Breathing pauses occur as a symptom of so-called sleep apnea mostly at night during sleep. Affected are about 2-4 percent of the adult population – especially overweight men who snore conspicuously. The breathing pauses lasting several seconds to minutes can lead to an acute oxygen deficiency of the organism and, if left untreated, to a variety of chronic complaints in those affected. Special breathing masks can provide relief.
What are breathing stops?
Breathing pauses are brief interruptions in the involuntary breathing process. They usually occur as part of sleep apnea syndrome. Breathing pauses are brief interruptions of the involuntary breathing process. They usually occur in the context of sleep apnea syndrome (a-pnea – Greek: without breath). The nocturnal breathing pauses usually last a few seconds, but in extreme cases they can last up to 2 minutes. By definition, sleep apnea syndrome is present when at least 5 breathing pauses lasting 10 seconds or more are recorded per hour. The cause of the pauses in breathing may be due to a tissue-related obstruction of the trachea or faulty regulation of the diaphragm muscles, as a result of neurological disorders. Involuntary pauses in breathing during the day are very rare. They may refer to asthmatic diseases, or occur in mental disorders.
Causes
People who suffer from cessations of breathing often have physiological peculiarities in the pharyngeal-nasal area. Affected are mainly men, who generally snore pronouncedly, for example, due to a curved nasal septum or voluminous palatal tissue. About 80 percent of apneics suffer from overweight. High weight promotes increased accumulation of fatty tissue in the posterior pharyngeal-palate region. The soft, heavy tissue can then easily sink during sleep, especially in the supine position, and temporarily block the air supply. In the event of a threatening drop in the oxygen content of the blood, released stress hormones cause a brief awakening that causes the affected person to take an abrupt breath. Breathing stops occur more frequently after alcohol consumption, since alcohol additionally relaxes the palate tissue. Neurological disorders associated with a regulatory disorder of the respiratory muscles in the chest and abdomen can be considered as further, but rare, causes.
Diseases with this symptom
- Sleep apnea
- Fibromyalgia (fibromyalgia syndrome)
- Obesity
- Nasal septum-
curvature
- Bronchial asthma
- Fatigue syndrome
- Allergy
- Alcohol disease (alcoholism)
- Sinusitis_frontalis
Diagnosis and course
Since the affected person usually can not remember the nocturnal pauses in breathing, it is often partners or relatives who first notice the disorder. Observable in apneics are often strongly pronounced snoring and several unusually long pauses in breathing during sleep, which are terminated by abrupt startling or noisy gasping for air. The affected persons themselves suffer from strong daytime tiredness despite supposedly sufficient sleep duration, since waking up several times during the night prevents a restful sleep. A medical diagnosis can be made quickly on the basis of the partner’s description and the patient’s typical symptoms of fatigue. A broad clarification by an ENT, neurologist and oral surgeon is useful at first. In addition, it is advisable to visit a sleep laboratory to assess the extent and severity of the breathing cessations. Here, various parameters such as heart rate, oxygen content of the blood, brain waves, etc. are analyzed in detail while the patient sleeps. If left untreated, the breathing pauses lead to a chronic sleep deficit over a longer period of time. This in turn promotes a general reduction in performance and drive. Concentration, memory, and possibly also libido disorders occur. The repeated physical alarm states can lead to high blood pressure in the long term and increase the risk of heart disease and diabetes.
Complications
Breathing cessations are usually seen at night, particularly affecting men who snore heavily or are overweight. The breathing pauses can last several seconds, sometimes minutes. This is very dangerous, because the organism is no longer supplied with sufficient oxygen.Without treatment, breathing stops can become life-threatening. However, if sufferers wear special breathing masks, relief can be found quickly. The breathing stops occur during the night and last for a few seconds. In particularly bad cases, breathing can stop for up to two minutes. During the day, breathing stops are rare. These patients should visit a sleep laboratory and have the cause of the breathing stops precisely determined. Sufferers often have physiological peculiarities, for example, the pharynx and nasal cavity may be to blame for the breathing pauses, and many patients have a curved nasal septum. About 80% of patients suffer from obesity, which only encourages the breathing pauses. In the supine position, the tissues can also easily sag and block the air supply. If the blood oxygen level drops dangerously low, stress hormones are released by the body, causing the sleeper to wake up briefly, gasping for air. This phenomenon is observed particularly frequently after alcohol consumption; the palate tissue is additionally relaxed as a result. Very rarely, neurological disorders are also considered, they can also cause breathing cessations.
When should you go to the doctor?
