Apnea-like phenomenon

Introduction Apnea refers to breathing that lasts for more than 20 seconds or less than 20 seconds but is accompanied by bradycardia and abnormal breathing in the purple group. According to the cause of primary and secondary, primary apnea is divided into three types: central, obstructive and mixed. About 25% of premature babies develop varying degrees of apnea. The clinical manifestations of sleep apnea syndrome are diverse. One of the most common and typical symptoms at night is snoring. Generally speaking, the louder the snoring, the more obvious the narrowing of the airway, but the snoring of patients with sleep apnea syndrome is different from ordinary The snorer.

Cause

1. Upper airway stenosis or blockage: Stenosis or blockage of any anatomical part of the upper airway can cause obstructive sleep apnea. Anatomically, there are three places above the larynx that are prone to stenosis and obstruction, namely the nose and nasopharynx, oropharynx and soft palate, and the base of the tongue. Clinical findings, nasal septum deviation, nasal polyps, hypertrophic rhinitis, nasal tumors, adenoid hypertrophy, nasopharyngeal atresia or stenosis, nasopharyngeal neoplasms, tonsil hypertrophy, uvula sag, pharyngeal spasm, tongue hypertrophy , jaw deformity, throat cartilage softening, etc., can cause snoring.

2. Obesity: Obese people have thick tongue, soft palate, uvula and pharyngeal wall with excessive fat deposition, which easily lead to airway obstruction. The volume of the lungs of obese people is significantly reduced, resulting in obesity-induced hypoventilation syndrome.

3. Endocrine disorders: such as the enlargement of the tongue caused by hypertrophy of the extremities.

4. In the old age, the tissue is slack, and the muscle tension is reduced, causing the throat wall to relax and collapse, causing snoring. Frequent episodes of sleep apnea lead to decreased arterial oxygen partial pressure, increased carbon dioxide partial pressure, respiratory acidosis, shortness of breath, cyanosis, irritability and other symptoms. Long-term hypoxia can lead to heart failure, increased blood pressure, rapid heartbeat, and even heart rhythm disorders, the heart stops. Arrhythmia is the leading cause of sudden death in sleep. Hypoxia can also lead to memory loss, mental decline, personality changes, behavioral abnormalities, and so on.

an examination

Related inspection

EEG examination

The clinical manifestations of sleep apnea syndrome are diverse. One of the most common and typical symptoms at night is snoring. Generally speaking, the louder the snoring, the more obvious the narrowing of the airway, but the snoring of patients with sleep apnea syndrome is different from ordinary The snorer. The snoring of such patients is loud and irregular, intermittent and intermittent, and the sounds are high and low; those with serious illnesses, whether in the lateral or supine position, will even make a fuss when they are in a meeting or in a car. In addition, patients with frequent apnea at night, accompanied by abnormal sleep, insomnia, dreams, nightmares, polyuria, enuresis and so on. In the daytime, the common manifestation of sleep apnea syndrome is lethargy, that is, dozing off indefinitely during the day, regardless of location, and even involuntarily entering a dream when sitting, reading, or attending classes. When someone talks, they will unconsciously fall asleep. Because of the poor quality of sleep in these patients, about two-thirds of patients have different levels of sleep, and some people often sleep for more than a dozen hours, or even sleep all day. The patient will also be consciously fatigued, with memory loss, decreased academic performance, and irritability.

Differential diagnosis

Central sleep apnea syndrome (CSAS) refers to the absence of airflow in the upper airway for more than 10 s without chest and abdomen breathing. CSAS is less common and can coexist with obstructive sleep apnea syndrome (OSAS). It can occur in any sleep phase, but obvious abnormalities are only seen in slow phase sleep (NREM, also known as normal phase sleep and slow wave sleep). CSAS can exist alone or in conjunction with central nervous system diseases such as brain stem trauma, tumors, infarctions, and infections. There have also been reports of CSAS associated with neuromuscular disorders such as polio and myotonic dystrophy. Appropriate ventilation can be maintained when awake, but during sleep, there is an abnormal regulation of the respiratory center, and a central (or obstructive) apnea occurs. There is no airflow through the mouth and nose for 10s, and there is no respiratory movement.

Sleep apnea : refers to the temporary stop of breathing during sleep. The most common cause is obstruction of the upper airway, often ending with loud snoring, body twitching or arm twitching. Sleep apnea is associated with sleep defects, daytime snoring, fatigue, and bradycardia or arrhythmia and EEG wakefulness.

Sigh-like breathing: manifested as a deep breathing in the normal normal breathing rhythm and often accompanied by a sigh of breathing, patients who read more chest tightness, difficulty breathing, but no objective indicators of breathing difficulties, common in children.

Tidal breathing: both respiratory rhythm changes and respiratory amplitude changes. From shallow to slow, then from deep to shallow, followed by an apnea, so repeated. Each tidal breathing cycle can be as long as 30s to 2 minutes, and the apnea can last for 5 to 30 seconds.

The clinical manifestations of sleep apnea syndrome are diverse. One of the most common and typical symptoms at night is snoring. Generally speaking, the louder the snoring, the more obvious the narrowing of the airway, but the snoring of patients with sleep apnea syndrome is different from ordinary The snorer. The snoring of such patients is loud and irregular, intermittent and intermittent, and the sounds are high and low; those with serious illnesses, whether in the lateral or supine position, will even make a fuss when they are in a meeting or in a car. In addition, patients with frequent apnea at night, accompanied by abnormal sleep, insomnia, dreams, nightmares, polyuria, enuresis and so on. In the daytime, the common manifestation of sleep apnea syndrome is lethargy, that is, dozing off indefinitely during the day, regardless of location, and even involuntarily entering a dream when sitting, reading, or attending classes. When someone talks, they will unconsciously fall asleep. Because of the poor quality of sleep in these patients, about two-thirds of patients have different levels of sleep, and some people often sleep for more than a dozen hours, or even sleep all day. The patient will also be consciously fatigued, with memory loss, decreased academic performance, and irritability.

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