Sleep Apnea

Sleep apnea syndrome, commonly known as sleep apnea among the public, is a quite frequently encountered condition. This definition was first made in 1965. Included among sleep disorders, this ailment manifests as short-term cessation of breathing during sleep. Although the person experiencing sleep apnea struggles to breathe, the upper respiratory tract sometimes becomes obstructed during sleep. This obstruction of the upper respiratory tract causing breathing to stop for at least 10 seconds is called apnea, while a decrease in breathing is called hypopnea.

This cessation of breathing in sleep apnea can even reach 1-2 minutes in some cases. A feeling of choking may also occur during the cessation of breath. After an apnea or hypopnea, the patient starts breathing with difficulty by snoring. In total, the involuntary cessation of breathing occurring in one night can be more than 200, 300, and sometimes 400 times an hour. In sleep apnea, although there is often no disease in the lungs, a decrease in the amount of oxygen in the blood is observed because no air enters the lungs during apneas.

As a result of the awakenings caused by the cessation of breath during deep sleep, the person becomes extremely sleepless and lethargic in the mornings. Also, they may complain of frequent morning headaches. Since people experiencing sleep apnea may face serious conditions such as high blood pressure, heart rhythm disorders, stroke, and heart attacks, the earlier precautions are taken against this condition, the better it will be for the person's health. This disease, which is not very well known among the public and doctors, can be diagnosed late for this reason.

Who Does It Affect?

This ailment can be seen in almost all age groups. However, it can frequently emerge between the ages of 40 and 65. Regardless of gender, it can be seen equally in both men and women. Nevertheless, it is among the findings that it is seen slightly more in men by a small margin. It develops more frequently in people who are overweight, have high blood pressure, snore loudly, or harbor structural problems in their upper respiratory tracts. The fact that this problem is encountered more in some families is a sign that the condition could also be genetic.

Obesity, which is the nightmare of many people in our country as in the rest of the world, is an important risk factor in sleep apnea. Studies have revealed that sleep apnea syndrome is almost 10-12 times more common in obese individuals. It has been determined that as weight increases, the incidence rate of the sleep apnea problem increases, and it decreases in people who lose weight. However, although sleep apnea syndrome is more frequently seen in people with obesity at rates of 40-60%, it should not be forgotten that it can also be seen in normal individuals. Usually, sleep apnea syndrome can be encountered in non-obese people due to structural disorders belonging to the face and jaw and narrowness in the upper respiratory tracts.

What Are the Symptoms of Sleep Apnea?

Like all other diseases, sleep apnea has some symptoms. These symptoms are signs of whether a person has sleep apnea. To list these;

• Extreme sleepiness during the day
• Extreme fatigue during the daytime
• Lethargy
• Headaches
• Dry mouth
• Waking up tired in the morning

Along with these symptoms, people experiencing these conditions are constantly distracted because they cannot rest comfortably in their night sleep. For this reason, they can experience various accidents. For example, accidents caused by those driving due to lack of concentration are not to be underestimated.

Treatment of Sleep Apnea

Sleep apnea treatment is planned based on the examination, the patient's history, and the data resulting from the sleep test. The treatment of sleep apnea can be divided into three as surgical treatment, CPAP (continuous positive airway pressure), and intraoral appliance applications.

Surgical Treatment in Sleep Apnea

Surgeries can be performed by Ear, Nose, and Throat specialists on patients who only experience snoring and some selected patients with sleep apnea syndrome. However, for this, it is necessary for the patient to have a structural narrowing located in the upper respiratory tracts that can be corrected by means of surgery. A complete recovery might not be seen with surgical treatment, and it may not be offered as the first option among treatment methods. Usually, CPAP treatment is frequently preferred as the first method.

Surgical interventions can generally be performed on snoring and sleep apnea patients to eliminate the obstruction in the respiratory tract. To list these surgeries;

• Surgery directed at the base of the tongue
• Surgeries directed at nasal congestion
• Stimulation of tongue muscle nerves
• Surgeries performed directed at the soft palate
• Bringing the airway out of the neck (Tracheostomy)
• Surgeries aimed at advancing the lower and upper jaw bones

While creating a plan for surgery, treatment mostly starts with resolving the problems in the nose, and throat, soft palate, larynx surgery, base of the tongue, and if deemed necessary, more advanced surgical operations are performed. Increasing the air passage volume behind the uvula and soft tissue is the main goal of this surgery. Also, reducing the tendency of these tissues to collapse is important.

Along with all these, surgical procedures on the base of the tongue are also applied for apnea treatment. Among these, there are applications aimed at reducing the base of the tongue with the tongue suspension technique, base of tongue radiofrequency applications; the Coblator method, surgery, laser, and robotic surgery techniques that are frequently applied in recent years.

The person undergoing surgical treatment needs to take a number of precautions in the subsequent process. Pain can continue for up to 10 days following the sleep apnea surgical application. Sometimes bleeding can also be seen in this process. To comfort the patient during this period, medications and IV fluids recommended by the specialist doctor can be used. In the initial periods, liquid foods should be consumed until the doctor deems otherwise. The patient can return to their normal life after an average of 6 days.