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Exercises To Completely Cure Snoring Summary

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Snoring and Obstructive Sleep Apnea

Snoring is extremely prevalent but is also the most common symptom of obstructive sleep apnea. OSA occurs when the upper airway collapses during sleep, leading to obstruction, hypoventilation, and hypoxemia. OSA has been associated with development or exacerbation of hypertension, coronary artery disease, pulmonary hypertension, poor concentration, impotence, obesity, depression, and increased risk of motor vehicle crashes. It is a potentially serious medical condition that can be overlooked if not specifically sought. Men have OSA more than women, and children can also be affected. Adults with OSA are often overweight or stocky. They are told that they snore loudly, and episodes of respiratory obstruction or gasping might be witnessed by a family member. Symptoms of OSA include loud snoring, daytime fatigue, morning headache (secondary to hypoxemia), restless sleeping habits, and frequent catnaps (often unintentionally, sometimes while driving). Strong suspicion of sleep apnea should...

Snoring

An important problem often associated with heavy snoring is obstructive sleep apnea. Many affected patients are overweight and have a history of excessive daytime sleepiness. A bed partner may describe the patient as at first sleeping quietly then a transition occurs to louder snoring, followed by a period of cessation of snoring, during which time the patient becomes restless, has gasping motions, and appears to be struggling for breath. This period is terminated by a loud snort, and the sequence may begin again. It is common for patients with sleep apnea to have many of these episodes each night.

Acu Points to Soothe You to Sleep

If you can't sleep on your back, then we suspect excess condition of lungs or heart if you can only sleep on your back with outstretched arms, excess heat sleeping on your stomach would indicate a deficiency, possibly of the stomach on your side points to deficient Qi or blood. Snoring which affects 25 percent of men and 15 percent of women is characterized by excess phlegm of the stomach channel. For all of these conditions, I've found that acu-points and or Chinese herbal medicine bring great relief.

Obstructive Sleep Apnea

Habitual snoring, which is more common in males than in females, occurs in 6 to 12 percent of children and 5 to 20 percent of adults. OSA has a prevalence of about 1 percent in children, 2 percent in adult women, and 4 percent in adult men. 17' , '18 Clinical Features and Associated Disorders. The usual presenting symptoms are snoring, excessive sleepiness, daytime sleep episodes, and a sense that sleep is not restful. Morning headaches, frequent nocturnal urination, and nocturnal restlessness are also common. Some patients have no complaints and present only because the bed partner has noted periods of apnea. Others are referred because of a suspicion that OSA contributes to headaches, pulmonary or systemic hypertension, cardiac arrhythmias, or impotence. Loud snoring, sometimes exceeding 90 dB, occurs in more than 80 percent of patients and usually begins years before the onset of sleep apnea. Some patients report that they cannot go on camping trips...

Mecanism Of Centripetal Lipid Accumulation Supraclavicular Fat And Face

Hypersecretion of GH is related to a somatotroph adenoma in 98 of cases. Approximately 20 of GH-secreting adenomas also secrete PRL. Other causes include excess GHRH from a hypothalamic hamartoma or choristoma, or from ectopic production (i.e., bronchial carcinoid, pancreatic islet cell tumor, or small-cell lung cancer). Hypersecretion of GH leads to the clinical syndrome of acromegaly in adults and gigantism in children. Acromegaly is characterized by an enlarged protruding jaw (macrognathia) with associated overbite enlarged tongue (macroglossia) enlarged, swollen hands and feet resulting in increased shoe and ring size coarse facial features with enlargement of the nose and frontal bones and spreading of the teeth (Table 6-1). Musculoskeletal symptoms are a leading cause of morbidity and include arthralgias leading to severe debilitating arthritic features. Skin tags hyperhidrosis (in up to 50 of patients), often associated with body odor hirsutism deepening of the voice...

Nasal Congestion Had Enough of the Stuff

When your sinuses are inflamed, it feels like your whole face hurts. If you tap on your forehead or just under your eyes and feel pain, you probably have an infection. You may also experience further unwanted symptoms such as low-grade fever, headache (often described as splitting) difficulty breathing through your nose, loss of smell, and yellow or green nasal discharge. (Yum, yum.) Unfortunately, that gunk may also be draining down your throat, creating a sore throat, nausea, snoring, or a cough.

