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What are the apneas during the sleep?

Definitions

Sleep apnea: apnea during the sleep.
O.S.A.S.: several episodes of sleep apnea with snoring.
Obese ipo-ventilatory syndrome: syndrome (including O.S.A.S.) characterized by obesity, ipo-ventilation, ipersomnia, respiratory periodism, ploly-globulia.
Central apnea: ceasing of the nose - mouth flows and of the abdomen-thorax movements.
Mixed apnea: initially a central apnea followed by an obstructive phase.
Respiratory periodism: alternative periods of ipo-ventilation with or without apnea.

Apnea index: number of respiratory events per hour of sleep able to produce a reduction of the percentage of oxygen in the organism (SaO2) lower than 85%.
Overlap Syndrome: association of OSAS with another pathology, generally chronic - obstructive bronchial pneumopathy (BPCO).
Nadir: lowest peak of SaO2 during the sleep.

Some snorers also suffer from the Apneas Syndrome during the sleep. In this case, besides a partial passage of air in the throat (with a consequent snoring), we also have a complete obstruction of the main respiratory ways (apnea).

Apnea means an absence of a correct respiration for 10 seconds at least. This absence could reach 60-70 seconds. Given that during an apnea the respiratory ways are blocked and the air is not passing through the throat, the oxygen level in the blood is suddenly reduced, while the blood pressure increases. At the end of an apnea, we generally have a brief wake-up that often the subject doesn't realize. Gradually, we're going to have a real Sleep Apnea Syndrome (SAS), cause of an important reduction of the organism's oxygenation during the rest. The continuous phases of oxygen reduction and increase carbon dioxide in the blood, stimulate the brain and provoke several wake-ups in the subject, whose sleep characterized by agitation, continuous changes of position, frequent wake-ups, loud and violent snoring, interrupted by phases of silence (apneas).

At morning, the subject wakes up tired, often suffering headache, and during the day he shows loss of energy and concentration, irritability, loss of memory, humour changes. Other consequences are anxiety, depression, obesity, diminution of the sexual impulses.

Causes of the main Roncopatie

Remembering that breathing we give oxygen to our organism, it's important to remember that the air must enter through the nose, the only physiological way, while the mouth is only an emergency way. Through the nose, the air reaches the pharynx and from here, through the larynx, bronchi, trachea, reaches the lungs, where there is the exchange between the oxygen and the carbon dioxide produced by our organism. Any obstacle the air finds from nose to lungs will produce flow irregularities and the nose might be obstructed by a sect deviation, by a pathological increase, by the presence of polyps etc.

In all these cases the oral respiration keeps to take the place of the nasal one. The air passing through the nostrils undergoes an important force of aspiration, causing turbulences that provoke vibrations of the soft palate and the uvula, producing the characteristic noise. Besides the anatomic conditions, there are many factors that can make the frequency or importance of the snoring increase.

Obesity: the increase of weight or the overweight provoke an increase of fat deposit in all the tissues, including the ones around the mouth and throat; this action produces a shrinking of the respiratory ways and relaxation of the soft tissues, favouring the snoring. Alcohol consumption at dinner: to drink more than two glasses wine at dinner causes the relaxation of the soft tissues in the rear part of the throat, favouring their vibration at the passage of air.
Increased respiratory secretions: This circumstance can be cause by several factors, like smoking, Chronic sinusitis, some kind of soft cheese or milky products eaten at dinner.

Complications

Progressive forms of worsening from the snoring to sleep apnea syndrome often pass unobserved, and are generally noted after more important complications appear. Therefore, it's important not to under-consider a problem that is no dangerous only in a superficial analysis: it must be treated very previously, in order to avoid serious damages. The study of the sleep allowed to show the existing ties between the sleep apnea syndrome and some cardiac, brain and lung complications.

During the periods of apnea (respiratory arrests of more the 10 seconds that may be happen until three hundreds time a night), we have a reduction of blood oxygenation, and this reduction is the event from which the complications may develop.
Cardiac and circulatory complications: increase of the arterial pressure and cardiac frequency; sometimes we have alterations of the cardiac rithm until the arrest. This factor may explain why many heart and brain accident happen at night.
Brain complications in patients affected by sleep apnea syndrome: we have a chronic insufficiency in the brain oxygenation, cause of a suffering of the nervous cells that may explain many of its neurological symptoms.

Besides, the apnea crisis provoke many wake-ups inthe night, with a diminution of the capability to have dreams and consequent negative influences of the psychic balance.

Hormonal and sexual diseases: in patients affected by sleep apnea syndrome, we observe a reduction of the thyroid hormones of growth. Clinical studies on more than 1.000 patients with erection problems showed that 92% had more then five apnea episodes per hour during the sleep.
Bronchial-respiratory complications: a prevalent oral respiration obstacles a correct nasal filter, because the air is not warmed, humidified and filtered by the nose, becoming an irritation element for the lower respiratory ways.
The reduced exchanges of oxygen at bronchial and lungs level and the reduced blood oxygenation provoke frequent wake-ups during the night sleep.