Frequent pauses in breathing. What is sleep apnea in adults: symptoms, causes, treatment

Stopping breathing during sleep, or more precisely, repeated stops of breathing indicate the presence of a serious disease - sleep apnea syndrome.

The person with apnea, for obvious reasons, does not notice or remember what happens to him in his sleep. As a rule, the problem is first noticed by his relatives, who, watching the sleeping person, see how he repeatedly stops breathing for 10, 20, 40 or more seconds, and often turns pale or blue when breathing stops.

The disease of respiratory arrest is observed in 5-7% of people, and in hypertensive patients and those suffering from coronary artery disease its frequency reaches 30%. But despite the widespread prevalence of the disease, surprisingly little is said about sleep apnea syndrome.

What to do?..

Very often, patients report that when they suspected symptoms of apnea, they were at a loss: “What to do if you stop breathing during sleep? What to do? Who to contact?". Fortunately, we have answers to these questions.

First of all, it is important to understand: sleep apnea syndrome cannot be cured on your own at home. That is why the first step towards recovery should definitely be a visit to a doctor who deals with sleep problems - a somnologist. He will be able to diagnose apnea, assess the severity of the condition and select treatment appropriate to the situation.

How does the disease occur?

Sleep apnea occurs because the pharynx, which is normally a hollow tube through which air flows to the lungs and back, at some point becomes completely closed for a number of reasons. In this case, doctors talk about the development of obstructive apnea syndrome, from the word “obstruction” - blockage.

Much less often it happens differently: the problem arises at the level of the central nervous system. The brain's respiratory center works intermittently and transmits impulses to the muscles of the chest and abdominal muscles irregularly, which leads to interruptions in breathing during sleep. This type of apnea is called central.

Causes of sleep apnea

We can say that obstructive apnea syndrome is a disease of obese people: adipose tissue, like a muff, envelops the pharynx from the outside, leading to its compression and narrowing. During sleep, when the muscles relax and lose tone, the airway sometimes closes completely and the person stops breathing.

Then the following happens: the concentration of oxygen in the blood begins to decrease, and this happens until the “emergency response system” is triggered and the brain awakens. The brain sends an impulse to the muscles and tones them. The person takes a deep breath, often with a loud snore, and continues to sleep. Then the muscles gradually relax again, and the situation repeats.

There are other causes of sleep apnea besides obesity. Apnea in adults occurs due to the use of sleeping pills, sedatives, smoking, drinking alcohol, impaired nasal breathing, age-related changes and much more. A combination of several causative factors is also not uncommon.

Obstructive apnea syndrome in a child is formed in the presence of adenoids or a pronounced enlargement of the palatine tonsils (for example, with chronic tonsillitis), less often with obesity and allergic rhinitis.

Central apnea syndrome develops due to heart failure, disease and brain injury.

Treatment for sleep apnea

The apnea treatment program directly depends on the examination results. If it turns out that sleep apnea is caused by excess soft tissue in the throat, mild forms of sleep apnea may require surgery on the roof of the mouth. For a deviated nasal septum and adenoids, a specialist may also recommend appropriate surgery.

In severe and moderate cases of the disease, surgical treatment of sleep apnea gives no more than 30% of positive results. In this situation, CPAP therapy is often the only highly effective treatment method. To carry it out, special equipment is used, with the help of which air is pumped into the respiratory tract of the sleeping person under slight positive pressure. The air straightens the airways and prevents the throat from closing.

For central apnea, CPAP therapy is also used, as well as adaptive servoventilation, BIPAP and TRIPAP therapy, which are other types of artificial ventilation.

In addition to the listed treatment methods, others are also used situationally. For example, for nasal congestion (especially often with allergic rhinitis), special hormonal drops are used, which eliminate swelling of the mucous membrane and improve breathing.

People who use sleeping pills and alcohol can sometimes cope with apnea syndrome by simply refusing to use the listed drugs and alcohol. Quitting smoking always has a positive effect on respiratory function.

Obstructive sleep apnea syndrome is a risk factor for the development of such life-threatening complications from the cardiovascular system as stroke, various arrhythmias, cardiac trophic disorders - heart attacks, as well as sudden death during sleep. Most of these conditions occur at night, between 3 and 4 am, and more than 80% of them are directly related to breathing problems.

Important! Do not ignore the problem, but contact a specialist in time for diagnosis and correct treatment.

