BEIJING, May 14 (Xinhua) — If you suffer from sleep apnea, you may not normally care, but in fact, sleep apnea is closely related to diabetes, heart disease and other diseases, putting you at risk, according tomedia reports.
Around 1 billion people worldwide suffer from mild or severe sleep apnea
Neil Steinberg said in an interview: “I feel like I’m dying, during the day, I feel my knees stoofully, my head is drowsy when I drive, I’ve been trying to control myself, I’m driving as awake as possible, and sometimes I look in the mirror and i’m tired and wrinkled.” At night, I often wake up, my legs cramp, and then suddenly wake up, gasping for breath, my heart beats faster. “
Stenberg’s doctors were puzzled by the symptoms and asked him to have blood tests, urine tests, and electrocardiograms, which he thought might be related to heart disease, especially palpitations at night. But Stenberg’s check-up showed that his heart was healthy and his blood was in good shape.
In 2008, he had a colonoscopy, forcing himself to drink five litres of milk to clean his intestines so gastroenterologists could take a closer look at the analysis. When Stenberg regained consciousness, the doctor told him, “Your colon is very clean, there are no signs of cancer, and there is no worrying polyps.” But one thing has to be said, when you lie down and sleep, you stop breathing for a while, and it’s recommended that you rediagnose, and it’s likely that you’re suffering from sleep apnea. At the time, Stenberg was stunned, saying he had never heard of sleep apnea.
Sleep is a sign of the body’s dynamic changes, it is composed of different stages, when people are in the sleep stage, breathing, blood pressure and body temperature will be high and low, when people wake up, muscle tension is basically the same, but in addition to the rapid eye movement sleep phase (REM), REM stage accounts for a quarter of people’s sleep time.
Most muscle groups in the body are noticeably relaxed during sleep, but if your throat muscles are over-relaxed, the airways will collapse and block, resulting in obstructive sleep apnea. If people suffer from sleep apnea, they experience non-stop breathing during sleep, causing oxygen levels in the blood to plummet, and then you wake up and gasp for breath, which can occur hundreds of times a night, with multiple adverse effects.
According to statistics, about 1 billion people worldwide suffer from mild or severe sleep apnea, sleep apnea increases heart pressure, the human body has to pump blood faster, so as to make up for the lack of oxygen. Fluctuations in oxygen levels in the body can also cause plaques to build up in the arteries, increasing the risk of cardiovascular disease, high blood pressure and stroke.
Apnea causes sleep deprivation at night and makes people feel tired and tired, which is associated with memory loss, anxiety and depression. In addition, lack of sleep can lead to lack of concentration and is prone to traffic accidents. In 2015, researchers found that drivers with sleep apnea were 2.5 times more likely to be involved in traffic accidents than drivers with sleep apnea, while drivers with sleep apnea were more likely to be laid off.
A study showed that people with severe sleep apnea had a three-fold higher mortality rate than healthy people over an 18-year study, a condition that is prevalent globally, with nearly 1 billion people worldwide suffering from mild to severe sleep apnea, according to a 2019 study.
That means about a billion people around the world are struggling with sleep apnea – but they don’t even realize it, let alone how to treat it, and now the medical world is focusing on sleep apnea and trying to find solutions, from hypoxia research to new surgeries and instruments to treat hypoxia. For patients, what do they face is if they can effectively address this health crisis.
The insatuned health crisis
Although there are long-term risks to sleep apnea, such as obesity, thickening of the neck, enlarged tonsils, smaller jaws, or accelerated aging, there are physical red flags only when people fall asleep, so the only way to diagnose the disease is to monitor a person’s sleep.
So in early 2009, Stenberg, exhausted and at the doctor’s urging, made an appointment with a medical expert at the Sleep Medical Center, where Stenberg consulted sleep medicine specialist Lisa Shives, examined Stenberg’s throat, and then suggested that he do a polyptogram, a body test of sleep quality that records the patient’s breathing, blood pressure, heart rate, brain and muscle activity.
A paramedic took Stenberg into a small bedroom with a double bed and a large wardrobe, and a window where a lab could be seen, full of equipment, and Stenberg changed into a flange dinghies and called the paramedics, attached electrodes to Stenberg’s chest and head, and then put a fishnet shirt on him to secure the connections to his body. At about 10 p.m., Stenberg turned off the lights and soon fell asleep.
He woke up at 4.30am the next day, but was still feeling a little sleepy and planning to go back to sleep, when paramedics told him he had now recorded six hours of data and could now finish the test. When Stenberg got dressed, Schiffs told him he had severe sleep apnea and then told me about the condition in detail, and Stenberg was worried.
A few weeks later, this time during the day, Schiffs sat in front of a computer screen with colorful curves and numbers, as well as a small black-and-white video of Stenberg sleeping, which made him very upset, like watching his own crime scene.
Speaking about death, Schiffs told Stenberg: “When you test at night, you stop breathing for 112 seconds, almost two minutes.” Normally, the normal oxygen saturation measured by the pulse oxygen meter is between 95% and 100%, the oxygen saturation of patients with chronic obstructive pulmonary disease is more than 80%, and your oxygen saturation is only 69%. “
How bad is that? According to a World Health Organization surgical guidelines report, if a patient’s blood saturation drops below 94%, he should immediately check to see if the airways are blocked, if the lungs are collapsing, or if there is a problem with blood circulation.
