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Ailmemts & Remedies

Sleep Apnea

Definition:-
Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called apneas (Greek: ?p???a (ápnoia), from a- (a-), privative, p??e?? (pnéein), to breathe), lasts long enough so that one or more breaths are missed, and occurs repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2), a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram.

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Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram). There are three distinct forms of sleep apnea: central, obstructive, and complex (complex is a combination of central and obstructive) making up 0.4%, 84% and 15% of cases respectively.  Breathing is interrupted by the lack of effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite effort. In mixed sleep apnea, there is a transition from central to obstructive features during the events themselves.

Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body (sequelae). Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

Breathing Problems During Sleep

Many people consider snoring a minor annoyance, but it can signal a potentially serious condition called sleep apnea (temporary interruptions in breathing during sleep).

An article in the June 13, 2001, issue of The Journal of the American Medical Association reports an association between sleep-disordered breathing and a genetic marker called apolipoprotein E ?. The authors speculate that this marker may be one of many genetic factors that make someone susceptible to developing sleep-disordered breathing.


Sleep apnea is disturbed or interrupted breathing during sleep. For those affected by sleep apnea, there can be many temporary interruptions in breathing, each usually lasting about 10 seconds, throughout the sleep period. These interruptions in breathing can occur as often as 20 to 30 times per hour.

Symptoms of Sleep Apnea:-

Because some of the symptoms of sleep apnea occur during sleep, they may be recognized first by people with whom one shares living quarters.

* Heavy snoring, although not everyone who snores has sleep apnea
* Struggling to breathe during sleep
* Interruption in breathing during sleep followed by a snort when breathing begins again
* Being excessively sleepy during the day
* Falling asleep during activities that require attention and concentration, such as driving, working or talking

If you are experiencing these symptoms, see a doctor; you may have sleep apnea or some other condition that needs medical attention.

Causes of Sleep Apnea:-

* Obstructive — Partial or complete obstruction of the airway, which can be caused by relaxation of the muscles of the throat, soft palate, and tongue during sleep
* Central — Problems with signals from the brain that control breathing

Risk factors for sleep apnea include

* Being overweight
* Having a physical abnormality in the nose, throat, or other parts of the upper respiratory tract
* Having high blood pressure

Treatment

For mild cases of sleep-disordered breathing one can

* Sleep on one’s side instead of back
* Avoid drinking alcohol before sleeping
* Avoid using sleeping pills
* Avoid smoking or using other tobacco products
* Lose weight, if overweight

The most common medical treatment for sleep apnea is continuous positive airway pressure (CPAP), which is a therapy that uses pressure from an air blower to circulate air through the nasal passages and upper airway. The patient wears a mask over the nose that is connected to the air pressure hose, and the air pressure is adjusted to keep the airway open during sleep. Other therapies include dental appliances that change the position of the jaw and tongue, and various surgeries to keep the airway open during sleep.

Special situation: surgery and anesthesia in patients with sleep apnea syndrome

Many drugs and agents used during surgery to relieve pain and to depress consciousness remain in the body at low amounts for hours or even days afterwards. In an individual with either central, obstructive or mixed sleep apnea, these low doses may be enough to cause life-threatening irregularities in breathing.

Use of analgesics and sedatives in these patients postoperatively should therefore be minimized or avoided.

Surgery on the mouth and throat, as well as dental surgery and procedures, can result in postoperative swelling of the lining of the mouth and other areas that affect the airway. Even when the surgical procedure is designed to improve the airway, such as tonsillectomy and adenoidectomy or tongue reduction – swelling may negate some of the effects in the immediate postoperative period.

Individuals with sleep apnea generally require more intensive monitoring after surgery for these reasons.

Click for more information :-> www.nhlbi.nih.gov/about/ncsdr

Resources:
http://www.medem.com/medlb/article_detaillb.cfm?article_ID=zzzwt155mnc&sub_cat=593
http://en.wikipedia.org/wiki/Sleep_apnea

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Featured News on Health & Science

Sleep Apnea Can Lead to Memory Loss

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Loud snoring can seriously affect your memory.In what will come as a stern warning for 36 million Indians, American and Indian scientists have for the first time jointly discovered that people with obstructive sleep apnea (OSA) suffer tissue loss in brain regions that help store memory.

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This has been reported by researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, and UCLA (University of California, Los Angeles) in the June edition of the journal ‘Neuroscience Letters‘ .

