As the saying goes, "a good night's sleep is better than taking a tonic". After daytime activity, our body can rest and relieve fatigue through night's sleep. Therefore, sleep is very important for maintaining good health. However, most people believe that sleep snoring is a sign of sleeping well and soundly. Is that so? Let's unravel the mystery layer by layer.

One. How does our body change during sleep?

Since researchers first successfully detected human brain currents in 90 years, subsequent EEG studies have given us a more objective and in-depth understanding of sleep. According to the characteristics of brain waves in the sleep state, according to the 0 hours of sleep time, for example, the whole night will generally go through 0~0 sleep cycles, each sleep cycle is about 0 minutes, and each cycle will go through 4 stages of falling asleep, light sleep, deep sleep to REM sleep.

During different stages of sleep, the body undergoes different changes. As the level of sleep deepens, the body becomes more and more relaxed, the muscles become relaxed, the breathing heart rate slows down, the brain waves slow down, and gradually enter the deep sleep stage, also known as the "slow wave sleep" stage. "Slow-wave sleep" is very important for the human body, sufficient "slow-wave sleep" can promote the secretion of growth hormone, relieve fatigue, ensure the recovery of physical strength, remove garbage in the brain, enhance memory, and improve learning ability.

Two. What about snoring?

Under normal circumstances, when we breathe, gas enters the lungs through the mouth, nose and pharynx cavity for gas exchange, ensuring the body's blood oxygen supply and expelling carbon dioxide produced by the body's metabolism. When we are in a state of sleep, as the degree of sleep gradually deepens, the musculature around the throat becomes relaxed, and the tissues around the airway of the pharyngeal cavity fall, under normal circumstances, this muscle relaxation and falling does not affect the patency of the airway, and the activity of the chest and abdomen is also normal.

However, when there is a narrowing in any part of the area that affects the passage of gas, such as obesity leading to an increase in fatty tissue in the throat wall or hypertrophy of the turbinates, the collapse of the airway is more pronounced after falling asleep at night as the muscles relax. When the air flow passes through a narrow area, a vortex is generated, which causes vibrations and snoring.

If the soft tissues and muscles of the upper airway collapse further, it will lead to airway obstruction, then the respiratory airflow will disappear or be restricted, resulting in a decrease in the concentration of oxygen in the blood and an increase in the concentration of carbon dioxide, reaching a certain concentration of CO2 will stimulate and awaken the brain, resulting in a micro-awakening of the cortex, driving the respiratory center, thereby promoting the contraction of respiratory-related muscle groups such as the chest and abdomen, promoting the reopening of the upper airway, the opening of respiratory airflow, the gradual discharge of CO0, the restoration of oxygen supply to the body, and the patient to fall asleep again. This process occurs repeatedly throughout the night, with clinical manifestations of snoring during sleep or frequent sleep apnea.

Three. Are snoring and sleep apnea harmful to the body?

The answer is yes. Frequent nocturnal sleep apnea can cause interstitial hypoxia between the brain and the body, resulting in frequent micro-awakenings in the brain, shortening the sleep cycle or disordering the sleep structure, making it difficult for the body to enter "slow-wave sleep", or reducing "slow-wave sleep", resulting in poor sleep quality, and the brain and body can not get enough rest and can not effectively remove fatigue. In this way, it will lead to dry mouth in the morning, sleepiness, drowsiness during the day, and poor spirits. Long-term poor sleep quality and lack of sleep will further lead to memory loss, slow response, and even chronic diseases such as hypertension and coronary heart disease.

For children, due to their growth and development needs, they need more slow-wave sleep than adults. If children are accompanied by snoring and sleep apnea, they will cause slow-wave sleep to decrease or shorten the duration due to long-term intermittent hypoxia and micro-awakening of the brain, resulting in poor sleep quality and decreased nocturnal growth hormone secretion. As we age, we experience slow growth, decreased concentration, and decreased memory and learning. If it is accompanied by airway obstruction, it will lead to prolonged mouth breathing, which can lead to shortening of the jaw and changes in facial appearance.

Four. How can we assess our sleep?

During sleep, brain waves change in the brain, accompanied by corresponding changes in the body. Polysomnography (PSG) is equipped with brain electrodes, which can be used to monitor the changes of brain waves during sleep, equipped with relevant electrodes to monitor muscle activity, eye movements, and electrocardiogram activity, as well as accessories to evaluate respiratory airflow, blood oxygen levels, and chest and abdominal movements. Some clinical hospitals are equipped with synchronous video monitoring, which can more intuitively observe the behavior state during sleep, such as sleepwalking, yelling, falling, etc. Polysomnography is also currently considered the gold standard for diagnosing sleep apnea.

Five. When do I need to check for sleep apnea?

If a family member reports that he or she has sleep snoring or apnea, and if it is accompanied by daytime and nighttime related symptoms, then further hospital consultation is required. At present, due to the complexity of the etiology of the disease, treatment may involve the cooperation of multiple disciplines, such as otolaryngology, neurology, sleep specialists, respiratory, stomatology, surgery, etc. You can consult the corresponding department according to your own situation and the situation of the local hospital.

6. If sleep apnea is diagnosed, how is it treated?

1. Generally, symptoms can be reduced by sleeping on the side, exercising appropriately, and controlling weight.

2. If you are just overworked at work, for example, you often work overtime, you are drunk and drunk, and you have symptoms of snoring while sleeping, but it will be relieved after resting, then this situation can be observed first. Some women also snore during sleep after pregnancy due to changes in hormone levels, as well as weight changes. Postpartum snoring will gradually disappear, and if postpartum snoring persists, further medical attention can be seen.

3. If it is determined that there is sleep apnea, the next step of treatment can be determined based on the type of sleep apnea, the number of apneas per hour during the night (AHI), and the degree of oxygen reduction in the blood.

(1) For some patients with position-related obstructive sleep apnea syndrome, lateral decubitus rest can improve the airflow obstruction and hypoxia caused by airway collapse during nighttime sleep.

(2) For children with adenoid hypertrophy or narrowing of the respiratory passage caused by tonsillar hypertrophy, snoring during sleep, or even awakening at night, surgical treatment is usually required, including adenoid ablation, orthodontics/orthodontics.

(3) Some patients can visit the otolaryngology department to check the upper airway, such as nasal polyps, nasal septum deviation, chronic rhinitis, turbinate hypertrophy, etc., and can be treated with targeted medication or surgery, such as nasal septum or nasal surgery (nasal expansion, nasal septum three-line reduction and tension plasty), velopharyngeal surgery (uvulopalatopharyngioplasty), and mandibular anterior migration.

(4) For obvious snoring, moderate to severe sleep apnea and hypoxia, or obvious daytime drowsiness and fatigue. Non-invasive positive airway pressure (CPAP) is the first choice. Hypoxia can be mitigated by continuously applying pressure to the airway to support the upper airway and avoid collapse and blockage.

(5) For patients with simple snoring or mild to moderate obstructive sleep apnea, accompanied by jaw retraction, unable to tolerate non-invasive positive pressure ventilation therapy, unable to operate or with poor surgical effect, oral appliances can be used as a supplement or alternative treatment measure to CPAP treatment.