Nocturnal breathing pauses can become dangerous, so early visit to the doctor is necessary. When the tongue falls back into the throat during sleep, the airway becomes blocked. This can lead to breathing pauses lasting seconds, sometimes minutes. The sooner sleep apnea is treated, the better, because it can increase the risk of high blood pressure and type 2 diabetes. The condition is often treated with a special breathing mask and positive airway pressure therapy. CPAP therapy creates a standing column of air in the throat, keeping the upper airway open. Wearing the mask is uncomfortable for many patients, but because daytime sleepiness due to lack of sleep is eliminated, it is readily accepted, as are dry nose and throat. These side effects are far less unpleasant than the breathing pauses. The success rate with the CPAP mask is 95-98%. An alternative therapy is an anti-snoring splint, which also has good success rates. Smokers should give up smoking immediately. Since the sufferers notice little of their breathing pauses, it is primarily the partners who are called upon. Sleep apnea mainly affects overweight people, but children can also get this disease. Affected persons can find the right therapists among ENT physicians and in sleep medicine clinics. Here there are special sleep laboratories, where sleep rhythm and sleep course of the subjects are observed.
Treatment and therapy
Depending on the underlying cause of the breathing cessations and findings of the sleep laboratory analysis, there are various treatment options available that are tailored to the individual. Most commonly, patients are advised to wear a breathing device. Continuous Positive Airway Pressure (CPAP) therapy involves ventilating the sleeper at night with slight positive pressure, which prevents tracheal obstruction. The pressure and composition of the supplied breathing air, e.g. additional enrichment with water to prevent mucous membrane drying, can be varied individually. If the breathing stops are caused by enlarged palatine and pharyngeal tonsils or nasal polyps, surgical removal may be indicated. Surgical procedures on the tongue and palate tissues may also result in widening of the throat and thus improved airflow. In cases of jaw misalignment, oral surgical interventions through (bite) splints, braces or surgery alleviate breathing difficulties. In milder cases, simple measures that prevent supine positioning during sleep may be sufficient. These can be devices worn at night that send alarm signals when the sleeping position is unfavorable. A countermeasure that can be carried out by oneself can also be, for example, sewing disturbing, but not injury-threatening, objects (e.g., tennis balls) into the back of pajamas.
Outlook and prognosis
The consequences of nocturnal breathing cessations are more far-reaching than just resulting fatigue and difficulty concentrating. Fatigue-induced microsleep at the wheel can lead to life-threatening accidents. The reduced quality of sleep has a negative effect on the regeneration of the entire organism and represents a heavy burden on the body in the long term. If left untreated, sleep apnea can therefore be a trigger for many secondary diseases.The oxygen supply to the brain is interrupted by the breathing pauses. To compensate for this lack of oxygen, the heart rate is increased, which can result in cardiac arrhythmias and high blood pressure. Sufferers also have an increased risk of suffering a heart attack or stroke. In general, patients with untreated apnea have a ten-year reduced life expectancy compared to healthy people. Timely treatment is therefore crucial for a good prognosis and can greatly reduce the risks. Sleep quality can be significantly improved with CPAP ventilation therapy, which has a 98% success rate. The acclimatization phase to the respiratory mask can be difficult, but after that, improvement occurs quickly in most cases. Patients are more efficient and a reduction in blood pressure can also be achieved with ventilation.
Prevention
The common treatment measures for respiratory failure – such as wearing special breathing devices – are at the same time based on the principle of prevention. Affected individuals can also take action themselves to positively influence the course of the breathing disorder. In general, a reduction of excessive weight is recommended. Abstaining from alcohol and cigarettes also has a beneficial effect on healthy sleep and reduces severe slackening of the palate tissue. Especially late in the evening, these stimulants should be avoided to prevent nocturnal breathing pauses.
What you can do yourself
Nocturnal breathing pauses, known as sleep apnea, are dangerous because they increase the risk of stroke by twice. Basically, the ENT doctor is the right contact for the treatment of breathing pauses. A sleep mask is usually prescribed, but patients can also take preventive measures. Those who eliminate the causes of sleep apnea may soon be able to enjoy continuous periods of sleep. Typical risk factors for sleep apnea are stress, obesity and smoking. Quitting smoking increases the likelihood of restful sleep and increases life expectancy. Reducing excess weight often leads to success and also prevents cardiovascular disease. If a slight misalignment of the jaw is the cause of snoring, a splint can provide relief. This is only worn at night. Incorrectly dosed sleeping pills and tranquilizers can cause paralysis of the throat muscles and trigger breathing pauses. The fewer sleeping pills taken, the better for health. Alcohol also has a slight paralyzing effect. Those who abstain from it in the evening sleep more peacefully and more deeply. Sometimes a new pillow already helps, however, because a down pillow into which the patient with sleep apnea sinks deeply is not helpful. The exact causes of insomnia can be determined in a sleep laboratory. In a self-help group, those affected and their relatives receive valuable tips and moral support. This supports them in coping with the disease.
