Sleep, which has a great role in a strong immune system, acts as an important shield that protects our body from infections. While irregular sleep causes serious damage to the immune system, even a single night’s sleeplessness invites diseases. In particular, obstructive sleep apnea, which causes breathing to stop for a minimum of 10 seconds during sleep, poses a great risk during the coronavirus pandemic period we are in.
It is useful to remind once again that the disease of COVID-19 is much more difficult in people with a weak immune system. Because of their effects on the immune system, sleep quality and healthy breathing are therefore of great importance. In addition, studies have proven that people with sleep apnea have a much higher risk of getting COVID-19 than healthy people. The rate of hospitalization and respiratory distress of patients with sleep apnea due to COVID-19 increases at least 2 times compared to normal patients.
Snoring and sleep apnea
The mildest of the breathing disorders seen during sleep is snoring and the most severe form is obstructive sleep apnea. The snoring problem is most commonly seen in middle-aged and obese men in adults, and its frequency increases with age. In women, it can be seen more frequently with the menopause period. In children, especially the nasal flesh, the large tonsils, and obesity are important factors that cause this problem.
How does snoring occur?
We call snoring for the sound caused by the vibrations of the tissues in these regions as a result of the obstructions in the inner part of the nose during sleep, small tongue and palate sagging that causes the narrowing of the airway behind the tongue, and the growth of the tonsils or the narrowing of the structures at the pharynx level.
The tension of the small tongue, soft palate, tongue, and throat muscles decreases in cases such as excessive weight, sedative medication or sleeping pills, excessive alcohol use. Fat accumulation is seen around the pharynx in overweight people. When the relaxed muscles lie on their back, they cannot prevent the tongue and small tongue from sliding towards the back of the throat, in this case, the person starts snoring in a way that disturbs the environment even if he is not very aware.
Pathologies that cause nasal obstruction appears as one of the most important causes of snoring. In these people, negative pressure is created in the nasal passage with the respiration effort to take the air while asleep, and the tissues in the throat are pulled towards the airway. As a result, people who do not snore with their nose open begin to snore. This explains why some people snore only during allergic periods or when they have flu or sinusitis. Deviation in the middle part of the nose, nasal polyps, enlarged concha (nasal concha), tumors in the nose, and nasal cavity are the reasons for snoring that cause this type of nasal congestion.
What is obstructive sleep apnea?
Sleep apnea (breathing pause during sleep) is the name we give to the picture that occurs when breathing stops for 10 seconds or more during sleep. Factors that cause snoring can lead to this picture in more advanced stages. Obstructive sleep apnea is seen in at least 5 out of every 100 people. This rate is even higher in overweight middle-aged men. It has been reported that the incidence of obstructive sleep apnea in children is 10-12%.
How does sleep apnea affect our health?
Getting a good night’s sleep is essential for a healthy life. As a result of the disruption of night sleep patterns with obstructive sleep apnea, there will be nights spent without rest. People with an obstructive type of snoring can go into a deep sleep in a very small part of their sleep. The deep phase is the only way to get real rest. After a restless and restless night, a sleepy, tired, and unproductive day will begin. While slight sleepiness was observed while watching television or after a meal before, later more serious problems will arise as the severity of apnea increases. Drowsiness may be seen while driving or at work. Studies have shown that the driving of people with sleep apnea is responsible for some of the fatal traffic accidents.
During night sleep, apneas can reach 100-200 times an hour. During an apnea, the blood oxygen level drops and the heart has to pump the blood faster as a result. While the heart rhythm is disturbed, high blood pressure, heart enlargement, and even sudden deaths during sleep can be seen over the years.
Sleep apnea can cause negativity in children
Sleep apnea in children is mostly seen in the pre-school period. If it is not noticed, very serious problems such as defects in the tooth-palate structure, growth retardation, stagnation of the child’s height and weight compared to his peers, school failure and mental development problems may occur. In addition to these, behavioral disorders, hyperactivity, peeing at night, heart and rhythm disorders can be seen.
How are snoring and sleep apnea diagnosed?
Snoring or apneas can be detected by the person’s family or relative during sleep. In this case, first of all, it is necessary to consult a specialist doctor to determine whether there is a problem in the ear-nose-throat system and the reason must be revealed. If deemed necessary by the doctor, a detailed sleep examination may be required at the sleep center. In the sleep test, which we call polysomnography, more detailed information about the level of the disease is obtained by looking at many parameters including blood-oxygen level, heart rate, respiration during sleep.
Methods used in the treatment of snoring and sleep apnea
There are some situations that adults who snore and have shortness of breath should be especially careful. These:
– The excess weight should be lost and a sportive lifestyle should be chosen to gain a good muscle tone.
Alcohol intake should be restricted.
– Attention should be paid to the use of sleeping pills, sedatives, and antihistamines, as they may increase apnea.
– Heavy meals should be avoided 3-4 hours before sleep.
– Excessive fatigue should be avoided.
– Sleeping on one side should be preferred instead of sleeping on the back.
If complaints continue despite these measures, the following methods can be used:
– Initiatives for the removal of obstructions: We know that surgeries for large tonsils and adenoids in children solve the problems to a great extent and provide significant improvements in the quality of life of the child. In adults, first of all, pathologies in the nose should be corrected, if any. Elimination of curvatures in the middle part of the nose, reduction of enlarged nasal concha, removal of formations such as polyps, cysts, tumors in the nose, and interventions to relieve obstruction are priority procedures.
– Interventions for the mouth and throat: The sagging of the palate and small tongue, growths in the tongue base and tonsils, and disorders in the mouth and jaw structure should be corrected with appropriate surgical techniques. The most basic principle in these surgeries is to provide maximum benefit in a comfortable way by giving minimal damage to tissues.
– Positive pressure oxygen therapy: Positive pressure oxygen therapy (CPAP), which is given with the help of a mask through the mouth and nose when overweight, has no serious problems in the nose and throat area, and surgery is too risky or not desired by the patient, is actually a device that provides significant benefits in obstructive sleep apnea. . The disease is tried to be treated by overcoming the obstruction with the air sent at pressures that vary according to the patient’s condition. However, as there is a situation such as sleeping with a mask on their faces, some of the patients may have a problem of adaptation to this situation. Some appliances applied in the mouth or nose can be useful in some patients with mild apnea or simple snoring.