Is it possible to get rid of obstructive sleep apnea and snoring once and for all?

Snoring is a fairly common problem. Moreover, both the snorer himself and those around him suffer from it. Patting on the back and turning over on one's side helps, only for the time of awakening. The person who snores cannot hear himself. But the other half hears him perfectly. It is noteworthy that ten percent of all marriages break up precisely because of the partner’s snoring.

Statistics say: every fifth person on Earth snores shamelessly! It has been proven that men are most often susceptible to this condition, since they have abdominal breathing. At the age of thirty, almost half of the male population begins to snore constantly in their sleep. Women begin to snore in their sleep closer to the age of fifty. In childhood, this figure is lower - only 10% of children snore.

This delicate problem is not only social, but also medical: five percent of people suffer from the so-called obstructive sleep apnea syndrome (OSA). In this condition, snoring is replaced by a temporary cessation of breathing. In one percent of patients with OSA, breathing can stop up to fifty times a night!

That is, we are dealing with a real disease that not only bothers others, but also causes real harm to our own health. Therefore, you must fight snoring to the bitter end!

How does snoring occur?

A person can snore evenly, with each inhalation and exhalation. This condition is called uncomplicated. It is much worse if a person begins to snore intermittently and stops, holding his breath for a certain time. In medicine, this pathology is called “sleep apnea” - stopping breathing movements during sleep.

The mechanism for the occurrence of snoring sounds is as follows: air flows passing through the respiratory tract encounter an obstacle in front of them. At the moment of collision these unpleasant rattling sounds appear. There are many reasons why this obstacle comes from. They are divided into physiological, pathological and hormonal. Air flow can be hampered by: weakened soft tissues and muscles of the oropharynx and soft palate, causing the tissues to sag; adenoid vegetations; tumors; polyps; swollen throat tissue; deviated nasal septum.

The problem of adenoids mainly affects children and adolescents. Adenoid vegetations are a proliferation of lymphoid tissue of the pharyngeal tonsil. Even allergies and infectious diseases can provoke the growth of adenoids. As the adenoids grow, they narrow the lumen of the pharynx, making it difficult for air to circulate without touching them. The muscles of the pharynx make rattling sounds.

A deviated nasal septum is a fairly common cause of snoring. With such an anatomical anomaly, the nasal passages are often blocked, and air requires a lot of effort to pass through them. This process is also accompanied by vibrating sounds.

Therapy methods

Treatment of apnea and snoring is always individual. In some cases, it is enough for the patient to get rid of bad habits and lose excess weight, in others it is important to undergo a comprehensive, comprehensive elimination of colds and viral diseases in a timely manner.

Since snoring and breathing problems at night can be a sign of allergies, it is necessary to do wet cleaning and ventilate the bedroom well before going to bed.

Patients may also be advised to:

• physiotherapy
• taking certain medications
• special exercises to improve muscle tone of the soft palate

CPAP therapy is also provided. It is prescribed for moderate and severe forms of pathology. This treatment involves creating constant positive pressure in the airways. This allows you to maintain their constant normal patency during sleep.

Patients with congenital or acquired anomalies of the nasopharynx undergo surgical interventions. Surgeries are permissible for snoring or apnea of ​​mild to moderate severity. In severe forms of pathology, surgical interventions are contraindicated.

Stages of snoring development

Snoring is conventionally divided into two types:

• Episodic snoring occurs in people regardless of gender and is not a sign of pathology. This type of snoring can be triggered by overwork, a cold, or drinking alcohol the night before.
• Constant snoring – a person snores every night or at least three times a week.

During sleep, a person's breathing may stop for more than 10 seconds. In medicine, this condition is called obstructive sleep apnea syndrome. It is dangerous due to its consequences, including the risk of developing a heart attack or stroke.

If there is no apnea, such snoring is called isolated, or primary. But the percentage of such patients is very small. Most snoring is accompanied by apnea.

