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Ночное апноэ


Ночное апноэ_2.jpgНочное апноэ представляет собой состояние, для которого характерно прекращение лёгочной вентиляции во время сна более чем на 10 секунд. Чаще у больных отмечается продолжительность апноэ 20-30 секунд, хотя в тяжёлых случаях может достигать 2-3 минут и занимать до 60 % общего времени ночного сна. При регулярных апноэ (обычно не менее 10-15 в течение часа) возникает синдром апноэ во сне с нарушением структуры сна и дневной сонливостью, ухудшением памяти и интеллекта, жалобами на снижение работоспособности и постоянную усталость. Различают обструктивное и центральное апноэ во сне, а также смешанные формы.

Причины

Процесс блокирования воздушных путей достаточно сложен. Во время сна мышцы глотки расслабляются, делая воздушные пути более склонными к спаданию. Негативное давление воздуха, создаваемое легкими в суженных дыхательных путях, может вызвать их коллапс, аналогично тому, как уплощается и спадается соломинка, если Вы зажмете один ее конец и потянете воздух на другом. При закрытых дыхательных путях дыхания не происходит и уровень кислорода падает. Для того, чтобы начать дышать снова, человеку надо кратковременно проснуться, что, в конечном счете, вызовет не приносящий отдыха сон.

Остановка дыхания во сне является потенциально опасным для жизни состоянием, сопровождающимся гемодинамическими расстройствами и нестабильной сердечной деятельностью. Дыхательные паузы продолжительностью 10 секунд при синдроме сонных апноэ вызывают гипоксию (недостаток кислорода) и гипоксемию (повышение углекислоты), стимулирующие головной мозг, что ведет к частым пробуждениям и возобновлению дыхания. После нового засыпания вновь следует кратковременная остановка дыхания и пробуждение. Количество эпизодов апноэ зависит от тяжести нарушений и может повторяться от 5 до 100 раз в час, складываясь в общую продолжительность дыхательных пауз до 3-4 часов за ночь. Развитие синдрома сонных апноэ нарушает нормальную физиологию сна, делая его прерывистым, поверхностным, некомфортным.

Симптомы

Среди симптомов ночного апноэ можно назвать:

Периодическая остановка дыхания во время сна (апноэ). Обычно тот, кто спит рядом с Вами может почувствовать периодическое затишье со стороны Вас.

Периодические приступы удушья во время сна.

Громкий, шумный храп.

Внезапное просыпание для того, чтобы возобновить дыхание.

Пробуждение в поту ночью.

Ночное апноэ_3.jpgОщущение того, будто Вы не выспались утром.

Головная боль, боль в горле или сухость во рту утром.

Сонливость днем.

Лечение

В качестве методов лечения применяются общие методы, такие как:

Снижение веса

Соблюдение гигиены сна

Снижение потребления алкогольных напитков, контроль за курением

Отказ от медикаментов, ухудшающих процессы ночного дыхания (например, успокоительные и снотворные препараты)

Воздержание от употребления вечером кофе, чая и напитков типа «кола»

Важное правило - не спать на спине, так как это повышает риск возникновения остановок дыхания во сне. Это достигается либо при помощи одевания на ночь заполненного, например, газетами, рюкзака, либо при помощи вшивания сзади в пижаму теннисных мячей. 



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