Obstructive sleep apnea is a condition characterized by periodic pauses in breathing during sleep. It is interesting to know that even normally a person can stop breathing for a short time, but such pauses have absolutely no effect on the state of the body.

A condition is considered pathological when a period of apnea lasts more than 10 seconds and occurs more than 30 times during a seven-hour sleep. The average duration of breathing pauses is about 40 seconds, but in severe cases can reach 3 minutes and occupy more than 60% of sleep.

During apnea, a person balances on the line between sleep and wakefulness; he cannot fall into deep sleep, but constantly seems to be dozing. As a result, the body's resources are not restored, the nervous system does not rest.

As a result, the patient wakes up in the morning exhausted and sleep-deprived, and his work productivity is significantly reduced. Over time, this condition leads to exacerbation of chronic and development of new diseases of various organs and systems.

Why do pathological pauses in breathing occur during sleep?

To prescribe the correct therapy to a doctor, first of all, you need to determine the reason why breathing stops. There are a number of anatomical and physiological features that can provoke this pathological condition:

Too wide neck due to obesity. In cases where the neck is wide from birth, this cannot cause apnea;
Anomalies of skull development
Retrognathia – protruding lower jaw;
Micrognathia is a pathology characterized by underdevelopment of the lower jaw;
Narrowness of the upper or lower jaw;
The tongue is too large and does not fit normally in the mouth;
Enlarged tonsils or swelling of the palate.
Hypotonia of the muscles, that is, their weakness, which are located near the respiratory organs.
Defects of the nasal septum.
The presence of polyps or other formations in the respiratory tract.
Obstructive pulmonary pathologies.

In addition, the appearance of apnea may be preceded by certain diseases, such as obesity or diabetes.

Attention! Another interesting condition that can occur when falling asleep is old witch syndrome.

Risk factors

In addition to the direct causes of obstructive apnea, there are risk factors that do not guarantee the development of pathology, but significantly increase the risk of its occurrence:

Gender – respiratory arrest occurs more often in the male half of the population. This is due to the fact that men generally weigh more than women and their necks are much thicker. However, everything changes with age; with the onset of menopause, women become more vulnerable.
Age – the peak incidence occurs between 40 and 60 years, but this does not prevent apnea from appearing both in the early and later periods of a person’s life.
Genetics – if close relatives have a history of OSA, then the patient has a high risk of developing the disease.
Abuse of tobacco products and alcohol.

Important! Monitor your body weight, since obesity is a major factor in the development of obstructive sleep apnea syndrome.

How can you suspect apnea?

Reasons for suspecting the presence of OSA may include complaints of restless sleep, lack of a feeling of vigor after a normal period of rest, morning headaches, and constant fatigue.

In addition, the patient’s performance is significantly reduced, attention and the ability to concentrate on anything are reduced. Such patients are absent-minded and constantly forget something. They also have an increased tendency to fall asleep, that is, falling asleep at work, during a boring lecture, or even while driving a car - a common occurrence for people with obstructive apnea.

In addition to the above, patients may present the following complaints:

Feeling of suffocation at night;
Insomnia;
Frequent nightmares that lead to awakening;
Increased irritability, it becomes difficult for such people to control their emotions;
Depression – some patients become depressed due to constant lack of sleep;
Dyspnea;
Nocturia – the need to frequently visit the toilet at night;
Impotence in men and a significant decrease in libido in women;
Severe night sweats;
Bruxism – teeth grinding;
Increased activity during sleep - a person constantly turns over from side to side, shudders, moves his arms and legs;
Talking in your sleep.

Relatives or simply close people focus their attention on, sometimes they also notice pauses in breathing during sleep. The patient himself is not able to see these changes.

Symptoms of OSA in children

In children, sleep problems due to respiratory arrests manifest themselves somewhat differently than in adults. The most common manifestations are:

Longer sleep – children, especially those with severe OSA, need much more time to get enough sleep;
Difficulty breathing - a lot of effort is required from the child to fill the lungs with oxygen;
Changes in behavior - the baby becomes somewhat aggressive and, despite fatigue, hyperactive;
Involuntary urination;
Deviations from the norm in height and weight;
Morning headaches.

Important! These signs are nonspecific, that is, they can occur not only with obstructive sleep apnea syndrome, but also with other diseases. Therefore, if such symptoms appear, the child should be shown to a specialist.

Diagnosis of OSA

The diagnosis is based on the patient’s complaints and objective examination. But since the symptoms of apnea are not typical and often practically do not appear, doctors resort to a diagnostic method such as polysomnography.