Intraoral devices

Another direction for treating snoring and sleep apnea is the use of intraoral devices (mouth guards), which are installed on the upper and lower teeth and slightly move the lower jaw forward. The displacement of the jaw increases the lumen of the pharynx. Intraoral mouthguards are effective for uncomplicated snoring and up to moderate obstructive apnea. For obvious reasons, such devices are most effective in patients whose snoring and apnea are caused by retrognathia and micrognathia (a backward, small jaw). This is usually manifested by a “sloping” chin, posterior displacement of the lower teeth and their “crowding” (Fig. 17). The most advanced anti-snoring mouthguards are made individually by dentists using dental impressions. They have special mechanisms that allow the lower jaw to gradually move forward over several weeks until the desired effect is achieved (Fig. 18). It is clear that this is a very expensive pleasure. The cost of such mouth guards can exceed 80,000 rubles.

There are simpler, but also very effective heat-labile mouth guards. They are made of a special plastic that becomes soft in hot water. The heated “blank” of the mouthguard is installed on the teeth of the upper jaw, the patient closes his mouth with the lower jaw extended forward. The material hardens quickly, and the mouth guard is ready for further use. The whole procedure takes no more than 10 minutes. Subsequently, before going to bed, the patient places a mouthguard in the mouth, and the lower jaw automatically moves forward. The procedure for the initial installation of a mouthguard is carried out at an appointment with a somnologist or other doctor who has experience working with such devices.

The main advantages of thermolabile mouthguards are ease of installation and low price (about 5,000 rubles), as well as the ability to repeat the installation procedure in case of any difficulties with use. Such a device can be used constantly or considered as a trial option before installing an individually made adjustable mouthguard. Agree, it’s better to try a mouth guard for 5,000 rubles than for 80,000 and make sure that for some reason it doesn’t suit you.

Physiological reasons

It happens that quite simple and obvious things “make” you snore, and if you get rid of them, the problem disappears by itself. Such physiological factors include:

• an uncomfortable pillow (on such a pillow the neck is bent and the larynx is pinched);
• a pillow that is too soft, when the head falls in, and, in fact, the person sleeps all night with his head thrown back;
• allergies (down and feathers in pillows, synthetic linen, carpets next to the sleeping person);
• dry air in the room, or the room is too hot (unfavorable conditions in the bedroom cause swelling of the larynx, and accordingly the passage for air through it narrows);
• dust, smoke - all those factors that irritate the mucous membrane of the nasopharynx.

Buy another pillow, a more comfortable one, or simply ventilate the room - these measures are often enough to forget about the problem.

A deviated nasal septum, which we have already mentioned, or other facial features (for example, abnormalities in jaw development) can also be attributed to physiological factors. Eliminating them, and therefore getting rid of snoring, can only be done surgically. But doctors resort to this only in cases of OSA.

"Medicines" in a pharmacy

Anti-snoring remedies in pharmacies seem trustworthy at first glance. They're from the pharmacy! This means they should work like other medications.

In fact, sprays, tablets, aerosols, drops are useful only for 10% of snorers. Their main effect is hydration of the mucous membrane and a slight anti-inflammatory effect, and this works if the problem is caused by dry air or smoking (and this is not always the case). Such low effectiveness is normal, because any such “medicines” do not cure, but only slightly improve the condition of the pharyngeal mucosa.

Pathological and hormonal factors

If physiological factors are not the cause of snoring, and changing the pillow, for example, does not solve the problem, then the reasons lie deeper, and we are dealing with some pathologies of the body.

Among the pathological factors can be identified chronic diseases of the upper respiratory tract and adenoids. An otolaryngologist will help you identify the exact cause of snoring. Already at the first appointment, the ENT doctor, after conducting an examination, will be able to recognize adenoid vegetations, or indicate the presence of chronic inflammatory processes in the body. With a correct diagnosis, the otolaryngologist prescribes complex therapy, including drug treatment and physiological procedures aimed at reducing the proliferation of lymphoid tissue of the pharyngeal tonsil in the case of adenoids, or at destroying the causative agent of inflammation (taking antibiotics, antiviral or antifungal drugs).

If the problem is related to exposure to allergens on the body, it is necessary to eliminate the source of the allergy and take decongestant antihistamines.