The study focused on structures called mammillary bodies – involved with the processing of recognition memory on the underside of the brain.

The team scanned the brains of 43 OSA patients, using MRI to collect high-resolution images of the entire brain, including slices of the mammillary bodies. The structures’ small size makes them difficult to measure by conventional MRI.

When they compared the results to images of 66 control subjects, the scientists discovered that OSA patients’ mammillary bodies were nearly 20% smaller, particularly on the left side.”The findings are important because patients suffering memory loss from other syndromes, such as alcoholism or Alzheimers disease, also show shrunken mammillary bodies,”said lead author Rajesh Kumar, assistant researcher in neurobiology from SGPIMS.

“Our findings, therefore, demonstrate that impaired breathing during sleep can lead to a serious brain injury that disrupts memory and thinking,”said principal investigator Ronald Harper, professor of neurobiology at UCLA.”The fact that patients’ memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury,”Harper added.

Sleep apnea occurs when a blocked airway repeatedly halts the sleeper’s breathing for 10 seconds, at least five times per hour of sleep. Untreated OSA can cause high blood pressure, ultimately causing heart attacks and stroke. It also increases risk of diabetes, impotency, irregular heartbeats and automobile accidents due to excessive daytime sleepiness.

ENT specialist from AIIMS K K Handa says nearly 60% of those who snore suffer from OSA.”I am not surprised by this finding, especially because OSA reduces oxygenation to brain tissues and the central nervous system. At present in India, even children are suffering from OSA,”Dr Handa added.

You may click to see:->

>Sleep Apnea Leads to Hypercapnia

Sources:The Times Of India

Categories
Ailmemts & Remedies

Snoring

Snoring is a noise produced when an individual breathes (usually produced when breathing in) during sleep which in turn causes vibration of the soft palate and uvula (that thing that hangs down in the back of the throat). The word “apnea” means the abscence of breathing.
All snorers have incomplete obstruction ( a block) of the upper airway. Many habitual snorers have complete episodes of upper airway obstruction where the airway is completly blocked for a period of time, usually 10 seconds or longer. This silence is usually followed by snorts and gasps as the individual fights to take a breath. When an individual snores so loudly that it disturbs others, obstructive sleep apnea is almost certain to be present.

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There is snoring that is an indicator of obstructive sleep apnea and there is also primary snoring.

Primary Snoring, also known as simple snoring, snoring without sleep apnea, noisy breathing during sleep, benign snoring, rhythmical snoring and continous snoring is characterized by loud upper airway breathing sounds in sleep without episodes of apnea (cessation of breath).

How Does Primary Snoring Differ from Snoring that Indicates Obstructive Sleep Apnea?
A complaint of snoring by an observer
No evidence of insomnia or excessive sleepiness due to the snoring
Dryness of the mouth upon awakening
A polysomnogram (sleep study) that shows:
Snoring and other sounds often occurring for long episodes during the sleep period
No associated abrupt arousals, arterial oxygen desaturation (lowered amount of oxygen in the blood) or cardiac disturbances
Normal sleep patterns
Normal respiratory patterns during sleep
No signs of other sleep disorders
What can be done about primary snoring?
First of all, it is absolutely necessary to rule out obstructive sleep apnea or other sleep disorders. Be wary of any doctor who says it is not necessary. Behavioral and lifestyle changes may be suggested. Losing weight, sleeping on your side, refraining from alcohol and sedatives are often recommended.

The Causes Of Snoring:
Modern research reveals snoring to often have more than one cause. These include the many factors that lead to nasal blockage such as nasal allergy or deformities of the nasal septum (the cartilage partition between the two sides of the nose) and other internal nasal structures. This nasal blockage can contribute to poor nasal airflow into the lungs and can in turn set the soft tissues of the palate (roof of the mouth) and throat vibrating. These vibrations cause the loud fluttering noise of snoring.

Other factors which can influence the snoring condition are obesity; lack of fitness or aging and associated loss of general muscle tone, congestion of the throat due to the reflux of stomach acid (heartburn); and the effects of alcohol or smoking.

Congestion of the throat tissues leads to swelling of fluids within the tissues. This causes loss of muscle tone and generally makes the lining tissues of the airways flop. Where nasal congestion causes faulty or turbulent airflow through the airway, then the resonance of these floppy tissues contributes to the noise known as snoring.

