Snoring. Identification of causes and comprehensive treatment in EMS

Narrated by Alexander Slavskiy,
otorhinolaryngologist, doctor of the highest category, PhD

Snoring often accompanies a person's breathing during sleep. Sleep apnea, or sleep apnea, is a condition characterized by the presence of snoring, periodic collapse of the upper respiratory tract at the pharyngeal level and cessation of pulmonary ventilation with continued respiratory efforts, decreased blood oxygen levels, severe sleep fragmentation and excessive daytime sleepiness. In severe forms of snoring with apnea, up to 400-500 respiratory stops per night with a total duration of up to 3-4 hours can occur, which leads to an acute and chronic lack of oxygen during sleep.

The incidence of the disease reaches 9% in women and up to 24% in men. It is estimated that in more than 80% of patients with snoring and sleep apnea, the disease remains undiagnosed for one reason or another, and only 10% of patients receive the necessary treatment.

As a rule, patients at the doctor's office complain of noisy breathing, respiratory arrest during sleep, pronounced daytime drowsiness, frequent awakenings and poor sleep, arterial hypertension (mainly night and morning), frequent night urination, fatigue in the morning, decreased potency, decreased mood background. It should be added that these patients often have a low, hoarse voice due to chronic injury to the structures of the pharynx during snoring, which in men can lead to the development of erectile dysfunction. The decrease in libido and potency is due to a number of factors. Firstly, the patient simply chronically does not get enough sleep, which, of course, negatively affects his desires. Secondly, a pronounced sleep disorder causes a decrease in the production of the male sex hormone testosterone and the development of impotence.

The treatment methods for snoring with apnea are diverse and depend on the combination of causes and severity of apnea. EMC has developed its own protocol for the treatment of such patients. Neurologists, dentists and otorhinolaryngologists take part in it. The treatment program must include:

One of the priority areas in the treatment of snoring in EMC is the surgical removal of obvious anatomical defects at the level of the nasal cavity and oropharynx. And only the next stage, as a rule, is intervention on the soft palate.This type of treatment is etiological, that is, it is aimed at the cause of the disease. According to the indications, patients undergo septoplasty, correction of the lower nasal concha, endoscopic polysinusotomy, adenotomy and other interventions. A differentiated approach to choosing the optimal option for combined surgical treatment for various degrees of snoring and apnea allows for a good clinical result in 75% of the operated patients.

Author:Alexander Slavskiy, otorhinolaryngologist, doctor of the highest category, Candidate of Medical Sciences