Snoring can also be triggered by changes in a person’s hormonal levels, for example, with decreased thyroid function (hypothyroidism). In this case, consultation with an endocrinologist is necessary.

We have described the most common causes of snoring, now let's take a closer look at the characteristics of the pathology depending on gender. What are the most common reasons that cause men to snore in their sleep, and which women? Let's find out.

Is the pathology treatable?

Obstructive sleep apnea and snoring are treatable once the causes are identified. For this, comprehensive diagnostics are carried out.

All treatment options boil down to increasing the tone of the soft tissues of the pharynx and eliminating factors that lead to narrowing of the airway. Which method is suitable for a particular patient is determined only by the doctor. At the same time, he evaluates all indications and contraindications. This allows you to perform therapy with minimal risks and maximum effectiveness.

Important! Treatment should be carried out with the aim of eliminating not the manifestations of the pathology, but its causes. Only in this case will it be effective.

Causes of snoring in men

Speaking about snoring in men, a joke immediately comes to mind: “Men snore in their sleep to protect women from “babaika”.” Jokes aside, one of the most common causes of divorce, as noted above, is snoring. As an experiment, ask family members to record your snoring on a cell phone voice recorder, and then turn on this “musical” accompaniment at night and try to fall asleep. It is unlikely that you will succeed quickly. Therefore, identifying the root cause and treating snoring is an important task for both the snorer and his family members.

Notably, snoring can reach a threshold of 100 decibels (dB). For comparison, a normal conversation between people takes place at a volume of 50 dB, and the noise emitted by an airplane is 140 dB. From this comparison it is clear what discomfort a snorer causes to others.

In men, the cause of snoring, which ranks first among all physiological and pathological factors, is excess weight. Obesity is the scourge of our time. According to statistics, the likelihood of snoring in a mildly obese man is ten times higher than in people with a normal BMI (body mass index). And the higher the degree of obesity, the higher the likelihood of developing OSA. Excess fat puts pressure on the airways, preventing normal air circulation, which causes unpleasant sounds at night.

The next most popular reason is alcohol abuse. Alcohol itself relaxes the muscles. Under the influence of alcohol-containing drinks, the soft palate and tissues of the oropharynx become limp and the lumen of the larynx narrows, and snoring appears. Moreover, if a man snores even without alcohol, then drinking strong drinks only aggravates the situation and can provoke apnea. The brain of a drunk person in a dream cannot control the normal function of breathing - breath holds are longer. The person is not breathing, and the brain does not realize that breathing needs to be restored. It is very dangerous!

Various sedatives and sleeping pills work on the same principle: these drugs cause muscle relaxation and provoke snoring. In people suffering from OSA, taking sleeping pills increases hypoxia during temporary cessation of breathing.

If a man smokes, sooner or later he will start snoring, since this dangerous bad habit leads to chronic injury to the respiratory tract. They swell, and during sleep, when the muscles relax, the swollen airways further narrow the lumen of the larynx, which is inevitably accompanied by “sound” accompaniment.

Of course, men are also susceptible to other reasons that were described above, but the leaders were and remain bad habits.

Why do women snore

Women who suffer from snoring wonder: “Why did I start snoring? After all, I’m not a man!” However, women snore for the same reasons as men. The only differences exist in what specific causes of snoring come first among representatives of one sex or another.

In women, snoring often occurs during periods of serious hormonal changes: during pregnancy and menopause. In the first case, vasomotor rhinitis occurs, provoked by changes in hormonal status. In addition, pregnant women experience rapid weight gain. All this leads to snoring, which often prevents your bed partner from sleeping.

During menopause, the production of sex hormones that help maintain muscle tone fades, and the turgor of the skin and mucous membranes decreases. The muscles of the pharynx weaken, the soft tissues sag - so it turns out that the woman snores in her sleep.

There are other causes of female snoring. Women are more likely to use sleeping pills to combat insomnia and are more likely to take sedatives. When using them, a person snores heavily. This is explained simply: sleep medications additionally relax the muscles of the pharynx. Sleeping pills also raise the brain's threshold for responding to a lack of oxygen, leading to longer pauses in breathing in sleep apnea patients and more severe snoring when breathing resumes.

