Sleep apnea (sleep apnea), known as sleep breathing, seriously affects human health. This disease causes breathing to stop and the person to be unable to breathe during sleep. A person experiencing temporary suffocation while asleep may wake up suddenly. If it does not wake up or if the depth of sleep decreases and does not become breathing as before, it may even result in death.
An efficient sleep is not possible due to reasons such as waking up frequently or not being able to enter the deep sleep phase, and the effects of this are felt in daily life. Irregular sleep can cause you to spend the day tired, sluggish and nervous. These are the most important symptoms of sleep apnea. This disease is not incurable. If there are symptoms, it is necessary to consult a doctor first and, if the doctor deems it appropriate, to take a sleep test.
In order to detect sleep apnea, a test is performed in which many parameters are measured during sleep. This test is called polysomnography (PSG). After the test, a report is prepared. The values in this report are very important for the diagnosis and treatment of the disease. Especially the apnea hypopnea index (AHI) is one of the most important parameters for diagnosis. The AHI value is included in the sleep apnea reports issued by the physicians, as well as in the reports of the respirators used by the patients for treatment.
Today, people have difficulty understanding the disease in the first place. It is likely to be confused with other ailments. Sleep apnea has many symptoms. The most effective of these are:
- Frequent waking from sleep
- Don't forget what you did the day before
- Waking up tired
- Being sleepy during the day
These symptoms do not seem abnormal to the person, as they are often in daily life. It is thought to be temporary. For this reason, it is not easy for a person to realize that he is sick.
Sleep apnea is a syndrome disorder. Syndrome diseases are caused by the coexistence of several related or unrelated disorders. If there are symptoms, a physician should be consulted as soon as possible. It should not be forgotten that the problems experienced may cause different diseases. For the diagnosis of sleep apnea, the patient's condition is first observed by the doctor. Afterwards, sleep test (polysomnography) is performed if necessary. With this test that can be done during sleep, the patient's respiratory distress can be detected. A measurement of at least 4 hours is required.
Apnea and hypopnea numbers are determined according to the results. Apnea is respiratory arrest and hypopnea is respiratory slowdown. If the person's breathing has stopped or slowed more than five times within an hour, this person can be diagnosed with sleep apnea. The most important parameter that helps in diagnosis is the apnea-hypopnea index, briefly referred to as AHI.
As a result of polysomnography, many parameters related to the patient are revealed. Apnea-hypopnea index (AHI) is one of these parameters. It is found along with other parameters in reports issued after the sleep test. It is the most important value used in determining the disease and its severity. The AHI value is obtained by dividing the sum of apnea and hypopnea numbers by the person's sleep time. Thus, 1 hour AHI occurs. For example, if the person taking the test has slept for 6 hours and the sum of the apnea and hypopnea numbers during sleep is 450, the AHI value is 450 if the calculation is made as 6/75. In this way, the level of sleep apnea can be determined and appropriate treatment can be started.
AHI values for adults can be categorized as follows:
- Normal: AHI <5
- Mild sleep apnea: 5 ≤ AHI <15
- Moderate sleep apnea: 15 ≤ AHI <30
- Severe sleep apnea: AHI ≥ 30
Respirators such as CPAP, OTOCPAP, BPAP, BPAP ST, BPAP ST AVAPS, OTOBPAP and ASV can be used for sleep apnea treatment. The current AHI value can also be seen in the reports received from these devices.
What are the Types of Sleep Apnea?
Sleep apnea is a type of disease. It occurs for all kinds of different reasons. Although simple snoring disorder and upper respiratory tract resistance syndrome are not types of sleep apnea, sleep apnea may occur with the progression of these disorders. Types of sleep apnea can be specified as OSAS, CSAS and MSAS.
- OSAS = Obstructive sleep apnea syndrome = Obstructive sleep apnea syndrome
- CSAS = Central sleep apnea syndrome = Central sleep apnea syndrome
- MSAS = Mixed sleep apnea syndrome = Compound sleep apnea syndrome
Snoring alone is an ailment and increases the risk of heart attack. In sleep tests, if the AHI is measured below 5, if the oxygen saturation during sleep is above 90%, if breathing continues normally, if the pressure measured in the esophagus does not fall below -10cmH2O level during breathing and only snoring is in question, this is called a simple snoring disorder.
Upper Respiratory Tract Resistance Syndrome
In sleep tests, if the AHI is measured below 5, the oxygen saturation during sleep is above 90%, and the pressure measured in the esophagus during breathing falls below -10cmH2O, then upper respiratory tract resistance syndrome can be mentioned. Snoring may also accompany this. Respiration does not continue in its normal course in upper respiratory tract resistance syndrome. It's like constrained.
Obstructive Sleep Apnea Syndrome (OSAS)
In sleep tests, if the AHI is measured above 5, the oxygen saturation during sleep is below 90%, and if there is a respiratory arrest or slowing down for at least 10 seconds, obstructive sleep apnea syndrome, or obstructive sleep apnea syndrome, can be mentioned. Breathing is restricted by a blockage in the upper respiratory tract. Mild, moderate, and severe sleep apnea disease can be detected by looking at AHI and oxygen saturation parameters. In obstructive sleep apnea, there is breathing effort in the muscles of the body, but breathing cannot occur due to the obstruction.
Central Sleep Apnea Syndrome (CSAS)
Central sleep apnea syndrome is much less common than obstructive sleep apnea syndrome. It constitutes about 2% of apnea cases. It occurs because the signals that control breathing and emanating from the brain cannot reach the muscles sufficiently. Thus, breathing decreases or stops altogether. Patients with central sleep apnea wake up and remember more often than patients with obstructive sleep apnea. In central sleep apnea, there is no respiratory effort in the muscles of the body.
Compound Sleep Apnea Syndrome (MSAS)
Obstructive and central sleep apnea coexist in patients with mixed sleep apnea syndrome. It accounts for about 18% of apnea cases. First of all, the symptoms of obstructive sleep apnea are seen. When this apnea is treated, signs of central apnea occur. Compound sleep apnea syndrome can also be detected during sleep testing.