Etiology of obstructive sleep apnea
Anatomical risk factors include
- An oropharynx “filled” by a short or retracted jaw
- Basis of prominent tongue or tonsils
- Round head shape and a short neck
- A neck circumference> 43 cm (> 17 inches)
- Thick side pharyngeal walls
- Side para-pharyngeal fat pads
- Anatomical risk factors are common among obese people.
Other risk factors identified include postmenopausal status, aging, and use of alcohol or narcotics. There is a family history of obstructive sleep apnea in 25-40% of cases, which probably reflect hereditary factors that affect the ventilatory impulse or an unusual genetic craniofacial structure. The risk of OSA in a family member is proportional to the number of family members affected.
Hypothyroidism, acromegaly and sometimes stroke can cause OSA. The disorders that occur most frequently in patients with obstructive sleep apnea include hypertension, stroke, diabetes, hyperlipidemia, gastroesophageal reflux, nocturnal angina, heart failure, and atrial fibrillation or other arrhythmias.
As obesity is a common risk factor for obstructive sleep apnea and the syndrome of obesity and hypoventilation, both disorders often coexist.
The inspiratory effort against an obstructed upper airway causes inspirational paroxysms, reduced gas exchange, altered sleep architecture, and partial or total awakenings. These factors may interact and cause characteristic signs and symptoms, including hypoxia, hypercapnia, and sleep fragmentation.
Sleep apnea is an extreme aspect of upper respiratory tract resistance. Less severe forms that do not cause O2 desaturation include:
- High resistance to airflow of the airways that causes noisy inspiration but no sleep wakes
- Upper airway resistance syndrome, characterized by increasing snoring that end in respiratory-related arousals.
Patients with the airway resistance syndrome are younger and less obese than those with obstructive sleep apnea and complain of daytime somnolence more than patients with primary snoring. Frequent arousals occur, but strict criteria for apneas and hypopneas may not be present. The symptoms, diagnostic evaluation, and treatment of upper airway resistance syndrome and snoring are the same as obstructive sleep apnea.
- Obesity, upper respiratory tract anatomy, family history, certain disorders (e.g., hypothyroidism, stroke), and the use of alcohol or sedatives increase the risk of OSA.
- Patients usually snore, have restless, restless sleep, and often experience daytime drowsiness and tiredness
- Many people who snore do not suffer OSA.
- The most frequent disorders in patients with obstructive sleep apnea include hypertension, stroke, diabetes, gastroesophageal reflux, nocturnal angina, heart failure, atrial fibrillation, or other arrhythmias.
- The diagnosis is confirmed by polysomnography.
- Control modifiable risk factors and treat the majority of patients with CPAP and oral devices designed to open the airway.
- Consider surgery for anomalies that invade the airway or if the disorder is intractable.
Cure rhinitis, allergies and breathing pathologies
Chronic rhinitis and allergies cause swelling of the mucous membranes, with obstruction of the airways. Curing the cause, snoring improves. In the case of deviated nasal septum, a septoplasty is recommended to improve breathing. Turbinate bone pathologies, nasal polyposis, and septum deviation can also be treated simultaneously with a laser intervention against snoring.