Causes of snoring in women

Women, like men, are susceptible to the same factors that cause snoring. But still, the main cause of snoring in women remains changes in hormonal levels.

As a rule, women begin to snore around the age of fifty. It is at this time that hormonal changes occur in the body and menopause begins. A woman’s body produces less and less estrogen (female hormones). It is known that estrogens are responsible not only for reproductive function, but also for muscle tone, therefore, when the level of estrogen decreases, muscle tone certainly decreases, which provokes their relaxation and snoring.

Hormonal changes can be caused by uncontrolled use of hormonal contraceptives. Such drugs should be prescribed exclusively by a gynecologist based on the tests performed and the patient’s health condition. Only then is taking hormonal contraceptives safe!

This problem is also exacerbated in pregnant women. In addition to hormonal changes, other factors are also involved: weight gain, stress, fatigue.

Excess weight is also a big problem, but often it is the result not of overeating, but of decreased thyroid function. The hormone responsible for metabolism in the body (thyroxine) is produced less and less, so a woman, even if she eats right, may become overweight.

What you definitely shouldn't waste time and money on

There are two categories of remedies that do not help anyone. First of all, nose clips. Don't be fooled by advertising! There are no special points in the nose that block snoring. They don't exist at all, so the clip is completely useless.

The second is traditional treatment... Eating baked carrots before bed, drinking cabbage juice, placing a piece of ginger in the navel - in our time this is not just ignorance, but unforgivable stupidity. The only folk method that occasionally helps is gargling with vegetable oil before bed. It softens the mucous membrane, prevents the walls of the pharynx from sticking together, so the procedure sometimes has a positive effect.

Causes of snoring in children

Snoring can occur not only in adult patients, but also in childhood. In children, the causes of snoring often lie in excess weight or problems with the nasopharynx. The main causes of snoring in children:

• adenoids;
• nasal congestion;
• allergic rhinitis (can be seasonal or year-round);
• inflammatory diseases of the nasopharynx (sinusitis, tonsillitis, influenza, ARVI, etc.);
• deviated nasal septum;
• obesity.

In addition to snoring, your child may experience other symptoms:

• weakness, lethargy, the child does not get enough sleep;
• deterioration in concentration, memory, decreased performance at school;
• nasality in the voice.

It happens that the only thing that bothers you is snoring. Then it’s worth observing how the child sleeps: how loudly he snores; does breathing stop during sleep; does the child wake up at night because it is difficult for him to breathe; does he sleep restlessly; Does he take strange positions in his sleep?

All this is a good reason to show the child to an ENT doctor and, if necessary, undergo competent treatment.

Useful tips

What to do if someone close to you snores? Try some helpful tips to help restore your sleep and keep your household healthy.

• You need to be careful when you sleep with headphones on, because the cord can compress your throat when it wraps around your neck.
• You should not cover the mouth or head of a snoring person with anything to make the sound quieter, as this may result in suffocation.
• You should not self-medicate or use medications against insomnia or allergies without consulting a doctor. Because the side effects and interactions of these drugs with other drugs can be very serious, especially when their dosage is exceeded.
• When snoring sounds very loud and monotonous, and not evenly, in the rhythm of breathing, the snorer may suffer from apnea syndrome, so he should not take allergy medications. After all, such people can be sensitive to any medications, especially those taken before bed, which can be fatal.

If you're wondering, “What can I do to help me fall asleep quickly,” try following a few tips that will help you cope with your loved one's snoring, as well as normalize your own healthy sleep.

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Dispatch

What is the danger of snoring

The very presence of snoring already signals that there is a problem with the airways: they are partially blocked. And the more the paths through which air passes are blocked, the worse the body, and most importantly, the brain, are saturated with oxygen.

A snorer's brain does not rest. A person is unable to enter the deep sleep phase; accordingly, he cannot rest during the night and wakes up tired and “broken.” This condition is especially dangerous in childhood. During sleep, the child actively produces growth hormone. When a child cannot enter the deep sleep stage, the production of this hormone decreases, which entails developmental delays.

