【Local Medical】Changing your daily routine to help alleviate the disease trilogy to identify sleep apnea

Text: He Jianxing

(Kuala Lumpur News) Even if sleep apnea has entered a moderately severe stage, patients can still improve their condition with the help of some specific equipment, and then change their living habits. .

Discovery and diagnosis of multiple causes of cardiovascular disease

Dr Sia Kian Joo, Consultant of Otorhinolaryngology and Head and Neck Surgery, pointed out that there have always been few patients with sleep apnea who would take the initiative to report the situation and receive treatment. The main reason is that snoring is not a disease in the minds of ordinary people. People or their own sleep quality, and therefore patients are often found due to other ENT diseases, or even cardiovascular diseases.

“It also includes going to receive treatment for cardiovascular disease or metabolic syndrome (metabolic syndrome) such as diabetes and obesity, and being referred to the ENT department by a specialist doctor suspected of suffering from sleep apnea at the same time. Coupled with family members complaining of excessive snoring, sleep testing often proves to be moderate or above sleep apnea.”

He said that how to identify whether there is sleep apnea, the doctor will carry out the so-called “trilogy”, which are history, physical examination and investigation.

“Through the above three steps, doctors can determine the patient’s problem and prescribe the right medicine one by one. With the current medical technology, sleep apnea can be alleviated through changes in living habits, medication or equipment, and surgery.”

He said that during the consultation, the doctor will gain an in-depth understanding from the following five points:

1. Is there a snoring sound?(Although snoring does not necessarily mean sleep apnea, people with sleep apnea do snore, so it must be viewed with caution.)

2. Did you wake up due to suffocation during sleep?(In the past, some people with sleep apnea have had several sudden awakenings during the night when they couldn’t breathe.)

3. Is there frequent urination?(People with sleep apnea experience these symptoms.)

4. Did you experience the dilemma of not getting enough sleep the next day? (The most common complaints of people with sleep apnea are lack of energy, inability to concentrate, headaches, anxiety, and easy depression. This is because the apnea prevents them from entering the deep sleep stage and can only wander in light sleep.)

5. Is there high blood pressure?(Often people with sleep apnea have symptoms of high blood pressure.)

“After completing the consultation, the doctor will conduct a physical examination, including the Body Mass Index (BMI). If the subject’s index has exceeded the 30 mark, there is a risk of sleep apnea.”

Then the doctor will check the neck circumference (neck width), tonsils, soft palate and tongue, etc. If necessary, nasal and throat endoscopy will be performed for further detection and blood pressure measurement.

He said that the market is full of various devices that claim to prevent snoring, such as adhesive tape on the bridge of the nose, plastic stuffed in the nostrils, etc., but in fact it can only help a small number of snorers, because the formation of snoring is in the The human respiratory tract involves the soft palate, the base of the tongue, and the throat. Only a small number of patients have blocked nostrils. Therefore, these devices may slightly reduce the snoring volume, but at best they can only treat the symptoms but not the root cause. Choking is useless.

Anti-snoring equipment treats the symptoms but not the root cause

He said that for pillows that claim to improve snoring, they are designed so that people can sleep on their side comfortably, because when a person sleeps on their back, the tongue will fall back and narrow the airway, and vice versa. Sleeping (whether on the left side or the right side) can reduce the occurrence of the tongue falling back, and naturally reduce the volume of snoring, which can more or less relieve mild sleep apnea.

“The medical school professor told me that there is a small trick to do this, which is to tuck a tennis ball into the collar of the pajamas, so that the patient can stay on his side throughout the night. The principle is the same as mentioned above. The principle of the pillow is not far behind.”

He said that there are still methods that claim that wearing a watch can improve the sound of snoring. It can only be said that it can detect the rhythm of the heartbeat, including the reduction of the number of heartbeats when snoring, but it is unfounded to say that it can improve snoring statement.

“Instead of relying on equipment to change, it is better to intervene in daily life, exercise more, lose weight, reduce BMI below 30, do not smoke, do not drink alcohol, do not take sleeping pills, and keep sleeping on the side, all of which can reduce snoring and even The harm of sleep apnea, but only in mild sleep apnea patients, that is, the sleep apnea index (AHI) stops breathing 5 to 15 times per hour, but for moderate or severe patients must receive other treatment.

Sleep 4 to 6 hours at home sleep test condition

If sleep apnea is suspected after the test, the doctor will order a sleep study (sleep study) and a polysomnogram.

Xie Jianyu said that the examinee must stay in the hospital for one night, and then the technician will install a sleep analyzer on him to record various physiological data after falling asleep, including brain waves (EEG), eye movements, electrocardiograms, air flow and Blood oxygen saturation will also be used to determine the volume and frequency of snoring, or how many times of suffocation, how long the suffocation is, etc. through the caller and the respirator in the nostrils. The doctor will make a diagnosis based on these data and clinical experience the next day.

Home tests are no more accurate than hospital tests

“With the current technology, the person undergoing the test chooses to stay in the hospital overnight for the test to obtain the most complete data. However, due to the limited space in the hospital, some medical device companies also provide home test services, that is, technicians come to install the equipment and go to the hospital the next day. Collect the data and give it to the doctor for analysis.”

“Although this kind of home test is not as accurate as the sleep test in the hospital, it can avoid the problem that the subjects have difficulty falling asleep in an unfamiliar environment.”

He pointed out that although this test must be equipped with many sensors, judging from past cases, it does not cause panic (phobia), and even fat children can complete it. Generally, only 4 to 6 hours of sleep are required to obtain reliable data. To determine whether the subject has fallen asleep, it can be known through brain waves and muscle activity.

“Taking normal people as an example,

It is reasonable for the blood oxygen saturation (SpO2) to be between 98% and 100%.

But for patients with sleep apnea,

Once suffocation symptoms appear, it may only be 70% to 80%,

When blood oxygen saturation drops,

Irregular heartbeat or bradycardia,

The heart rate can drop to 50 to 60 beats per minute. “

“A sleep test can determine whether a person has mild to severe sleep apnea and is arguably the most widely used test for sleep.”

Severe cases stop breathing more than 30 times in 1 hour

Sleep apnea can be divided into mild, moderate and severe based on the sleep apnea index (Apnea-Hypopnea Index). As long as you stop breathing for more than 15 seconds, it is considered once, and some can even last as long as 1 minute.

Mild – stop breathing 5 to 15 times in 1 hour

Moderate – stops breathing 16 to 30 times in 1 hour

Severe – stop breathing more than 30 times within 1 hour

“Remember, to confirm whether it is sleep apnea must be done step by step. It must be from the initial diagnosis to the examination, and finally arrange the sleep test. There is no need to rush.”

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