Correction of snoring may not only require surgical intervention, but will probably also need cessation of smoking, minimised alcohol consumption, control of gastric acid reflux where neccessary and weight control
.

The Anatomy of the Upper Airway Passages.

CURE & TREATMENT:
Pillar Procedure
The Pillar Procedure is a new snoring treatment.
It is an operation carried out under local anaesthetic in most cases. Three tiny implants, made from woven polyester, are injected into the tissues of the soft palate. Floppiness of the soft palate, that part of the roof of the mouth which extends from the bony hard palate to the uvula (or central, dangling portion of the soft palate), is a frequent contributor to snoring. Stiffening the soft palate has been well known to quieten snoring in selected cases. However, palatal stiffening is suitable for patients who have been carefully evaluated by an ear, nose and throat surgeon with an interest in snoring problems. It does not assist every patient. Other factors may be contributing to snoring in these patients.

Now, what are Pillar implants?
The Pillar implants, made from polyester material, were developed in Europe and now have FDA US Government authority approval for surgical use. This material has been frequently used in medical products and can be safely inserted within the body. The implant creates a fibrous capsule around the implant which is the mechanism of the stiffening.

How do they work?
During the Pillar Procedure, three tiny woven inserts are placed in the soft palate to help reduce both the vibration that causes snoring and the ability of the soft palate to obstruct the airway. The Pillar inserts add structural support to the soft palate over time and prevents palatal fluttering (snoring).

The complex anatomical structure of the upper airway passages is due to the close association of the air, food and fluid passages. We not only breathe through our mouth and nose, but we also eat and drink through our mouth. The food passages of the mouth, throat and oesophagus leading to the stomach are separated from the airway by the soft palate and epiglottis and associated structures of the larynx or voicebox. This normally prevents food or fluid passing into the air passages and lungs. Occasional strong coughing fits are reminders that this is not always the case!

The nasal air passages serve to moisten the air intake and also provide the olfactory, or smell sense. Alternating congestion of the nasal passages helps channel the air intake between the two lungs.

ORAL/DENTAL DEVICES
There are mouth/oral devices (that help keep the airway open) on the market that may help to reduce snoring in three different ways.

Some devices:
bring the jaw forward or
elevate the soft palate or
retain the tongue (from falling back in the airway and thus decreasing snoring).

SURGERY
There is also surgery. Snoring is Not Funny, Not Hopeless. There is uvulopalatopharyngoplasty (UPPP) or Laser-Assisted Uvulopalatoplasty (LAUP), that involves removing excess tissue from the throat.

The newest surgery, approved by the FDA in July 1997 for treating snoring is called somnoplasty and uses radio frequency waves to remove excess tissue.

Injection Snoreplasty and Non-Surgical Snoring Cures are some other options.

10 Natural Tip for a Silent Night

Home Remedy of Snoring…….(1)

Home Remedy …………...(2 )

Regular Yoga Exercises like Meditation, Breathing Exercise etc. are also a permanent cure for snoring and sleep apnea.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Source: www.snoring.com.au

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WHY CORNER

Why do people snore while sleeping?

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Snoring  happens  to all of us: tossing and turning sleeplessly while the person in the next room snorts and snarfs his way through the night. Why is it that a perfectly normal, healthy person makes such an awful noise?

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While breathing during sleep, structures like the palate, uvula (fleshy conical lobe at the back of the mouth) and tonsils may flap against each other as there may be excess tissue in this region. The vibration of relaxed floppy tissues that line the upper airway causes the sound that you hear when someone is snoring. This is because when you sleep, all the muscles in the body are relaxed and muscle tone decreases.

The upper airway is lined with muscles that keep the airway open. When these muscles relax during sleep, the diameter of the airway decreases and, in some people, this partially blocks the airflow, leading to turbulence.

Instead of air flowing smoothly down the airway into the lungs, it flows with gusts and bursts. Travelling through such an airway, the air picks up speed and gets whipped around in different directions. As the air bounces around, it hits the relaxed, floppy tissues lining the throat and causes them to vibrate, like a flag in the wind. This produces the snoring sound.

People don’t make a snoring sound when they are awake because the muscles in the throat hold the airway open wide enough for a smooth flow of air into the lungs.

Also, we snore more as we get older because our muscles become increasingly flaccid with age. Gaining weight also adds to the chances of snoring as fat deposits accumulate in the tissues of the airwaymaking them heavier so they fall more into the line of airflow.

Source:The Telegraph (Kolkata,India)