Due to the fact that the brain does not rest during sleep, a person does not get enough sleep. Chronic fatigue, irritability, and various nervous disorders appear. Memory deteriorates and performance decreases.

In addition, people who snore may experience other dangerous health effects:

• atherosclerosis;
• jumps in blood pressure, which increases the risk of heart attacks, strokes, hypertension and other diseases of the cardiovascular system;
• problems with the kidneys and bladder.

For humans, such a condition is also dangerous with the risk of developing obstructive sleep apnea syndrome. Apnea is a condition in which a person holds their breath for more than ten seconds while sleeping. Outwardly, it looks like this: a person is sleeping, makes snoring sounds, and at some point the sounds stop, breathing stops, followed by a loud snoring sound, and breathing is restored.

With such poor quality sleep, a person experiences unpleasant symptoms during the day: headaches, drowsiness, nervousness. Statistically, people with OSA are much more likely to have car accidents.

As a result of one of the studies of the American National Institute of Health, it was found that the absence of gravity allows astronauts not to snore in their sleep. But the people remaining on Earth have to deal with the force of gravity. It leads to the retraction of the tongue in a supine position and the occurrence of snoring. We talked about the features of this disease with Roman Vyacheslavovich Buzunov, President of the Russian Society of Somnologists, Honored Doctor of the Russian Federation, Professor, Doctor of Medical Sciences, leading Russian expert on insomnia, snoring, sleep apnea and CPAP therapy.

What are the main causes of snoring?

There are many causes of snoring and obstructive sleep apnea (diseases of stopping breathing during sleep): excess weight, smoking, alcohol consumption, long uvula and low soft palate, retrognathia and micrognathia (small, backward-displaced lower jaw), ARVI, adenoids and hypertrophy of the palatine tonsils , deviated nasal septum, nasal polyps, allergic rhinitis, hypothyroidism, acromegaly (increase in the size of the tongue, proliferation of tissue at the level of the pharynx and narrowing of the airway), taking sleeping pills, tranquilizers and even pregnancy.

It is worth paying attention to the fact that this problem is common not only among adults. Approximately 10–14% of children snore, and obstructive sleep apnea (OSA) occurs in 2%. In other words, now in Moscow there are approximately 40–50 thousand children with OSA. In 90% of cases, the cause of childhood snoring is adenoids and hypertrophy of the tonsils, followed by allergic rhinitis, as their predecessor, and childhood obesity, which is now actively developing, especially in the United States. There are also more rare causes, for example, various deformations of the maxillofacial skeleton.

To emphasize the seriousness of the problem, I’ll start a little from afar. Why do you think a newborn baby sleeps for 16 hours?

Most likely, he needs a lot of energy to form the body...

Your reasoning is correct. The fact is that on average a child is born weighing 3.5 kg, and by adulthood, if it is a boy, he reaches a weight of approximately 70 kg. That is, body weight increases 20 times. In fact, the brain, speaking globally, is engaged at night in the construction and support of the vital functions of organs and systems.

The second task is information processing. A baby dreams for an average of 6 hours, and an adult for 1.5–2 hours at most. Why? Because in the first 6 years of life, a child learns 80% of all audiovisual information that he will encounter throughout his life. And in REM sleep (from the English rapid eye movement - rapid eye movement) information processing and cataloging occurs. That is, the brain thinks what to forget, how to sleep, the problem, what decisions to make and how to adapt to the environment. Long-term memory is also formed during sleep.

Now imagine that with sleep apnea, the quality of sleep is significantly impaired. It's not just snoring, it's stopping breathing during sleep. There are several hundred of them per night. They disrupt the structure of sleep, its stages, cycles, and it turns out that sleep can no longer fulfill its construction and informational functions. Children who snore and those with sleep apnea do not develop well physically. They are usually short and puny, because at night in the deep stages of sleep, somatotropic hormone or growth hormone is produced. Children grow around the clock, but peaks in the production of this hormone are observed precisely at night, in the deep phases of sleep, which disappear during apnea.