Polysomnography is a lengthy procedure, lasting approximately 8 hours. Using various devices, specialists examine the patient's sleep throughout the night. The diagnostic method consists of recording vital signs, brain waves, respiratory arrests, and their duration. Based on polysomnography data, the final diagnosis is made.

How to get rid of apnea

In mild, not advanced cases, it is enough to follow simple recommendations for apnea to subside:

To lose excess weight, you need to follow a special diet and lead an active lifestyle.
Avoid eating before bed. More than 3 hours must have passed since your last meal.
Stop smoking and drinking alcohol. If this is impossible to do completely, then at least do not pick up cigarettes 2-3 hours before bedtime, and reduce their number to a minimum during the daytime.
Take the correct position in bed while resting. Most often, respiratory arrest occurs in people who sleep on their backs, so you need to learn to rest on your side. If a person constantly turns over on his back in a dream, then you need to sew a pocket on the back of the nightgown and put some object in it. This will make lying on your back uncomfortable. In the first few nights the patient will wake up constantly and feel uncomfortable, but within 2 weeks he will get used to sleeping on his side.
Make sure that nasal breathing is free. For this purpose, you can use special plates or patches.

But for some patients, unfortunately, all of the above is not enough. For example, in the case of septal defects and the presence of polyps, surgical intervention must be performed, since there are no other ways to help. Patients whose sleep apnea occurs due to an improperly developed jaw can use special devices that are inserted into the oral cavity and correct the position of the jaw during sleep.

Assisted ventilation is often used for OSA. Using a device, oxygen is pumped into the airways and prevents them from narrowing. Unfortunately, this method does not lead to recovery, but only allows a person to sleep normally and avoid complications.

Important! In no case should you use sleeping pills if you have obstructive sleep apnea syndrome, as they relax the muscles and the person may simply suffocate.

Sleep apnea can have serious consequences, so you should not ignore the symptoms by thinking that it is just snoring. With timely diagnosis, the pathology is easily treatable, in most cases even without surgery.

Stopping breathing during sleep is very dangerous and can lead to hypertension, heart attack or stroke.

Sleep helps the body to rest and reload, relieves mental stress and “turns on” recovery processes in the body. But if your sleep is inadequate, you sleep little and poorly, then this threatens disruptions in the functioning of the body and the occurrence of various diseases. Sleep apnea is one of the serious disorders that interferes with the sleep process and can trigger other even more serious problems. A harbinger of apnea is often.

Snoring is a terrible harbinger of apnea!

Many of us snore in our sleep, but do not attach much importance to it, considering snoring a slightly unpleasant, but fairly harmless little thing. This may not be very convenient for family members who are forced to listen to the “songs” of the snorer, but it is not at all scary for the “singer” himself, snorers think. But that's not true. Snoring may be a sign that you are developing a physiological disorder that can lead to stopping breathing during sleep - sleep apnea.

What is apnea?

Apnea is a cessation of breathing that can occur for a variety of reasons. If such stops occur during sleep, they speak of sleep apnea. Stopping ventilation for more than 10 seconds is considered apnea. For those who suffer from sleep apnea, such stops can last several minutes and occur 10-15 times within an hour.

Types of apnea

There are central, obstructive and mixed apnea.

Causes central apnea are due to improper functioning of the brain. Provoke the appearance of central apnea:

atrophy of some parts of the brain
genetic predisposition

Obstructive apnea occurs when the airway is obstructed.

The most common cause of sleep apnea is mechanical collapse of the walls of the airways, and snoring is a harbinger of this. In addition to snorers, overweight people are also at risk. Apnea is more common in men than in women.

Single nightly stops in breathing may go unnoticed. But if apnea occurs often enough, the correct flow of sleep is disrupted and apnea syndrome occurs.

Apnea syndrome

Apnea syndrome has the following symptoms:

daytime sleepiness
feeling of lack of sleep
fatigue
decreased performance
mental retardation

Serious consequences

The above symptoms in themselves are not very pleasant and make it clear that apnea is not a harmless anomaly, but a serious disorder in the functioning of the respiratory system. Constant drowsiness, fatigue and lethargy can trigger the development of depression, disruption of the immune system and a shift in metabolism. But sleep apnea can lead to other serious problems. With frequent sleep apnea, the risk of developing hypertension, heart attack and stroke increases sharply, which in turn can cause death. Therefore, if you experience symptoms characteristic of sleep apnea, you should definitely consult a sleep specialist.

