnea: causes and risk factors

There are several factors that can cause a obstructive sleep apnea syndrome favor. These include:

  • Body mass index too high (overweight)
  • Age (the older, the more at risk of sleep apnea)
  • Gender (men are more often affected than women)
  • Taking sleeping pills or sedatives (muscles in the roof of the mouth relax more quickly and close the airways)
  • Deviations in the structure of the facial skull (craniofacial peculiarities): An example is a lower jaw that is too small or falling backwards or a crooked nasal septum.

Further risk factors are smoking, alcohol, pregnancy or existing diseases such as rheumatism, acromegaly, hypothyroidism or polycystic ovarian syndrome. A large tongue, enlarged tonsils, nasal polyps or a lot of fatty and connective tissue at the entrance to the airways can also promote sleep apnea. In general, irregular sleeping times can make symptoms worse.

The central sleep apnea is rare and is caused by disorders in the central nervous system (CNS). Due to neurological damage, the control of the respiratory muscles works poorly. One cause can be, for example, neuroborreliosis, a stage of tick-borne borreliosis.

Sleep apnea: examinations and diagnosis

Often the partner first notices the snoring. If breathing stops, it is advisable to see an ear, nose and throat (ENT) doctor. There is no such thing as “the one” sleep apnea test; instead, various diagnostic methods are used. The doctor will first ask you about your medical history (Anamnese) question, for example:

  • Do you know any previous illnesses?
  • Do you suffer from insomnia?
  • Do you take medication (e.g. sleeping pills or sedatives)?
  • How about your alcohol consumption?
  • Do you use drugs?
  • What are your sleeping habits? Since your partner often knows best, he or she should also take part in the survey if necessary.

The ENT doctor will then look for it anatomical abnormalities in the nasopharynx - for example, abnormal bites (position of the jaws in relation to one another), curvatures of the nasal septum or nasal and pharyngeal polyps. The paranasal sinuses are easy to visualize with imaging techniques.

Sometimes there is a walk into sleep-laboratory inevitable. Doctors analyze sleep behavior, breathing and other factors that indicate sleep disorders (sleep apnea screening). As a rule, the stay in the sleep laboratory lasts one to two nights. Here, doctors use electrodes on the skin to measure, among other things, the airflow of breathing, the pulse rate, the oxygen content in the blood and the movements of the chest. All of this is covered by the term "Polysomnography" summarized.

Drowsiness tests may also be necessary. The Multiple sleep latency test (MSLT) means that the patient should take a short nap of around 20 minutes several times a day with an interval of two hours. The test records the tendency to fall asleep and the degree of daytime sleepiness.

Read more about the examinations

Find out here which examinations can be useful for this disease:

Sleep apnea: treatment

You can read all important sleep apnea therapies in the article Sleep apnea treatment

Read more about the therapies

Read more about therapies that can help here:

Sleep apnea: disease course and prognosis

Obstructive sleep apnea should definitely be treated because it affects health as well as professional and private life. Patients with daytime sleepiness are three to seven times more likely to have an accident on the road. Sleep apnea is associated with high blood pressure, heart failure, coronary artery disease and cardiac arrhythmias (e.g. atrial fibrillation). A connection with pulmonary hypertension, diabetes mellitus, kidney failure and arteriosclerosis also seems likely. Overall, obstructive sleep apnea syndrome is linked to increased mortality.

Quite apart from that, the snoring and the stress Sleep apnea the partnership is also not insignificant.

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