Imagine that breathing stops once every minute. Accordingly, once a minute the brain wakes up because there is nothing to breathe, and it does not have the opportunity to reach the deep stage of sleep. Then REM sleep is destroyed, and the child stops assimilating information normally and does not form long-term memory well. He develops attention deficit hyperactivity disorder, the child cannot adapt to the external environment, remember and retain information. His brain does not ensure the full formation of neural connections.

With a long-term absence of normal nasal breathing due to adenoids, the child develops an “adenoid face”: a large nose with a hump, a small lower jaw displaced back with crowded teeth. So such children grow up small, puny, with defects in the development of the facial skeleton, and even with limited mental abilities.

Yes, the consequences are really serious. Let's talk about symptoms in children and adults.

In children, OSA is manifested by intermittent snoring, pauses in breathing during sleep followed by snoring, restless sleep, night sweats, and enuresis, which can persist up to 6-7 years. Sometimes young children also vomit at night. During the day, the child has attention deficit disorder, hyperactivity, difficulties in learning and adapting to the children's group.

What symptoms do adults show?

They also snore and stop breathing, but, as a rule, if we are talking about moderate degree of OSA, they experience severe daytime sleepiness. A person falls asleep, despite all attempts to stay awake: at the computer, at a meeting, while driving a car... Nocturnal and morning arterial hypertension, sweating of the head and neck at night, asthma attacks, night belching, headaches, restless and unrefreshing sleep are noted. Half of the patients in this case will complain of insomnia and feeling tired in the morning.

Imagine, such a patient comes to a neurologist and says: “Doctor, I have restless and unrefreshing sleep, frequent awakenings in the middle of the night, and in the morning I wake up tired and sleep-deprived. And during the day I’m worried about drowsiness, irritability and decreased performance.” What will the doctor think? About insomnia. And prescribe sleeping pills or tranquilizers. But in this case, insomnia is a symptom of sleep apnea! And in the instructions for use of these drugs it is written in black and white that sleep apnea is a contraindication to their use. Tranquilizers and hypnotics relax muscles and suppress brain activity. Apneas occur more often, last longer, and the brain sleeps and does not respond to a sharp decrease in oxygen. As a result, the risk of hypertension, cardiac arrhythmias, and sudden death during sleep increases.

Roman Vyacheslavovich, please tell us what are the approaches to correcting snoring?

Tactics depend on the combination of causes and severity. The causes are usually determined by examination. As I already said, in children these are adenoids and large tonsils in 90% of cases. Severe sleep apnea leads to impaired physical and mental development, which requires aggressive treatment.

If we see allergic reactions in children, they need to be actively and long-term treated to prevent the development of adenoids and hypertrophy of the tonsils. If a child is diagnosed with severe apnea due to already developed adenotonsillar hypertrophy, this is a 100% indication for surgical treatment. There's no point in waiting for a miracle, it won't get any better. Mild snoring can be treated therapeutically using the same corticosteroids, which are quite good at removing swelling and can even lead to a reduction in adenoids. If the cause of snoring is obesity, we will deal with it.

What recommendations can you give to adults on how to get rid of snoring on their own?

I suggest starting with the following:

• If a person smokes, give up this bad habit, stop drinking alcohol shortly before bedtime, and stop taking sleeping pills and tranquilizers. When it comes to positional treatment, it is important to choose the right pillow. It should not be too low - in this situation, when the person sleeps on his back, the head falls back, the tongue sinks, and the person’s snoring becomes heavier. At the same time, the pillow should not be too high: then the neck is in an unnaturally curved position, which, again, can aggravate snoring.
• Ideally, it is advisable to use an anatomical contour pillow with a thickening under the neck. It provides the most physiological parallel position of the head in relation to the body. It takes a few days to get used to this type of pillow. At first it may not even seem very convenient. But after a short time, sleeping on it will become comfortable.
• Among other things, it is important to ensure an elevated position of the headboard. You can raise it using a low (10–15 cm) stand installed under the legs of the bed from the head end. In this case, the entire bed is slightly tilted. Or only the head of the bed is raised (functional bed). In this situation, even in a supine position, the tongue sinks less. In addition, the fluid is redistributed to the underlying parts of the body, swelling of the nasopharynx decreases and its lumen increases.
• To alleviate the situation with snoring, you should sleep on your side and worry about normalizing your weight if you have extra pounds. One of the leading mechanisms for the development of snoring is weakening of the tone of the pharyngeal muscles. To return it to normal, it is recommended to do special exercises that strengthen the muscles of the pharynx and tongue. In many cases, with uncomplicated snoring, this helps a lot.