“Stop breathing for 112 seconds in sleep at night, nearly two minutes!” “
“I have very few options for treating Stenberg, and I can have a drooping pharynx-forming operation that is as scary as its name: removing tissue from the soft palate and expanding the airways at the back of the throat,” Schiffs said. But it’s going to be a very painful operation and the recovery process is going to be long. However, she was quick to reject the drooping pharynx surgery, which, after all, was too risky.
It is understood that when someone was found to have sleep apnea, there was only one treatment option for the next 15 years – tracheotomy, a surgical procedure that opens a trachea on the patient’s throat to bypass the collapsed upper respiratory tract. Although the treatment may alleviate sleep apnea to some extent, it can produce associated complications.
In diagnosing the initial symptoms of sleep apnea, doctors usually do not take tough measures to treat, because of the uncertainty of the condition, often take conservative treatment options, in the 1980s only found serious sleep apnea patients. They wake up with headaches, which are related to the inability of body tissues to get enough oxygen, and people can expect them to be very tired, depressed, moody, and grumpy.
Because of the many side effects, patients are understandably cautious about tracheotomy, which is now the “last surgical option” and only takes place in extremely urgent medical cases. Although the operation has caused some inconvenience to the patient’s life, it did eliminate sleep apnea and save many patients’ lives!
Despite the success of the medical field in treating sleep apnea, the life-changing ills of tracheotomy inspired Colin Sullivan, a professor of medicine at the University of Sydney, who invented the Circulatory Normal Pressure Meter (CPAP), which has become the latest first-line treatment device.
In the late 1970s, Sullivan went to the University of Toronto in Canada to help a sleep researcher study the breathing control of dogs during sleep, which included trachea making and losing experimental gas to dogs. When he returned to Australia, he designed a mask that could be worn around the dog’s nose to treat snoring.
‘I’ve met a human patient who, when he was scheduled to have a tracheotomy, was so eager to know if there were any other effective treatments, ‘ Mr. Sullivan said, ‘and it was his words that inspired me to try to modify the dog mask for use in human patients.’
He made a plaster model of the patient’s nose and a fiberglass mask, which could be attached to the mask. The mask’s blower comes from a vacuum cleaner and the headband comes from the ribbon structure inside the bicycle helmet, which is the circulating normal barometer he invented. In 1981, Sullivan published a study that said he and his colleagues used a circulatory pressure gauge on five patients, which showed that the device could completely avoid obstruction of the upper respiratory tract.
Sullivan patented the circulating positive barometer, after years of research and development upgrades, the latest circulating positive barometer can be used outside the laboratory, more convenient for sleep apnea patients, millions of people are now using the cycle positive barometer.
“25%-50% of sleep apnea patients give up the cycle normal barometer for one year! “
But as more and more patients are being treated and the cycle barometer technology is constantly being improved and upgraded, patient data can now be automatically uploaded to the cloud platform for analysis, however, doctors have found that the instrument’s primary treatment is often ineffective.
Electronic chips can track the length of the mask, and doctors eventually find that many patients don’t wear it at all. A 2012 New York Times report found that the cycle press is like some boring sci-fi movie device: big, double-stupid, and seemingly annoying, and research shows that 25 to 50 percent of people with sleep apnea stop using it for a year.
“I really felt a lot more comfortable the first night i was wearing a cycle press, and I woke up refreshed, refreshed and more energetic,” Stenberg said. However, the positive effects of the device gradually decreased, and there was no significant effect in using it outside the laboratory. The device is continuous lying, meaning that when you breathe there will be air into the mouth, when you exhale there will be air into the mouth, repeatedly, will make people feel uncomfortable, sleep ingress with this mask, even if the eyes are closed, the mask around the air will leak out, blowing the eyes dry pain. “
‘When I sleep with a circulating press, I often wake up in the middle of the night and pull the mask off involuntarily, and I go back to the Sleep Medical Center to check the device’s monitoring data,’ Stenberg said. ‘Shivs just debugs the pressure settings or encourages me to try other masks, and obviously I’m a regular, and the device doesn’t have a significant therapeutic effect.’
In the face of Stenberg’s repeated questioning, Schiffs eventually said angrily, “If you lose 30 pounds, these problems will go away!” “
While it’s possible to have sleep apnea in normal-sized people, the likelihood of obesity doubling, Stenberg says, was 1.79meter tall and weighed 68kg when I graduated from college, and by 2009 I had weighed 95kg. So since 2010, I decided to lose weight, I set a goal – to lose 13.5 kg, and finally I achieved my weight loss goal, by December 31, 2010 I lost 80.7 kg.
‘It turned out that I mistook my weight loss triumph for a healthy one, my weight bounced back, i gained 13 kilos over the next decade, and sleep apnea flared up again until I had a spinal surgery in the summer of 2019 to realize that there was a health crisis after my weight rebound,’ he said.
