Snoring and sleep apnea are two distinctly different disease entities, most often occur in the same patient, with symptoms typical night noise and periodic breathing.
are entities that have become increasingly important in recent years due to its high prevalence and the possibility of serious consequences for health. It has defined the apnea-hypopnea syndrome (SAHS) as occurrence of recurrent episodes of airflow limitation during sleep as a result of anatomical and functional alterations of the upper airway leading to its collapse, causing decreases in hemoglobin saturation and micro awakenings that lead to an unrealized dream repairer, EDS, neuropsychiatric disorders, respiratory and heart.
The micro awakenings induced disruption and alteration of sleep architecture, which explains the daytime symptoms of patients. The diagnosis of sleep apnea is suspected by the history of heavy snoring, excessive daytime sleepiness (EDS) and sleep apnea witnessed. The confirmation was made through a study of polysomnography (PSG) and respiratory polygraphy (RP) during sleep.
apnea syndrome and obstructive sleep hypopnea syndrome (OSAHS) is a common disease that affects 4% of the adult population. Its main symptom is excessive daytime sleepiness, along with mood disturbance and cognitive impairment, produce a progressive deterioration of the quality of life of patients. In addition, is associated with increased risk of hypertension, cardiovascular morbidity and workplace and traffic accidents.
This
entity is significantly underdiagnosed and medical liability improve detection for proper treatment. In children, most cases of OSA secondary to hypertrophy of tonsils or adenoids (adenoids).
Other less common causes craniofacial malformations, craniofacial trauma, sequelae of reconstructive surgery of the pharynx, vocal cord paralysis, deviated nasal septum, and laryngomalacia. As for hypertrophy of tonsils and adenoids is important to underline that to produce OSAHS is not necessary that the physical examination, a large block completely hypertrophy pharyngeal light, since the pharyngeal collapse during sleep occurs due to a combination of several factors: decreased pharyngeal area, muscle hypotonia, supine position during sleep, upper respiratory infections, which cause edema and the accumulation of secretions, increase the number and severity of obstructive sleep apnea.
Children with OSA usually do not have apnea or difficulty breathing during wakefulness, may be asymptomatic or present only signs of upper airway obstruction (nasal obstruction with mouth breathing, nasal speech ,...). During sleep, children often prefer to sleep sitting OSAHS or lots of pillows, sleep is often restless, breathing through the mouth, with snoring, apnea and episodes of awakening, continuous movements of the body, and sometimes sleepwalking, nightmares, enuresis, and increased functional activities (bruxism).
episodes of apnea-hypopnea is characterized by a significant increase in respiratory effort with a decrease or disappearance of snoring, hypoxemia, and progressive bradycardia. Apneic episode ends with an intense snoring, airflow resumed, decreasing the respiratory effort and tachycardia abruptly. We understand the decrease apnea greater than 90% of the airflow signal during a period of at least 10 seconds long .. Can be obstructive apnea when accompanied by chest and abdominal effort, central if this joint effort is absent or when they begin and end with a central component with obstructive component.
Although there are different definitions of hypopnea, the consensus document is recommended as the most accepted clearly discernible reduction in the flow signal ( > 30% and <90%)que cursa con una disminución de la saturación de oxígeno de al menos un 3% y/o un despertar transitorio (arousal) en el EEG. Aunando ambas alteraciones, se define el índice de apnea-hipopnea (IAH) como la suma del número de apneas e hipopneas por hora de sueño conducen al ronquido, que consiste en oscilaciones de alta intensidad del paladar blando, paredes de la faringe, epiglotis y lengua.
Snoring may represent an intermediate state between normal and OSAHS, in which the pharyngeal size and collapsibility are abnormal but fail to cause airway closure. However, it should be considered as a clinical marker to identify patients at risk for OSAHS or little symptomatic forms. Why
OSAHS causes an increased risk of CVD? Episodes of airway obstruction that occur during the night in patients with OSAHS generate alteration of pulmonary ventilation with a consequent fall in blood oxygen (hypoxemia) and increased carbon dioxide (hypercapnia) with this the body starts launched a series of mechanisms that generate momentary awakenings (micro awakenings) to return to restore breathing. During each of these episodes of apnea / hypopnea the body increases the activity of the nervous system that causes increased heart rate, vasoconstriction and increased blood pressure. These alterations may lead to the development of hypertension, cardiac arrhythmias, stroke, and heart failure. This means that people with OSA are at increased risk of CVD.
TREATMENT: Most of the symptoms of the disorder are reversible due to the current treatment, safe and noninvasive, involving the increased use of ambient air pressure (CPAP), from a soft compressor applied through a small mask placed over the patient's nose, only during sleep.
This form of treatment is most effective and used for sleep apnea when moderate and severe. When the snorer sleep the muscles of the oropharynx (throat) is closed, causing suffocation or apnea. The CPAP (acronym in English of continuous positive airway pressure) provides pressurized air (not oxygen) through a mask placed in the nose (there are also oral) connected via a hose or tubing to a small compressor which prevents to close the airway during sleep. The pressure required
to produce this opening is "individual" and therefore must be set overnight in the sleep laboratory. This pressure causes the immediate elimination of snoring and apnea.
The CPAP will be covered when: diminish or disappear apneas. You are eliminated snoring. It stabilizes the blood oxygen at night. Micros decrease nighttime awakenings. Is restored sleep architecture. The CPAP is safe and feel good the next morning confirmed that it has been properly titled. DRA
ESTER Matzkin.
This is a recommendation of the Red Cross worldwide: Ambulances and emergency medical services have realized that in accidents, often wounded carry a cell phone. However, when action not know who to contact in the long list of numbers. 