Apnea treatment

One common treatment for sleep apnea is CPAP therapy. In this case, the person sleeps with a special device connected, which creates a slight constant positive pressure in the airways. This ensures air access into the respiratory tract. Such a device not only prevents another apnea, but also has a positive effect on the muscles of the nasopharynx, restoring their elasticity over time.

Normalizing sleep is the most important task!

Apnea - what is it?

What is apnea, and in what forms does it manifest itself? Apnea is a disease, it is pathological and requires complex treatment depending on its form and severity.

Classification of apnea according to the mechanism of respiratory arrest:

Based on the duration of stops, the following types are distinguished:

Hypopnea - oxygen deficiency is up to 50%, the pathways are partially blocked (only part of the diaphragm moves, breathing is rapid);
Sleep apnea, which is characterized by complete relaxation of the larynx. The delay lasts more than 10 seconds.

To determine the severity, pay attention to the duration and frequency of the phenomenon:

Mild form - 5–20 attacks per night.
The average form is 20–40 attacks.
Severe form - more than 40 stops.

Less than five episodes per night is considered safe for humans.

The level of severity of apnea is calculated using a formula that takes into account these indicators and the duration of stops in seconds that occur during an hour of rest.

Symptoms

The main symptoms of apnea are sudden interruption of breathing during sleep, frequent awakenings, restless sleep and severe snoring (stops abruptly before breathing stops). The patient often does not remember nighttime episodes, so those around him - children, parents or a significant other - can point out deviations. The following signs should alert you:

Healthy sleep helps a person to restore strength; it is necessary to maintain the vitality of the body. However, disturbances in night rest often occur, one of which is stopping breathing when falling asleep. This is a serious problem that can cause great fear and panic. Various diseases and psychological disorders can lead to its appearance. It is important to identify the cause of the disorder in time and eliminate it in order to avoid complications.

Signs of respiratory system failure

Disturbances in the functioning of the respiratory apparatus, central nervous system and other organs can lead to breathing stopping when falling asleep. In this case, the person experiences very unpleasant sensations. In some cases, patients simply cannot sleep after an attack because they are afraid of dying from suffocation. You can talk about the appearance of this problem if there are the following signs:

feeling of a lump in the throat, impossible to swallow;
compression of the vocal cords, the ability to pronounce words disappears;
slow heartbeat or increased heart rate;
clouding of consciousness;
nausea and dizziness;
numbness of the limbs, tingling in them;
blue discoloration of the skin;
chills and sweating, abruptly replacing each other;
panic fear, feeling of anxiety.

When a person has not yet fallen into deep sleep, he may understand that an attack of asphyxia will soon occur. This is evidenced by a sharp increase in heart rate, the veins in the neck and temples swell, breathing becomes deep and fast, growing excitement occurs, thoughts are confused, and consciousness gradually becomes clouded.

When the first symptoms appear, you should get out of bed, take a sitting position and be sure to call for help.

Main causes of suffocation

Various diseases and disorders can cause respiratory center disorders. However, there are two factors that are the most common causes of choking while falling asleep. These are obstructive sleep apnea and hyperventilation syndrome (HVS). Let's look at them in more detail to understand what processes in the body trigger a failure in the supply of oxygen.

Obstructive sleep apnea syndrome (OSA)

Obstructive sleep apnea occurs when the airway muscles relax too much and the space between them becomes critically narrow or closes altogether.

Various factors can lead to this disease:

OSA manifests itself mainly at night, when muscles involuntarily lose their tone, but it can also disturb during periods of shallow sleep. Holding your breath lasts from a few seconds to 3 minutes or more.

When there is very little oxygen in the blood, the brain turns on a protective reaction - awakening. After the respiratory function has been restored, instability is observed for some time, inhalations and exhalations are chaotic and uneven.

Apnea must be treated with medications, hardware therapy or surgery; if the problem is left to chance, it can result in death from asphyxia.

Hyperventilation syndrome (HVS)

Hyperventilation syndrome is the most common form of vegetative-vascular dystonia (VSD). Most often, HVS develops against the background of a panic attack or anxiety disorder.

The appearance of suffocation is closely related to psychological problems, since breathing is the only body function that is controlled by both the somatic and autonomic nervous systems.

Failures are accompanied by the following additional symptoms:

chills and sweating;
chest pain;
nausea and dizziness;
rejection of the reality of the surrounding world;
fear of dying;
fear of going crazy;
sudden changes in sensations of hot and cold.