Nasal Congestion and Cough

Do not underestimate the impact of nasal congestion, especially if it is chronic and associated with snoring and sleep disorders. Rest, fluids, humidified air, nasal saline, and acetaminophen are the mainstays of therapy for the common cold. Recommend avoiding irritants and known allergens, raising the head of the bed at 30 to 45 degrees. Nasal strips might be helpful.

History and Geography

Yet a number of older reports in the medical literature of the Philippines have identified a sudden nocturnal death syndrome known as Bangungut. Previously healthy males die during the night, making moaning, snoring, or choking noises. Bangungut means to rise and moan in sleep in Tagalog, reflecting the folk belief that the deaths are caused by terror from nightmares. The victims are men 20 to 50 years old. No consistent cause has been found for these sudden deaths, even though they have been extensively evaluated with autopsies. The main postmortem finding is hemorrhagic pancreatitis, a condition most observers believe is not a cause of the syndrome but, rather, an effect after death.

Review of Systems and Examination of the Young Child

A child 1 to 5 years of age is becoming verbal and, if in pain, can tell you where it hurts. They may start to report nausea, sore throat, chest pain, fatigue, or headache. Note that headache in a preschool child is unusual and probably indicates a serious intracranial pathologic process. Other questions to add to the infants' review of systems include questions about snoring and loss of bowel or bladder control in a child who has been toilet trained. Most children have achieved daytime control by 4 years of age, although only about half of children are dry at night by then. Restless sleep, including nightmares, night terrors, and sleep walking are not uncommon at this age.

Review of Systems and Examination of the Older Child

School-aged children may have chronic somatic complaints such as headaches, stomach pain, or leg pains which often have a partly emotional basis. A good history of the circumstances in which these complaints occur can help you tease out the triggers. Other items to add to the review of systems for children aged 6 to 12 years include persistent sneezing and nasal itching, itchy eyes, snoring, disturbed sleep, daytime somnolence, chest pain, exercise-induced cough or wheezing, nocturnal cough, palpitations, polyuria, polydipsia, syncope, persistent sadness or worry, sports injuries, and concussion.

Disorders of Breathing

Sleep apnea may be obstructive or central in origin, or a combination of both. The effects of recurrent apnea extend well beyond simple fatigue or sleep deprivation, causing significant cardiovascular and neurologic disease. Patients with obstructive sleep apnea are often but not always obese. They experience episodes of intermittent apnea, often associated with snoring, especially during deeper stages of sleep. In addition to obesity, adenoidal or tonsillar enlargement, mac-roglossia, and laxity of the soft palate and pharyngeal tissue can contribute to sleep apnea. Stroke, brain tumors, trauma, cerebral edema, and other CNS disorders can affect breathing at the central level as well. Brainstem infarctions can lead to respiratory arrest and death. Cheynes-Stokes respirations describe an undulating pattern of breathing of increased depth and frequency alternating with waves of shallow, slower breathing and even apnea. Many patients with obstructive sleep apnea have elements of central...

Monitoring Of Respiratory Function

When combined technique of light general anesthesia, regional anesthesia, and sedation is used, a pulse oximeter is mandatory, especially in patients with a history of sleep apnea or snoring, significant obesity, and orofacial or neck disturbances. The pulse oximeter can determine the moment when the O2 saturation falls. To prevent this undesirable situation, respiratory rate interval monitoring can be used to detect the effect of opioids on the respiratory center. Apnea alarms are also useful if breathing is not detected over a predetermined period of time. A breath interval varies between 0.9 minute and 1.4 minutes and is a useful and reproducible method of monitoring the duration of opioid effect in anesthetized patients who can breathe spontaneously when surgical stimulation is not affecting the CNS. These data can provide information on the duration of action of fentanyl and can help to determine the correct dosage.123

Associated Medical Findings

The physical examination in a patient with a suspected sleep disorder focuses on several features. To assess for physical abnormalities associated with obstructive sleep apnea, particular attention is directed toward examination of height, weight, and blood pressure. Abnormalities of the upper airway, including enlarged tonsils, tongue, or low palate, can indicate possible airway obstruction. A reddened uvula and palate may be associated with loud snoring. Retrognathia and a small pharyngeal opening may also be seen in patients with sleep apnea.

Neurological Examination

Specific attention to pontine cranial nerve function (trigeminal, abducens, facial, and vestibulocochlear) are essential. Bulbar dysfunction in the form of dysphagia, hoarseness, and dyspnea can occur in neuromuscular disorders and myopathies. In checking for the gag reflex, the upper airway can be examined, and a reddened palate and uvula are suggestive of snoring.

