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General Practice 2023

Sleep apnea: what é, symptoms, causes and treatment

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Sleep apnea: what é, symptoms, causes and treatment
Sleep apnea: what é, symptoms, causes and treatment

Sleep apnea is a disorder that causes momentary stoppage of breathing or very shallow breathing during sleep, resulting in snoring and a little relaxing rest that does not allow you to recover energy. Thus, in addition to drowsiness during the day, this disease causes symptoms such as difficulty concentrating, headache, irritability and even impotence.

Sleep apnea occurs due to airway obstruction due to dysregulation of the pharyngeal muscles. In addition, there are lifestyle habits that increase the risk of developing obstructive sleep apnea, such as being overweight, drinking alcohol, smoking and using sleeping pills.

This sleep disorder should be treated by improving lifestyle habits and using an oxygen mask that pushes air into the airways and makes breathing easier.


Main symptoms

The main symptoms indicative of sleep apnea are:

  • Snoring while sleeping;
  • Waking up several times at night, even for a few seconds and imperceptibly;
  • Display breathing stops or suffocation during sleep;
  • Having too much sleep and being tired during the day;
  • Waking up to urinate or losing urine during sleep;
  • Have a headache in the morning;
  • Decrease income in studies or work;
  • Have concentration and memory changes;
  • Develop irritability and depression;
  • Having sexual impotence.

It is important that the doctor is consulted in the presence of signs and symptoms indicative of sleep apnea, as it is possible for the diagnosis to be made and, thus, the most appropriate treatment to be initiated, which may indicate the use of a device called a CPAP or, in some cases, surgery.

How to confirm the diagnosis

The definitive diagnosis of sleep apnea syndrome is made with polysomnography, which is an exam that analyzes the quality of sleep, measuring brain waves, the movements of the breathing muscles, the amount of air that enters and comes out during breathing, in addition to the amount of oxygen in the blood. This exam serves to identify both apnea and other diseases that interfere with sleep. Learn more about how polysomnography is done.

In addition, the physician will take a medical history and physical examination of the person's lungs, face, throat, and neck, which may also help differentiate between types of apnea.

Causes of sleep apnea

Sleep apnea occurs due to a narrowing in the airways, in the nose and throat region, which mainly happens due to a dysregulation in the activity of the muscles in the throat region called the pharynx, which can be excessively relaxed or narrowed. during breathing.

This situation is more common in people over 50 years of age, and the amount and intensity of symptoms varies according to the severity of the apnea, which can be influenced by factors such as excess weight and airway anatomy of the person.

Learn about other diseases that cause excessive sleep and tiredness.

Types of sleep apnea

There are 3 main types of sleep apnea, which can be:

  • Obstructive sleep apnea: occurs in most cases, due to airway obstruction, caused by relaxation of breathing muscles, narrowing and changes in the anatomy of the neck, nose or jaw.
  • Central sleep apnea: usually occurs after a disease that causes brain damage and alters its ability to regulate respiratory effort during sleep, such as in cases of tumor brain, post-stroke or degenerative brain diseases, for example;
  • Mixed apnea: is caused by the presence of both obstructive apnea and central apnea, being the rarest type.

There are also cases of temporary apnea, which can happen in people with inflammation of the tonsils, tumor or polyps in the region, for example, which can make it difficult for air to pass during breathing.

How the treatment is done

Treatment for sleep apnea usually starts with minor lifestyle changes according to the possible cause of the problem. Therefore, when apnea is caused by excess weight, for example, it is recommended to consult a nutritionist to make a nutritional plan that allows weight loss, in order to improve breathing.

When sleep apnea is caused or aggravated by smoking, it is advisable to stop smoking or reduce the number of cigarettes smoked per day, to avoid inflammation of the airways and facilitate the passage of air.

However, in more severe cases, such as when it is not possible to treat sleep apnea with only these small changes, other forms of treatment may be recommended:

1. Use of CPAP

The CPAP is a device, similar to an oxygen mask, but it pushes air into the lungs, allowing normal breathing that does not interrupt sleep and, therefore, allows you to have a more restful sleep. Learn more about how CPAP works.

Usually, this device is only indicated when there is complete obstruction of the airways during sleep or when it is not possible to improve the symptoms only with changes in the routine.

CPAP can be uncomfortable to use, so many people choose to try other CPAP-like devices or have surgery to correct the problem.

2. Surgery

Surgical treatment for sleep apnea is only indicated when other forms of treatment do not work, and it is recommended to try these treatments for at least 3 months. However, in some cases, the structures of the face need to be changed to correct the problem and, therefore, surgery can be considered as the first form of treatment.

The main types of surgery done to treat this problem include:

  • Tissue Removal: is used when there is excess tissue in the back of the throat to remove the tonsils and adenoids, preventing these structures from blocking the air passage or vibrating, causing snoring;
  • Repositioning the chin: is recommended when the chin is very retracted and decreases the space between the tongue and the back of the throat. Thus, it is possible to correctly position the chin and facilitate the passage of air;
  • Placement of implants: are an option to tissue removal and help prevent the soft parts of the mouth and throat from obstructing the passage of air;
  • Creating a new air passage: is used only in cases where it is life-threatening and other forms of treatment have not worked. In this surgery, a channel is made in the throat to allow the passage of air to the lungs.

Also, all surgeries can be tailored to treat each person's specific problem, so it's very important to discuss all treatment options with your doctor.

Signs of improvement or worsening

Signs of improvement can take from a few days to several weeks to appear, depending on the type of treatment, and include decreased or no snoring during sleep, reduced feeling of tiredness during the day, relief from head and ability to sleep without waking up during the night.

The signs of worsening happen when the treatment is not started and include increased tiredness during the day, waking up several times during the day with severe shortness of breath and intense snoring during sleep, for example.

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