Sleep apnea is one of the most common diseases today. According to the latest data, its incidence in the world is around 5-10%. Sleep apnea is a cessation of breathing for more than 10 seconds in sleep. Occlusive sleep apnea occurs when the muscles in the throat relax to close the space through which the air will pass. These muscles belong to the soft palate, uvula, pharynx, and tongue. When the muscles relax, the airway narrows during breathing, and breathing stops for a while. As a result, the amount of oxygen in the blood decreases; the brain perceives this decrease and tries to reopen the airway by reducing the depth of sleep. Following the decline in the depth of sleep, some people take one or two short deep breaths, and some start breathing again with severe snoring and swallowing sounds. This situation can repeat 20-30 times an hour all night, and it is not possible to go to deep sleep when there is frequent sleep apnea. People with sleep apnea are often unaware that their sleep is interrupted and think they are sleeping well.
It is more common, especially in the advancing ages, starting from 40-50. It is more common in men than women. Adenoid is also seen quite frequently in children with tonsil problems and advanced tonsil infections.
One of the most important risk factors is obesity. Generally, short stature, short neck, fat, and prominent jowl can make the person the most significant candidate for the disease. Having a short and thick neck causes narrowing of the airway in the throat. The increase in the fat tissue around the neck and throat due to excess weight is an essential factor that aggravates sleep apnea. A risk factor for sleep apnea is that the neck circumference, the shirt collar number, is more than 43 cm in men and more than 40 cm in women. However, sleep apnea can also be seen in thin people.
Tonsils being more significant than usual and having adenoids cause sleep apnea, mainly seen in children; however, it can sometimes be responsible in adults.
The most important symptom of the disease is waking up tired in the morning. Since breathing stops for 10 seconds during sleep, he has to wake up constantly fluttering. Since the patient’s sleep quality deteriorates, no matter how long he sleeps, he begins to feel completely tired when he wakes up in the morning and tends to sleep at any moment. The tiredness caused by insomnia can be reflected in business and social life. People with sleep apnea may fall asleep while working at work, watching TV, reading, on the bus, or even while driving. The risk of traffic accidents increases between 3 and 5 times in people with sleep apnea and drive. A decrease in school achievement usually manifests sleep apnea in children.
The part where all organs work at a minimum level, the rest is the sleep part. When organs are not rested, complaints specific to each organ occur. Most people with sleep apnea suffer from high blood pressure. Over time, the heart rhythm begins to deteriorate. Insulin resistance begins to happen in a significant part of it. After a while, diabetes and a tendency to gain weight appear—the susceptibility to bronchitis and pneumonia increases.
Sudden drops in oxygen in the blood during apnea cause an increase in blood pressure and strain on the heart and vascular system. Almost half of the people with sleep apnea have hypertension, which increases the risk of heart failure and cerebral hemorrhage. It is known that oxygen decreases caused by sleep apnea in people with heart disease increase the risk of sudden death during sleep due to heart attack.
Between 30 and 40 percent of adults experience snoring during sleep. But to say that every snorer has sleep apnea is a very wrong term. Snoring in sleep apnea is quite different. People with sleep apnea can snore very loudly. If the person with snoring wakes up tired and reluctantly, the rate of sleep apnea is relatively high.
When you lie on your back with the effect of weight, the inhaled air has difficulty passing through the airways. When it is forced, the most significant effect is the decrease in oxygen in the blood. When the oxygen in the blood drops, the longer this situation lasts and the more often it recurs, the premature aging of all organs, especially the brain. Death may occur due to lung failure or heart failure when breathing stops during sleep.
Use of alcohol, tranquilizers, and sleeping pills: These substances cause the throat muscles to relax during sleep.
Problems related to medical treatments that may be required for other reasons: People with obstructive sleep apnea may encounter respiratory system problems related to general anesthesia in surgeries that may be necessary for different reasons.
Problems with the partner: If there is severe snoring with sleep apnea, the bed partner cannot sleep; even a social problem arises, such as changing rooms.
Problems with brain activity: People with sleep apnea forgetfulness; may experience fatigue and irritability, frequent urination at night, and impotence. Hyperactivity and attention disorder syndrome can be seen in children.
First of all, if you have these symptoms, after a detailed examination of your doctor, the Polysomnography Test, also known as the sleep test, is performed, and the results of this test are acted upon. Although behavioral treatments such as losing weight, not using alcohol, quitting smoking and caffeine are sufficient in some patients, CPAP (positive pressure air given with the help of a mask that completely covers the patient's nose during the night, keeps the collapsed airway open and prevents the patient from getting blocked) method is used in some patients. Most patients benefit from losing weight with 1-3 months of CPAP treatment; both are motivated to continue treatment and preparation for surgical treatment. Surgical treatment is the best form of treatment for most cases. With surgical treatment, the obstructing elements in the patient's airway are reshaped, opening the airway.
Sleep apnea is a disease in which advanced technology is used, and its treatment is satisfactory. For the diagnosis, the patient's sleep is recorded when the patient is kept in the clinic for one night, and the cables are tied not to disturb his body. The patient's observations include eye movements, brain waves, respiratory movements, abdominal movements, leg movements, heart rhythm, jaw movements, sound during sleep, and most importantly, oxygen in the blood. By analyzing these observations, the events experienced by the patient during his sleep are revealed.
The patient is invited to the second-night study (LIPAP titration study), as it is a rehearsal of the treatment as soon as possible after staying in the clinic for one night. CPAP or BIPAP method is used in the treatment of the disease. This method is the means that pressurizes the ambient air to the body through a mask. On the second night, the patient is hosted in the clinic, the device treatment is applied, the optimum ideal pressure value is determined, and the treatment is started. The response to treatment is excellent.
Sleep apnea treatment entirely depends on the person's response to treatment. There is a minimum treatment period of 6 months on average. During this period, the device should be used every night. Then, when a specific improvement occurs in the treatment, the patient starts to use the device every other day or 1-2 days a week. When the treatment progresses positively, the patient begins to sleep without the device.
People who have weight problems should consult a dietitian or endocrinologist for the treatment to be successful. As a result of these treatments, the patient can lose weight and return to average values and achieve success in treating sleep apnea disease.