The causes and treatment of HVS can only be determined by a psychiatrist. It is typical that patients suffering from the disorder do not experience any deviations in physical health from the norm. Their attacks of suffocation most often occur against the background of severe stress, but over time they can occur without obvious help.

To cope with breathing problems, panic attacks and causeless anxiety, you need to do serious work on yourself, and it will be difficult to do without a specialist.

Other reasons

There are a number of pathologies that can also cause sudden disruption of respiratory function while falling asleep. All diseases are quite life-threatening, so it is important to diagnose them in time and begin treatment. You also need to know how to provide first aid to a patient to avoid asphyxia.

Let's take a closer look at what ailments lead to suffocation, and what to do if this problem takes you by surprise:

Violation	Mechanism of development of suffocation	First aid
Bronchial asthma	Choking occurs due to swelling of the respiratory tract and impaired gas exchange; it is caused by contact with allergens.	We seat the patient, provide a flow of fresh air, put a heating pad at his feet, and give Eufillin.
Allergic swelling of the larynx	If you have a personal intolerance to specific substances (allergens), severe swelling of the larynx may develop, in which the respiratory lumen closes completely and suffocation occurs.	We lift the patient out of bed, sit him down, give a solution of calcium chloride or any antihistamine (Diazolin, Diphenhydramine, etc.).
Heart failure	If the function of pumping blood by the heart muscle is impaired, a person in a supine position may experience congestion in the lungs, which leads to respiratory arrest.	We force the patient to take a vertical position, you can sit him on the bed and put pillows under his back, give Validol or Nitroglycerin, make a hot bath for the feet or put mustard plasters on the calves so that the blood drains from the upper part of the body to the lower.
Diphtheria	The disease can cause blockage of the airways with a fibrous film, which leads to suffocation.	We sit the patient comfortably on the bed, make a warming bath for the legs, which will ensure a rush of blood into the lower part of the body from the upper part.
Inflammatory infectious diseases (pharyngitis, laryngitis, etc.)	Such pathologies most often lead to suffocation in children, since they have very narrow respiratory passages. Swelling and inflammation of the mucous membranes can limit breathing and cause an attack of asphyxia.	We lift the patient out of bed, sit him down, calm him down, this should help, since in an upright position it is much easier for the respiratory muscles to work.
Sleep paralysis	The disorder manifests itself at the moment when the brain does not give a signal to the body to act, while the person does not sleep, but cannot talk or move; sometimes even hallucinations can develop against the background of such a disorder.	The patient needs to be completely awakened; light taps on the face will help bring him out of the state of paralysis; you can also sprinkle him with water, after which the person needs to be reassured and explained that everything is fine with him.

Temporary stops during the period of falling asleep should not be ignored under any circumstances. Choking may indicate serious malfunctions in the functioning of the heart muscle, respiratory and nervous systems. Only a doctor can find out exactly what is the cause of this condition. However, keep in mind that you may need to consult several specialists at once. Diagnosis and choice of treatment.

Somnologists conduct an in-depth and comprehensive study of sleep problems; an otolaryngologist, dentist, immunologist, allergist and psychiatrist can also help.

To determine what led to asphyxia, you need to carry out a number of diagnostic procedures:

After all the studies have been carried out, the attending physician makes a diagnosis. The patient may be prescribed drug therapy for heart pathologies, inflammatory processes and allergic reactions. To eliminate apnea, hardware therapy can be used, the essence of which is the regular supply of air during sleep.

HVS is eliminated through regular visits to a psychiatrist, auto-training, and sometimes medications are prescribed to relieve excessive excitability of the nervous system.

Danger of violation

If you do not treat respiratory arrest in a timely manner, you can get serious complications from this condition. In addition to the fact that the diseases that caused the disorder will develop rapidly, other pathologies may also develop.

Without receiving timely qualified assistance, the patient faces the following problems:

sleep disturbance;
decreased ability to work during the day;
development of oxygen starvation of the brain;
decreased concentration;
apathy, depression;
death from suffocation.

Drawing conclusions

If you stop breathing when falling asleep, you should immediately undergo a full examination. This disorder does not appear on its own; it is provoked by various physical and psychological disorders.

Many diseases that cause asphyxia are deadly, so it is important to detect and eliminate them in time. This disorder must be treated very responsibly, it will help preserve health and even life.