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snoring and apnea

Snoring is not just a noise at night. It is the external representation of a difficulty in the passage of air into our lungs. We have to understand that despite sleeping our brain must have special cycles during sleep and for this it is necessary that we do not wake up. This is what is called the circadian cycle. In a snoring patient, different situations occur in degrees ranging from continuous snoring but managing to ventilate adequately to patients who stop breathing for seconds. In these cases we can htalk about patients who are suffering from sleep APNEAS. There are different types of sleep apnea:

  • Obstructive sleep apnea, the most common form, which occurs when the throat muscles relax

  • Central sleep apnea, which occurs when the brain does not send the correct signals to the muscles that control breathing

  • Complex sleep apnea syndrome, also called treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea

If an apnea is repeated many times during an hour, it produces important problems in the health of a patient. We must understand that apnea, in addition to interrupting sleep cycles, produces a lack of oxygenation of the blood and therefore of the brain. That is defined as hypoxia. A continuous hypoxia generates important brain alterations and that even during the morning the patient can manifest headaches:

What are the signs of night apnea?

  • Snoring 

  • Suspension of breathing for many seconds (usually reported by the patient's partner)

  • Noisy breathing at night

  • Sensation of dry mouth in the morning

  • morning headache

  • Sleep disturbance, insomnia

  • Significant fatigue during cía  (hypersomnia).

  • Lack of attention in daily tasks

  • Bad mood

Which are the causes of apnea?

In general, they are the sum of factors, although there are cases in which there is a main factor that determines the presence in a radical way.

Predisposing:

  • small jaw

  • Big tongue

  • Obesity

  • smoking

  • Adenoids

  • nasal obstruction

  • Age

  • hereditary factor

  • Alcohol consumption before bed

  • Being a man

From the maxillofacial point of view, a key factor is the size of the mandible and the patency of the nasal and tonsillar pathways.

A key study for the diagnosis of apnea is the polysomnogram and the maxillofacial study that shows the cause of the problem is a three-dimensional cephalometry in a horizontal position and another in a sitting position.

Which is the treatment?

It must be approached multidisciplinary, otolaryngologists, neurologist, speech therapist, diabetologist, nutritionist.

From the maxillofacial point of view, the clearance of the airway is performed with a bimaxillary orthognathic surgery where we produce an important advance of the facial mass, generating an adequate space for the passage of air during the patient's sleep._cc781905-5cde-3194-bb3b -136bad5cf58d_

In less severe cases there is the possibility of propelling air during sleep through a device called CPAP, with a mask and a silent device air is injected preventing the apnea episode from occurring.

When should we consult?

Snoring can indicate a serious problem, but not everyone with sleep apnea snores. And on the other hand, not all snoring is a sign of apnea. The severity and depth of the condition must be determined, but the mere fact that the patient or his companion points out the problem is a sign that there is some alteration and must be studied.

The difference between restful sleep and unrefreshing sleep is just the beginning of the definition of quality of life.

Dr. Antonio Marino 

Maxillofacial surgeon

www.ortognatica.cl

www.maxillofacial.cl

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