When is snoring that makes us suffocated dangerous?

More and more people are suffering sleep apnea. In fact, the estimated prevalence of this pathology increased by 45% over the past ten years years.

This is warned by the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) and the Spanish Society of Dental Sleep Medicine (SEMDeS), which also attribute this increase to an increase in certain risk factors such as obesity, sedentary lifestyle and smoking.

According to a study published in The Lancet, about 1 billion people aged 30 to 69 suffer from sleep apnea severe form of the disease throughout the world, so the number of patients is very large, with different causes and associated problems.

This requires, according to experts, an interdisciplinary approach, including:

• Otorhinolaryngologists
• Head and neck surgeons
• Maxillofacial surgeons
• Dentists
• Pulmonologists, etc.

More than annoying snoring

At first glance it may seem that sleep apnea-hypopnea syndrome (SAHS) This is simply an excess of snoring and its intensity during rest hours. But that’s not true. As SEORL explained:

• “Apnea involves a complete cessation of respiratory flow for at least 10 seconds.”

In other words, you stop breathing for at least 10 seconds.

• This syndrome It occurs 2–3 times more often in men than in women..

• The main risk factor is obesity.

And as this phenomenon has increased significantly around the world, the prevalence of related diseases such as apnea has also increased.

• “We are faced with a very worrying case at the public health level, especially among children, where we see both pathologies on the rise.”

Therefore, as indicated Dr. Marina CarrascoPresident of the SEORL-CCC Commission on Snoring and Sleep Disorders:

• “As obese people are more likely to experience sleep-disordered breathing, this factor should be taken into account when consulting an otolaryngologist and dentist, who should refer suspected cases to a specialist.”

A recent study published in the journal Cranio confirms that:

• Body mass index (BMI) is significantly associated with the incidence of apneas and hypopneas, and people with a higher BMI have a lower hyoid bone.
• “It does breathing can be changed and it’s more difficult during sleep,” he adds.

As a result of the repetition of these episodes of airway obstruction during sleep, a number of secondary problems arise that can be serious.

We’re talking about:

• Excessive sleepiness during the day
• Cognitive behavioral disorders
• Respiratory system
• Cordial
• Metabolic
• Inflammatory.

Symptoms of sleep apnea

Otorhinolaryngology experts explain that there are various symptoms and signs that can lead us to suspect sleep apnea. Among them, SEORL highlights:

• Increased daytime sleepiness. This leads to the fact that “the patient has a tendency to fall asleep involuntarily in inappropriate situations. If it is not detected and corrected in time, it can become an important cause of disability and traffic accidents.
• Headaches. They appear in the morning and disappear during the day.
• Feeling like you can’t sleep.
• Depression or irritability. You may also experience an inability to pay attention or memory problems.
• Decreased libido.
• Snore. There will always be snoring, which may become more intense as the night goes on and is interrupted by apneas.
• Breathing pauses. Experts explain what they are in order to identify them. “These are apneas or hypopneas that usually end with choking sounds, loud snoring or even full body movements. The patient usually does not realize that he is suffering from them.
• Night excitement.
• Frequent awakenings.
• Large amounts of urination at night..
• Insomniaespecially problems falling asleep.
• heartburn.

Diagnosis and treatment of sleep apnea

The role of the otolaryngologist in the diagnosis and treatment of sleep apnea is very important. First of all, as Dr. Carrasco emphasizes:

• “Care should be taken to conduct an examination of the upper respiratory tract, which is critical to better understand the pathophysiology of the disease and identify possible predisposing abnormalities. This will also allow a topographic diagnosis to be made. obstacles.”

The most common treatment, especially in severe cases, is CPAP.

This is a compressor that medical mask fits tightly to the nosesupplies air at a certain pressure.

• Thanks to him CPAP “Airway pressure is maintained constant during the breathing cycle and, as a result, sudden awakenings are reduced, which improves the quality of sleep and daytime cognitive performance of patients.”

Oral devices such as Mandibular Advancement Device (MAD). Used in snore which are socially annoying, mild to moderate cases of obstructive sleep apnea, and when standard CPAP treatment is not tolerated.

Role of dentists

“This treatment can be performed by sleep-trained dentists. In addition, if, after starting treatment, a patient has difficulty breathing through the nose and does not tolerate an oral device, we will refer that patient to an otolaryngologist to treat this case. and improve this condition. “Respiratory function,” says Dr. Migues.

• And collaboration between dentists and otolaryngologists “is key to specialist diagnosis as they refer suspicious cases to us,” Dr. Carrasco says.

In fact, dentists “identify during consultation those problems that prevent the patient from exercising proper respiratory function, such as changes in the adenoids, tonsils, septum, turbinates, etc., and we refer them to an otolaryngologist,” explains the doctor. Manuel MiguezPresident of the Spanish Society of Dental Sleep Medicine (SEMDeS).

Surgery, the last option for reducing apnea

If neither CPAP nor oral devices have the desired effect in stopping apnea, surgery may be necessary.

And in some cases, there are certain physiological conditions in our airways that affect how we breathe.

Thus, surgical treatment Sleep apnea includes:

• nose surgery
• Surgery of adenoids (plants) and tonsils.
• palate surgery
• Operation based on tongue
• Epiglottoplasty.
• Tracheostomy, etc.

All of them relate to anatomical structures that are widely known and studied by otorhinolaryngologists.

Moreover, there are some skeletal-dental-facial changes which predispose to sleep apnea, so orthopedic-orthodontic treatment of the jaws in children who are growing and developing, or in adults with combined orthodontic treatment with orthognathic surgery, can help this pathology,” concludes Dr. Migues.