Many people think that snoring is a sign of sound sleep.

But "snoring" may be a manifestation of apnea syndrome, which will not only affect sleep quality, but also risk sudden death.

Today, I invite Han Fang, chief physician of the Department of Respiratory Medicine of Peking University People's Hospital and director of Peking University Sleep Research Center, to talk about the topic of sleep apnea syndrome.

  Snoring suddenly silent, need to be vigilant

  Nearly 1/4 of adults in my country have sleep apnea, of which 4%-5% of the patients are seriously ill and require treatment. Snoring is a disease.

  There are many people who snore, and some of them are patients with sleep apnea syndrome, but they don't know it.

How to tell who is a patient with sleep apnea syndrome?

  According to Han Fang, there are three main characteristics of abnormal snoring.

One is that the snoring is so loud that it can be heard in the next room; the other is that the snoring is uneven, the general supine snoring and drinking snoring are relatively light and even, while patients with sleep apnea syndrome will snoring suddenly. No sound." After about tens of seconds, the snoring with a "hook" appeared again; third, according to the family's description, there was "a profuse sweating, stretched arms and kicked legs, but turned over and snored like thunder immediately".

  In addition, if you always have dry mouth during sleep and prepare water at the bedside before going to bed, it is caused by snoring and mouth breathing, and you should also beware of the possibility of sleep apnea syndrome.

  The medical diagnostic criteria for sleep apnea syndrome are more than 30 times of apnea and hypopnea during 7 hours of sleep, or more than 5 times of apnea and hypopnea during each hour of sleep.

Among them, the duration of apnea is defined as 10 seconds or more.

  It's important to note that sleep disorders and sleep apnea syndrome are not the same thing.

Sleep disorders are the big concept of sleep disorders.

According to the International Classification of Diseases, sleep disorders have special diagnostic criteria. Up to now, there are more than 90 types of sleep disorders, including sleep apnea syndrome.

This is a sleep disorder characterized by repeated pauses in breathing during sleep that is often overlooked in the early stages.

People with sleep apnea don't necessarily have sleep apnea, but people with sleep apnea all snore.

  Young adults are the high-risk group

  Sleep apnea syndrome is not only as simple as snoring, but also affects sleep, reduces blood oxygen saturation, and further leads to hypertension, coronary heart disease, cerebral infarction, cerebral hemorrhage, diabetes, respiratory insufficiency, as well as anxiety, depression, dementia, etc. Sudden death even occurs during late night sleep.

  From the clinical point of view, the disease is more common in people around the age of 40, especially in the age group of 30 to 50 years old, and there are fewer people over 65 years old.

Han Fang introduced that young and middle-aged people often face problems such as old and young, high work pressure, fast pace of life, irregular work and rest, and less exercise time. Physical and mental fatigue is an important cause of the disease.

  Deaths from sleep apnea syndrome occur mainly at night, and from obesity, diabetes, and hypertension associated with prolonged apnea.

Therefore, it is not an exaggeration to say that this disease is a nighttime killer.

Han Fang reminded that sleep apnea syndrome, as a chronic progressive disease, is three times higher than the sudden death rate of people without the disease. Early detection, early diagnosis and treatment are very important.

  "Blood oxygen" monitoring is an important indicator

  Many studies have shown that effective treatment of sleep-disordered breathing can greatly improve the occurrence of other complications.

However, at present, people have not paid enough attention to the symptoms of hypoxia caused by sleep disorders.

Han Fang believes that this is closely related to the lack of awareness and popularization of monitoring equipment, and it is also related to the lack of attention in the academic field.

Taking long-term oxygen therapy as an example, the effect of increasing blood oxygen saturation after oxygen therapy should be evaluated, but if you don’t pay attention, it will naturally appear that it doesn’t matter if you breathe more and breathe less. In this way, whether you can achieve the best treatment The effect is unclear.

  In fact, apnea and blood oxygen saturation are highly correlated. In other words, a certain length of apnea will lead to a significant drop in blood oxygen saturation. Doctors can evaluate the risk of apnea according to the corresponding oxygen desaturation index and apnea index. situation to assess the risk of patients during sleep.

Therefore, monitoring pulse oxygen saturation is very important for the determination of sleep breathing events, and "blood oxygen" monitoring is an important clinical indicator.

  At present, the clinical method for evaluating sleep status is mainly nighttime sleep apnea monitoring.

After a patient sleeps in the sleep center of the hospital, a polysomnogram including EEG, EMG, EMG and other sleep information can be obtained through sleep monitoring to evaluate the sleep situation; at the same time, the doctor can understand the abnormal breathing of the patient Events, including nose and nose airflow breathing, chest and abdomen breathing exercise, blood oxygen saturation, snoring, etc., as well as heart conditions through ECG monitoring, finally form a sleep monitoring report that evaluates sleep structure and sleep quality.

  However, there are relatively few sleep professional medical staff in my country, and hospitals that can carry out sleep breathing monitoring work are relatively insufficient, and some patients may not sleep as usual due to the interference of too many sensors, and they will be affected by their poor sleep. Evaluation results.

For such patients, wearable devices can be used to make patients sleep on their own under the guidance of doctors, and relevant monitoring data can be observed by medical staff in the background, which will be more conducive to diagnosis and treatment.

  Zhong Yanyu (Author: Peking University People's Hospital)

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