Lack of deep sleep

Introduction Deep sleep deficiency is common in obstructive sleep apnea syndrome. During deep sleep, human cerebral cortical cells are in a state of full rest, which is extremely important for stabilizing mood, balancing mentality, and restoring energy. At the same time, many antibodies can be produced in the human body to enhance disease resistance. Studies have shown that the first three hours of sleep are important because deep sleep accounts for almost 90% of the time. This pathological condition not only has sleep snoring and extreme daytime sleepiness (EDS), but also recurrent hypoxic hypercapnia caused by hypopnea or apnea, which can lead to complications of heart and lung and other vital vital organs, and even sudden death.

Cause

Obstructive sleep apnea syndrome (OSAHS) is a pathological condition with a very complicated etiology that has not yet been fully elucidated. It is a disorder of sleep-disordered breathing. This pathological condition not only has sleep snoring and extreme daytime sleepiness (EDS), but also recurrent hypoxic hypercapnia caused by hypopnea or apnea, which can lead to complications of heart and lung and other vital vital organs, and even sudden death. Therefore OSAHS is a potentially lethal sleep-disordered disorder.

Sleep apnea is defined as a pause in the nose and mouth during sleep for more than 10 s. According to the different reasons and performance of apnea:

1 obstructive sleep apnea, that is, apnea caused by upper airway obstruction during sleep, which is characterized by the stop of air flow in the mouth and nose and the breathing action of the chest and abdomen.

2 Central sleep apnea, that is, the mouth and nose airflow and chest and abdomen breathing action stop at the same time.

3 mixed sleep apnea, that is, the two coexist, starting with central apnea, followed by obstructive sleep apnea. The amount of tidal volume during sleep is reduced, that is, the respiratory airflow is reduced by more than 50% of the normal airflow intensity, and the blood oxygen saturation is decreased by more than 4%, which is called hypopnea or hypopnea.

an examination

Related inspection

Polysomnography (PSG) cranial CT examination electrocardiogram polysomnography

Before the diagnosis, it is necessary to confirm the presence of airway obstruction during sleep and the location and severity of the obstruction, and to evaluate the vital organs of the whole body. Detailed medical history. Including the time of the disease, especially snoring, extreme daytime sleepiness and other symptoms, duration, previous diagnosis and treatment, systemic systemic history.

Clinical examination: In addition to general routine systemic examination, the upper airway and upper digestive tract should be comprehensively examined. It is best to check the standing position and the lying position separately to understand the upper airway obstruction, and secondly whether the craniomaxillofacial development is abnormal. an examination. The following are the shape and position of the jaw, the occlusion, and the condition of the oropharynx and nasopharynx. Special attention should be paid to the exclusion of lumps in the nasopharynx, oropharynx, and base of the tongue.

Differential diagnosis

(1) Central sleep apnea syndrome (CSAS)

The CSAS definition is that the upper airway has no airflow for more than 10 seconds, and there is no chest and abdomen breathing exercise. CSAS is less common and can coexist with OSAS. It can occur in any sleep phase, but obvious abnormalities are only seen during NREM sleep. CSAS can exist alone or in conjunction with central nervous system diseases such as brain stem trauma, tumors, infarction, and infection. 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.

(B) sleep disordered breathing in patients with chronic obstructive pulmonary disease

Patients with chronic obstructive pulmonary disease may be accompanied by significant respiratory and gas exchange deterioration, mainly due to severe arterial oxygen saturation reduction and transient specific respiratory abnormalities such as apnea and hypopnea. The phase of REM sleep is most obvious, and the mechanism is still unclear, which may be related to the abnormal respiratory activity accompanying the sleep. In addition, these patients have a slow chemical ventilatory response when they are awake, and can be further aggravated during sleep to reduce the ventilatory response.

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