How can modern medicine help with snoring and apnea?

It all depends on the characteristics of a particular case. Let’s say I look into a man’s throat and see his so-called “kissing” tonsils, which means he hasn’t been treated since childhood, third-degree hypertrophy, the pharynx is 90% closed. We remove the tonsils - and that’s it, we cure the patient of snoring and apnea.

If we are dealing with uncomplicated snoring, the airways are open, there is no obesity, there is no lower jaw displaced back and there is an elongated uvula that has lost its tone, it is worth trimming it and it will stop beating against the walls of the airways. And we get an excellent effect: we actually cure a person with such a surgical intervention. But, if the patient has a pronounced backward displacement of the lower jaw and collapse of the airways at the level of the root of the tongue, that is, there is a uvula there, there is no tongue, it does not matter at all. Nothing will change if you cut it off. The situation is similar with severe sleep apnea due to obesity.

In the case of a severe illness accompanied by obesity, we can completely rid a person of snoring only if he radically loses weight. It happens that you ask a patient: “How many kilograms have you gained since the onset of snoring?” He says, for example, 40. And I answer: “Minus 40 kilograms, and you are a healthy person who does not snore.”

The question arises, how to do this?

Yes, but it’s important to take into account this: at some stage, the severity of apnea is such that metabolic processes are disrupted. Remember when we said that growth hormone is produced during sleep? In children, it is responsible for growth, so children with snoring do not grow well, but in adults it has an anabolic function, responsible for converting fat into energy and muscle mass. It's actually an anabolic steroid. And if it begins to be lacking, then the fat that was deposited in the reserve does not leave well - once. Secondly, when our sleep is seriously disturbed, the production of ghrelin increases, which increases appetite. At the same time, the production of leptin, which is responsible for the feeling of satiety, decreases. That is, a person always wants to eat, he eats this stress all the time, and the fat deposited as a result of this lies as a dead weight.

People often say: “I don’t eat anymore, I even limit myself somehow. My wife eats twice as much, but I’m getting fatter.” The fact is that a person simply does not have enough oxygen, and all metabolic processes are inhibited. As a result, a vicious circle arises: obesity triggers apnea, and apnea at some stage triggers the process of further progression of obesity.

By the way, patients with morbid obesity, when body weight is exceeded by 50% of its normal values, and Pickwick syndrome, in which there is a decrease in the pumping function of the lungs, sleep apnea and hypercapnia (excessive accumulation of carbon dioxide), are at risk for developing acute respiratory syndrome. failure in COVID-19. Their compensatory mechanisms are already working to the limit, and then some part of the lungs is switched off during coronavirus pneumonia. This quickly leads to the development of acute respiratory failure and the need to transfer the patient to mechanical ventilation, at which mortality reaches 90%.

And how can you help a person with severe sleep apnea and obesity if he cannot lose weight?

In 1981, Australian professor Colin Sullivan invented CPAP, a special breathing machine that helps a person breathe. This is a real lifesaver for many people, especially for obese patients. The device is a compressor that, through a tube and a mask worn over the nose or nose and mouth, delivers a small stream of air into the airways, inflating the airways and preventing them from collapsing. The beauty of the method is that, whatever the initial severity of the disease, we eliminate all violations on the first night of treatment. A person goes to bed sick and wakes up relatively healthy. I say “conditionally” because this is a kind of replacement therapy. But while a person sleeps with the device, he, at least, gets a good night's sleep. His blood pressure normalizes, frequent night urination, headaches and other unpleasant symptoms of sleep apnea disappear. Many of my patients sleep with such a device for years and even decades.

