Sleep apnea

Introduction 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. Sleep apnea, obstructive sleep apnea hypopnea syndrome (OSAHS), is an unexplained sleep-disordered disease with clinical manifestations of nighttime sleep snoring with apnea and daytime sleepiness. Repeated episodes of nocturnal hypoxia and hypercapnia caused by apnea can lead to complications such as hypertension, coronary heart disease, diabetes and cerebrovascular disease, and traffic accidents, and even sudden death at night. Therefore OSAHS is a potentially lethal sleep breathing disorder.

Cause

The general reasons are divided into central and obstructive. The above airway obstruction leads to apnea. The nighttime sleep stops for more than two seconds. It is considered that the apnea is at this time. The oxygen in the blood is reduced in the hypoxic state. Apnea occurs frequently. If there are more than one or more hours of sleep per hour, the effective collection therapy will result in serious consequences. A series of pathophysiological changes may cause a central pause after long-term airway obstruction. For compatibility.

an examination

Related inspection

Respiratory muscle function test

The indication for polysomnography is that the patient's respiratory disorder index (RDI) is at least 20 times per hour, regardless of symptoms; or the AHI/RDI ratio is 10 times per hour with extreme daytime sleepiness. Once obstructive sleep apnea (OSA) is diagnosed, the patient will return to the study the night after. In the meantime, doctors will use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) to adjust the polysomnogram to a certain level in order to eliminate or significantly reduce the number of respiratory abnormalities. The indication for polysomnography is that the patient's respiratory disorder index (RDI) is at least 20 times per hour, regardless of symptoms; or the AHI/RDI ratio is 10 times per hour with extreme daytime sleepiness. Once obstructive sleep apnea (OSA) is diagnosed, the patient will return to the study the night after. In the meantime, doctors will use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) to adjust the polysomnogram to a certain level in order to eliminate or significantly reduce the number of respiratory abnormalities.

It should be known whether the upper airway obstruction and cranio-maxillofacial development are abnormal, such as the shape and position of the jaw, the occlusion, and the condition of the oropharynx and nasopharynx.

1.X-ray cephalometric measurement

Indirect understanding of airway obstruction, but it is not necessary to perform X-ray cephalometric measurements on all OSAHS patients.

2. Polysomnography

The polysomnography monitor (PSG) is the most important method for diagnosing OSAHS. It can not only determine the severity of the disease, but also comprehensively assess the patient's sleep structure, sleep apnea, hypoxia, and changes in ECG and blood pressure. . In some cases, it can be differentiated from central sleep apnea syndrome by means of esophageal pressure testing. It is not enough to rely solely on the symptoms described by the patient. Each patient should have at least one PSG test before, before, after, and after treatment. PSG examinations should be monitored for at least 7 hours in the sleep breathing laboratory. The items examined by PSG include EEG, electro-oculogram, diaphragm electromyography, anterior tibialis electromyography, electrocardiogram, chest and abdomen respiratory movement, nose and mouth airflow, and oxygen saturation.

3. Nasopharyngeal fiberoscopy

X-ray cephalometric measurements can diagnose airway conditions under static conditions, while nasopharyngeal fiberscopes focus on dynamic diagnosis.

Differential diagnosis

Clinical should be differentiated from tonsil and hypertrophic hypertrophy, upper airway obstruction.

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