The issue of snoring and fatigue is important, and despite medical science’s efforts to spread common knowledge about the issue, most sleep-snoring people realize that the phenomenon seriously affects their health. In 2017, a German study showed that while 40 percent of adults had sleep apnea, only 1.8 percent were hospitalized, which may have been linked to a lack of awareness of a health crisis.
Weight loss is the most effective treatment, the problem is, many people can’t!
According to a study in the New England Journal of Medicine, one in four people with selective surgery in the United States have sleep snoring and apnea, and for some groups, the proportion is even higher, such as 80 percent of patients treated for obesity, who suffer from sleep apnea and have a health crisis.
The study authors note that patients with sleep apnea have a significantly higher risk of lung complications and need intensive care services after plastic surgery or general surgery, which significantly increases medical costs.
‘I was diagnosed with sleep apnea and losing weight can significantly improve,’ Stenberg said in a preoperative questionnaire. Instead of being treated in a sleep center, I was not treated at the sleep center, but with a device used at home, the doctor instructed me how to tie a sensor belt to my chest, put a pulse blood omemeter on my finger, and wear a clip under my nose to monitor my breathing, but there was no electroencephalometer monitoring device in the home, and there was a drawback to the tests in which the device was not high – the device was not high in accuracy, and the monitoring device was not sure if I was in deep sleep.
Nevertheless, reducing diagnostic costs and reducing the inconvenience of analysis offer hope for more people to be diagnosed with sleep apnea, after laboratory-based multi-conductive sleep map analysis costs and long-term time were considered to be a major cause of lower diagnostic rates.
‘I found myself suffering from moderate sleep apnea and the anesthesiologist advised me to lose 5kilo pounds when i was anaesthetized,’ Stenberg said. Professor Philip Smith, a medical expert at Johns Hopkins University, said: “Losing weight is the most effective treatment, but the problem is that many people can’t. “
In addition, many people can not use the circulatory normal pressure meter, many sleep apnea patients have difficult to diagnose the phenomenon, so in the past 20 years, a number of treatment options have been introduced.
In the mid-1990s, a dental device was introduced by people who could not use a circulating normal barometer. Dentist David Turok said: “Obstructive sleep apnea occurs behind the mouth, and when your tongue doesn’t have enough space in your mouth, it blocks the airways, and the circulating press is used to force the air to sink, preventing the tongue from blocking the airways, an oral orthosis that moves the jaw forward and the tongue forward.” One can imagine it as a stent, with the upper jaw teeth acting as anchors, pushing the jaw teeth forward, widening the airways behind the throat. “
Like the circulating positive barometer, the oral orthosis is an imperfect solution, it will be fixed to the chin in an uncomfortable position, long-term use will change people’s oral bite, so that the chin protrudes forward, at the same time, the pressure of the oral orthosis will slightly change the position of the teeth.
“But these patients are mild to moderate, and for patients with severe sleep apnea, circulatory normalizer is the preferred choice for patients with severe sleep apnea,” he said. For those who do not adapt to a circulating normal or oral orthosis, the surest way to address sleep apnea is jaw lift surgery, which is a better procedure than expanding the soft tissue of the throat. In contrast, jaw-lift surgery involves bone healing rather than soft tissue healing, which is easier to achieve, but it also has some drawbacks, such as the need to break two jaw bones and the need to stitch the mouth after surgery. “
In addition, an under-tongue nerve stimulator (HNS) can be used to prevent people from shrinking back when they sleep. Circulating positive barometer is the recommended first-line therapy in the medical field, but the specific treatment needs vary from person to person. Although obstructive sleep apnea is considered a single condition, it is caused by a variety of causes, such as throat structure, muscle tension, obesity, etc., so there is no “one-size-fits-all therapy” for patients. We have some very effective treatment options, but there are some drawbacks, the key to treatment is to fully understand the patient’s condition, to provide appropriate treatment.
We still have a long way to go to perfect treatment, and it is hoped that a pill with significant efficacy will be developed in the future.
Neurochemical therapy is the most promising of the future, with scientists now using neurochemical methods to treat apnea in mice, and perhaps in the next 5-10 years, people will be able to use neurochemical drugs to treat sleep apnea, a condition that involves neurochemical processes in the human body. It’s not all about obesity, it’s not that fat compresses the airways, it’s that fat secretes certain hormones and causes the airways to collapse. “、
Sleep apnea is caused by the combination of obesity and hormones in the body, and in recent years, experts have been studying the phenomenon of fat cells secreting hormones.
At the same time, some therapies are expected to enter human clinical trials, with a 2017 paper noting that dronabinol is a synthetic cannabis substance that is “safe and well tolerated” and reduces the severity of sleep apnea compared to placebos. Instead of solving the cause, the circulatory barometer is the brain and nerve tissue that controls the upper respiratory muscles, altering the neurotransmitters that the brain communicates with the muscles.
In addition, there are promising therapies, a small international double-blind test (which the subjects and subjects were not aware of) and found that the combination of atomoxetine and oxybutynin drugs would significantly reduce apnea and reduce airway obstruction by 50% in all subjects during sleep. But for patients with severe sleep apnea, it will take a long time to wait for the drug therapy to actually go into clinical testing.