Sleep Disorders Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Sleep disorder breathing is a breathing disorder that occurs during sleep. Actually, this disease has been known in general and is associated with various medical problems.
There are several things associated with this respiratory disorder. Like Obstructive Sleep Apnea (OSA). What is OSA? This is a disease that occurs due to total or partial obstruction of the airways.
Some conditions that are risk factors for OSA include enlarged adenoids and tonsils (tonsils), obesity, and abnormalities in the nasal area. Obstructive sleep apnea can cause a variety of very detrimental disorders – such as brain development disorders in children, cardiovascular disorders, and death from traffic accidents due to drowsiness.
If obstructive sleep apnea is not treated, complications can occur in sufferers. Complications due to OSA can be divided into three categories, namely:
1. Sleep disorders
Sleep disorders can cause poor performance at work, decreased short-term memory, work accidents and when driving a motorized vehicle. Even OSA sufferers have a risk of 15 times more often getting a motor vehicle accident than the general population.
In addition, sleep disturbances can also make sufferers lose energy throughout the day, morning headaches, weight gain, mood disorders and depression, impotence, and decreased sexual appetite.
2. Cardiovascular
Cardiovascular disorders that can occur include hypertension (in 50% of OSA patients). If left untreated, the incidence of hypertension will increase the risk of heart attack or stroke, cardiac arrhythmias, and stress on the cardiovascular system. Basically, OSA causes the heart and lungs to work harder than they should.
Hypertension occurring in patients who are either undiagnosed or not receiving treatment for obstructive sleep apnea can be difficult to treat. Effective OSA treatment will help control blood pressure in some sufferers.
3. Impaired brain growth in children
Children’s brains develop optimally when they sleep. The presence of airway obstruction makes the oxygen that enters the blood to be reduced. Eventually, the brain becomes starved of oxygen and its growth becomes disrupted.
Waking up at night will make it difficult for children to fall back asleep. In the end, this situation reduces their sleep time. This of course will also reduce the golden period of their brain development.
Symptoms
Symptoms of Obstructive Sleep Apnea are divided into two, namely:
- Nocturnal symptoms while sleeping.
Drooling during sleep (Drooling/drooling), dry mouth, sleepless nights/awakening during sleep, visible stopping of breathing during sleep by sleeping partners, choking or shortness of breath during sleep. - Symptoms during the morning or afternoon
Drowsiness, dizziness when you wake up in the morning, gastroesophageal reflux (stomach acid rising into the esophagus), unable to concentrate, depression, decreased libido, impotence, waking up feeling not fresh, hard to think.
Reason
There are many things that can cause obstructive sleep apnea. But usually, it is a complex condition that influences each other – whether it is neural, hormonal, muscular or anatomical structure.
One of the most commonly associated causes is obesity – especially in the upper body. OSA prevalence rates in very obese people reach 42-48% in men and 8-38% in women. Weight gain is said to increase OSA symptoms. There are three risk factors for OSA:
1. Age:
The likelihood of OSA occurring and the degree of severity will increase with age.
2. Gender
Men are at risk 2 times higher than women for OSA.
3. Size and shape of the airway
Things to note in this case are the structure of the skull (cleft palate, disturbance of the position of the lower jaw), micrognathia (small jaws), macroglossia (large tongue), enlargement of the adenoid glands and tonsils, and small trachea (narrow airways).
Obstructive sleep apnea can also pose a risk for other diseases that are associated with failure to control breathing. Some of them are: emphysema and asthma, neuromuscular disease (polio, myasthenia gravis), nasal obstruction, hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, postpolio syndrome, and neuromuscular disorders.
Diagnosis
To determine the diagnosis of OSA, the doctor will collect information first. Furthermore, a physical examination and supporting examinations will be carried out if necessary.
The OSA test is carried out through a nightly sleep check with a polysomnography (PSG) tool. The parameters recorded on the polysomnogram include electroencephalography (EEG), electrooculography (eyeball movement), electrocardiography (EKG), electromyography (lower jaw and leg movement), sleeping position, respiratory activity, and oxygen saturation.
When performing PSG, the doctor will see if there is a recurrent decrease in oxygen saturation and partial or complete obstruction of the upper airway. In some severe cases it could have happened several hundred times.
The doctor will also observe if the decrease in oxygen saturation is accompanied by ≥ 50% decrease in respiratory amplitude and increase in respiratory effort. Changes in sleep stages that become shallower and oxygen desaturation occur are also things that need to be considered through this examination.
Prior to the PSG, you will be asked if you are willing to fill out the Berlin questionnaire. The aim is to determine whether there is a high risk of OSA. This questionnaire consists of 3 parts, namely:
- Contains about snoring habits. How loud (voice volume), how often, and the likelihood of snoring disturbing others
- Contains about fatigue after sleep. How often do you feel tired and have/haven’t fallen asleep while driving?
- Contains a history of hypertension, weight, height, age, gender and Body Mass Index (BMI).
You can be declared at high risk for OSA if you meet at least two of the three criteria above. Another thing that also determines someone can be said to suffer from OSA is if:
- Severe drowsiness throughout the day that cannot be explained by another reason.
- Two or more conditions such as choking during sleep, waking up several times during sleep, sleep that does not cause a feeling of freshness, feeling tired throughout the day and impaired concentration.
- PSG results showed ≥ 5 total number of apneas plus hypopneas occurring per hour during sleep (AHI ≥ 5).
- Negative PSG results for other sleep disorders.
Treatment
Obstructive sleep apnea treatment can be divided into 3 parts, namely:
- Surgical interventions
Nasal surgery, plastic surgery for the palate (palate), uvula and pharynx, or removal of the tonsils. - Lifestyle changes
Lose weight, avoid alcohol, avoid drugs that work to help sleep, and avoid consuming caffeine. - Artificial devices Tools
needed to reposition the jaw and prevent the tongue from falling back (to maintain the position of the tongue), cervical collars or pillows.
If OSA doesn’t really interfere with your daily activities and body rhythms, you don’t need special therapy. You just need to make lifestyle changes. For example, by exercising regularly and adjusting the type and pattern of eating.
However, if OSA complaints have reached the stage of interfering with daily activities, then you should immediately consult a doctor. Especially if it has caused a decrease in productivity.
Actually, OSA can be avoided. Things that need to be done so that you don’t experience this sleep disorder are exercising regularly, eating a high-fiber diet, and managing a balanced nutritional diet.
For people with asthma, it is necessary to control the disease. Apart from that, you should also avoid types of food that can stimulate tonsil enlargement, for example cold water and foods that use a lot of MSG. Also, remember not to drive a motorized vehicle if you are sleep deprived.