Some facts about snoring

• It turns out that the Koreans are considered the most “snoring” nation in the world. This is due to a natural predisposition: people of this nationality have a rather long and soft palate, which contributes to the occurrence of snoring.
• The level of snoring corresponds to the sound range from 50 to 100 decibels. A jackhammer sounds with the same force.
• Every year, about 3,000 people in the United States die in their sleep from causes directly related to obstructive respiratory arrest.

Diagnosis of snoring

An ENT doctor diagnoses and treats snoring. The snorer himself does not hear in his sleep that he is snoring. Therefore, diagnosis begins not only with interviewing the patient, but also his relatives, who can tell about the characteristics of the patient’s snoring, its intensity, sleep patterns, sleep apnea, etc.

Next, a physical examination is carried out: the doctor calculates the patient’s body mass index and assesses the condition of the nasopharynx.

To identify or exclude causes of snoring related to the anatomical features of the structure of the nasopharynx (for example, a deviated nasal septum), an endoscopic examination of the ENT organs is performed.

The patient may be prescribed rhinomanometry, a study that allows one to evaluate nasal breathing function.

If a person has signs that provoke the development of sleep apnea (diabetes mellitus, high blood pressure, headaches after waking up, depression), cardiorespiratory monitoring is performed. It allows you to record pauses in breathing during sleep, pulse, identify hypoxia, disturbances in heart function, etc.

If difficulties arise with diagnosing the disease, and the doctor has doubts regarding the diagnosis, the patient is sent for a polysomnographic study - a method for studying sleep and human behavior during sleep in a hospital setting.

Tablets, drops and sprays

There are special tablets, sprays and drops that help improve the patency of the nasal passages. These drugs relieve swelling of the nasopharyngeal mucosa, and also increase the tone of its vessels and muscles, so that air passages are not blocked during sleep. Such medications should only be used under medical supervision. It is dangerous to use them without permission, since in some cases they can cause significant deterioration in the condition.

Not all diseases can be treated with medications that affect vascular and muscle tone. Because of this, each drug has a number of contraindications, the presence or absence of which can only be determined by a doctor.

Folk remedies for snoring

The fight against snoring can begin with simple measures that should be taken at home:

• buy a comfortable orthopedic pillow so that your neck is always in the correct position while sleeping;
• remove allergens from the area around the sleeping person (for example, carpets and feather pillows);
• try to sleep on your side (some patients sew a tennis ball into the back of their pajamas to avoid sleeping on their back);
• use a special mouthguard, which is placed on the teeth at night and prevents the jaws from moving, thereby ensuring the normal passage of air through the respiratory tract;
• fight overeating and excess body weight;
• minimize alcohol and nicotine consumption;
• do special exercises to strengthen the muscles of the oropharynx (for example, before going to bed, sing the sounds “and”, “s” thirty times in three approaches);
• within a month, instill one drop of peach or apricot oil into the nasal passages (it has a good anti-edematous and anti-inflammatory effect);
• chop the cabbage, mix with honey, squeeze out this mixture and drink the resulting juice before bed for two to three months. Cabbage and honey help cope with acute respiratory diseases;
• gargle with a decoction of oak bark and calendula before going to bed (this decoction will increase the tone of the nasopharyngeal muscles);
• Boil eucalyptus leaves in a pan of water and breathe over the steam for ten to fifteen minutes (this procedure will prevent swelling of the tissues of the oropharynx).

It must be remembered that treatment with home remedies is a slow process and requires a lot of time and patience. Home remedies help only when the cause of snoring is not some pathology in the body.

Is it possible to get rid of the disease once and for all?

Yes! But you need to be prepared for the fact that treatment may take a long time. Some techniques (CPAP therapy, for example) are used throughout life.

It is also important to be prepared to follow all of your doctor’s recommendations without exception. Some patients have to seriously limit themselves, undergo a number of procedures and regularly visit a specialist. Only in this case will therapy be effective.

Important! Only a doctor can tell whether it is possible to completely eliminate the pathology in a particular case. Therefore, you need to start therapy with a consultation with a specialist.