Sleep related breathing disorders

Restful sleep is the prerequisite for a healthy life. In the case of disorders of respiratory regulation or muscle tone of the upper respiratory tract, this restorative function may be disturbed. In addition to daytime sleepiness with an increased tendency to accidents, this can lead to cardiac arrhythmias, arterial hypertension, high pressure in the pulmonary circulation, myocardial infarction, heart failure, stroke and psychiatric disorders.

Timely detection and treatment of sleep-related breathing disorders not only prevents disease, but directly improves quality of life.

The most common form of nocturnal breathing disorders is obstructive sleep apnea syndrome, which is found in 3 – 7% of adult men and 2 – 5% of adult women. In people with diseases of the cardiovascular system, the risk is increased 2 to 3 times.

During sleep, the muscle tone of the pharyngeal musculature is reduced, leading to snoring and finally to pauses in breathing due to the collapse of the soft tissues of the pharynx. During these pauses in breathing, the organism cannot be supplied with oxygen.

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Do I suffer from sleep apnea?

If you have three or more of the following conditions, you are at increased risk for sleep apnea syndrome, which increases with each additional condition.

  • Do you snore loudly?
  • Do you suffer from fatigue, tiredness or sleepiness during the day?
  • Has anyone ever noticed nocturnal pauses in your breathing?
  • Do you wake up at night with shortness of breath, racing heart or sweaty?
  • Do you suffer from high blood pressure, cardiac insufficiency or cardiac arrhythmia?
  • Is your body mass index > 35 kg/sqm (=body weight/body size2)?
  • Are you older than 50 years?
  • Is your collar size > 43 cm (men) or > 41 cm (women)?
  • Are you male?

How is sleep apnea syndrome diagnosed?

After the medical history and the physical examination, the initial assessment is carried out using a standardized procedure to identify concomitant diseases, daytime sleepiness and other aspects.

If there are indications of other diseases, such as cardiac insufficiency or pulmonary hypertension, these must be clarified further.

You will then receive a measuring device for recording various sleep parameters at home. With a small measuring device and a few sensors, the following parameters can be recorded: Respiratory flow, snoring sounds, oxygen saturation of the blood, heart rate, body position, waking reactions and the movements of the chest and abdomen. As a rule, the evaluation takes place immediately after delivery the next morning.

Therapy of obstructive sleep apnea

Obesity is a significant risk factor for obstructive sleep apnea syndrome. A weight loss of just 10 – 15 % leads to a halving of the nocturnal breathing pauses.

In addition to dietary measures and increased physical activity, surgical measures can also be considered to achieve this goal.

Special dental splints may be used in more slender patients with mild-to-moderate sleep apnea syndrome.

The most common form of treatment for all degrees of severity is nocturnal positive airway pressure (e.g., CPAP). This involves creating a slight positive pressure in the throat via a nasal mask. This prevents the throat from collapsing during sleep, so that snoring no longer occurs and breathing is once again possible without hindrance. The quality of life due to the now restful sleep normalizes immediately after the start of therapy.