Anesthesia-Online

Pauses in breathing

introduction

First of all, pauses in breathing can occur in every person during sleep.

Especially when falling asleep, breathing is often irregular, which can result in short pauses in breathing. However, if breathing pauses occur more frequently, this can hide a so-called sleep apnea syndrome.
For various reasons, this leads to long-term breathing pauses at night.
Since the brain is less well supplied with oxygen during this time, and the pauses in breathing also disrupt sleep, one is not recovered the next morning. This is because a wake-up reaction is set in motion whenever there is a drop in oxygen. Although this prevents you from suffocating, it leads to exhaustion in the morning even though you do not actively notice the waking phases.

In addition to increased daytime sleepiness, pauses in breathing at night have a number of other negative effects. They can damage the heart in the long term, cause strokes, trigger high blood pressure and shorten life expectancy.
The constant exhaustion can also promote the occurrence of depression. The risk of traffic accidents increases dramatically due to inattentiveness and fatigue during the day.
In this respect, any suspicion of sleep apnea syndrome should be clarified by a doctor and taken seriously.

causes

Breath pauses at night various causes to have.

A typical one is that the respiratory tract easy to lay mechanically. Then one speaks of the so-called obstructive sleep apnea (OSAS).
This can happen either when the airway itself is too narrow. For example through enlarged tonsils, one crooked nasal septum or the Jaw anatomy.

Or Obesity leads to the Tongue falls back in sleep and so interrupts the air supply. In addition, if you are overweight, the entire weight presses on you in the supine position Rib cagewhich makes breathing even more difficult. This problem is often exacerbated by the Consumption of alcohol. The muscle-relaxing effect of alcohol becomes noticeable in the area of the tongue.

A completely different cause of pauses in breathing can also occur in the brain yourself lie. Then one speaks of one central sleep apnea. There is a malfunction of the brain region that controls the activity of the respiratory muscles. This shape can e.g. caused by a stroke. Also a gone through Neuroborreliosis can trigger breathing pauses in this way.

Symptoms

Daytime sleepiness is the most common symptom of paused breathing.

First of all, the person concerned does not notice the pauses in breathing.

The partner may notice the pauses in breathing or the subsequent startled up from sleep. Most of the time, those affected snore, which means that the partner notices the pauses in breathing that follow snoring.

But sleep apnea without snoring is also possible. As a person affected, you are usually more likely to notice the effects of unrefreshing sleep. This includes extreme daytime tiredness, poor concentration and a general lack of performance.
The libido can also suffer from lack of sleep. Those affected often report severe headaches in the morning.
As a result, problems such as high blood pressure or cardiac arrhythmias often arise. This is because the body believes it is suffocating every time it pauses for breath and so puts itself in a state of alarm.
A lot of stress hormones are released, which also increase blood pressure. In the long run, these hormones are harmful to the body, especially since they are released here in a phase in which the body should actually recover.

Then there are the effects of the lack of oxygen in the brain. Patients with breathing pauses show increased arteriosclerosis and thickening of the vascular wall, especially in the cerebral vessels. This leads to increased strokes or so-called TIAs, short-term circulatory disorders in the brain.

Sleep apnea syndrome can also develop in the acute phase and in the course of a stroke. But then due to a central regulatory disorder in the brain. Overall, of course, not every snoring or irregular breathing rhythm is dangerous. But if there are more than 5 - 10 breathing pauses with a length of at least 10 seconds per hour, sleep apnea syndrome is likely.

diagnosis

A first indication of the presence of a Sleep apnea offers the symptom combination. Excessive tiredness during the day, together with snoring, breathing pauses and being overweight, make breathing pauses very likely.
Sleep should then be monitored for an exact diagnosis. It works best in one sleep-laboratory. Not only those breathingbut all relevant vital signs are recorded.
Movement during sleep and any restlessness are also recorded. Breath pauses and the resulting stress level for the body can be measured.
Also the Brain activity in the EEG or the Muscle tension can be registered here.

Isn't it possible for you in one? stationary sleep laboratory to stay overnight, or if you can't fall asleep there, there are now also smaller devices. Although these collect a little less data, they can also be used at home.

In addition, a ENT doctor must be sought out to rule out recoverable causes in the nose and throat. The medication should also be included as a further cause and changed if necessary.

frequency

About 2-3% of the population are from Sleep apnea syndrome affected.
The majority of those affected are between 45-65 years old. Breath pauses occur more often Men in front. This probably depends on the Fat distribution, in the form of belly fat, which makes breathing more difficult when lying on your back.

People who regularly Alcohol, nicotine or sleeping pills consuming are also at increased risk. Sleep apnea syndrome is more, though not exclusively, found in people who snore heavily.

therapy

The therapy for sleep apnea is closely related to the causes.

With light forms, it is often sufficient to make minor changes to the way of life. So can reducing excess weight, or giving up Alcohol, nicotine and sleeping pills already lead to improvements.
Already one Weight reduction of 10% can reduce the risk of nocturnal oxygen deficiency by 1/4.

A good Sleep hygiene, renouncing heavy meals immediately before going to bed, as well Sports can also have positive effects. Even when sleeping on your side, the tongue is usually well avoided. There are also simple aids for this purpose, some of which you can make yourself.
A sewn-in tennis ball on the back of the pajamas, or so-called Side sleeper pillow help to maintain the lateral position during the night.
Likewise can Teeth guards or bandagespulling the lower jaw forward will help relieve symptoms. Are for example enlarged tonsils or polyps the cause of the problem, thought can be given to removing it.

He also used the drug Theophylline can be used for light forms of the Sleep apnea syndrome Act.

If none of these measures help, a specific one at night may be necessary mask to wear. With this, air is pressed into the airways under a slight pressure. This ensures that air can pass through the obstructed airways gets into the lungs.
In addition, the pressure in the airways makes it easier for the oxygen to be absorbed. Although these help "Ventilators" very good against the symptoms, but there are patients who feel very disturbed by the mask.

Breathing pauses when falling asleep

Pauses in breathing while falling asleep are not necessarily a sign of one Sleep apnea syndrome. Breathing pauses can also occur due to the change in the breathing rhythm or the sinking back of the tongue during relaxation during the sleep phase.

Although these can drag on through the night, they don't have to.

Breathing pauses in the child

It is also with children Sleep apnea very common.

Something like snoring 10% of all children regularly, about every fifth of whom suffer from sleep apnea.
The problem is that the symptoms are often more likely to be overlooked in children than in adults. So in childhood there are so many reasons for having children restless, unfocused etc. are that often not on Pauses in breathing is thought.
But just that long-term consequences can be enormous in children due to the early onset of the disease. high blood pressure and other problems that are typical of adults often only appear later. But also with school problems and ADHD has been linked to sleep apnea syndrome in children.

When a child so snores heavily and often during the day restless, unbalanced and tired is, you should at least go to the pediatrician too Pauses in breathing consider as the cause. The causes in children are basically the same as in adults.
Whereby here enlarged tonsils or polyps are particularly common. If the cause cannot be removed surgically, a breathing mask is also the therapy of choice for children, even if it can be difficult to get children to tolerate it at night. In any case, if breathing pauses are suspected, especially in children, rapid diagnosis and therapy should be carried out. Development deficits that have arisen from bad ones Sleep and oxygen deficiency, can no longer catch up.