Obstructive Sleep Apnea Syndrome

Habitual snoring occurs in 3 to 12 of preschool-age children. The childhood incidence of obstructive sleep apnea syndrome (OSAS) is estimated to be 2 . The American Academy of Pediatrics has published an evidence-based guideline for the diagnosis and management of OSAS (AAP, 2002). In children, OSAS is most often associated with large adenoids and or tonsils, as well as specific facial features such as micrognathia, macroglossia, and Down syndrome. Unlike adults with sleep apnea, children can be affected without large drops in blood oxygen levels, because children can have frequent brief awakenings to quickly reestablish their airway. Thus, the primary clinical issue may be sleep fragmentation. In the context of a child with snoring and restless sleep, OSAS should be considered any time there are symptoms or signs suggesting sleep deprivation, such as difficulty paying attention, emotional lability, partial arousals during the night (night terrors, sleepwalking), or difficulty waking...

Basic Principles and Technique

Disorders of sleep are common and often respond well to treatment. Polysomnography is important in diagnosing and characterizing such disorders. It involves recording the EEG on two or a few channels to characterize the stage of sleep while recordings are also made of eye movements, mentalis muscle activity (chin EMG), electrocardiogram, respiration, and oxygen saturation. Respiratory movements are recorded by measurement of air flow through the nasal passages and the mouth using thermistors and by recording thoracoabdominal excursions with surface electrodes. Oxygen saturation is measured using an ear oximeter. A microphone can be taped to the face to record snoring.

Adenoid Hypertrophy

Adenoid hypertrophy is common in children. If identified in an adult, adenoid hypertrophy could indicate a lymphopro-liferative disorder or HIV infection. The patient may present with nasal symptoms or symptoms of eustachian tube dysfunction. In the pediatric population, adenoid hypertrophy causes chronic or recurrent nasal obstruction, rhinorrhea, snoring, cough, or otitis media. The diagnosis is usually clinical but can be confirmed with lateral neck radiograph. If symptoms are severe or persistent, adenoidectomy is indicated improvement is usually dramatic.

The pharynx

Tonsillectomy can also be used in the surgical treatment of snoring. Significant debilitating snoring, which can lead to extreme social distress, is related to obesity and, in some cases, tonsillar hypertrophy. Most surgical procedures for snoring involve modification and stiffening of the soft palate. The uvulopalatopharyn-goplasty (UPPP) operation involves palatal shortening and tonsillectomy. However, there is no good evidence that snoring surgery is beneficial, as results are often poor and snoring recurs within 2 years of successful surgery in 60 of patients. Snoring alone is not an indication for tonsillectomy.

Clinical

Continuous direct observation of the colour of the patient and movement of the chest and the reservoir bag in the breathing system is essential for safe anaesthesia. Both anaesthetic agents and opioids are potent depressants of respiration and hypoxic brain damage can occur in a few minutes. In cases where the patient is breathing spontaneously, constant observation is needed to detect tracheal tug, paradoxical chest movement and failure of the reservoir bag to move, indicating partial or complete airway obstruction. Free passage of air may also be confirmed by listening for the gentle sigh of clear airflow or feeling the warmth of expired air. Snoring, rattles or complete silence indicate impending or actual airway obstruction. Maintaining a clear airway in an anaesthetized patient is a skill requiring much practice, constant attention to detail and strong forearm muscles. Periodic auscultation of the chest confirms the position of a tracheal tube, detects any cumulation of...

Sleep Disorders

Sleep apnea may cause severe oxygen desaturation, pulmonary hypertension, and is associated with causing hypertension, stroke, and myocardial infarction. Patients often complain of poor concentration, memory impairment, malaise, and disinterest. A polysomnagram is indicated when the rehabilitation team observes a hypersomnolent, confused, and snoring or apneic patient. More than 5 apnea episodes per hour or 30 per night is abnormal. One study found an average of 52 sleep-disordered breathing events per hour in selected subjects within 1 year of stroke.268 The number of oxygen desaturation events and the oximetry measures during sleep disordered breathing have correlated with BI scores at 1 and 12 months after stroke.269

Sleep Apnea

The sleep apnea syndrome is a potentially disabling condition characterized by excessive daytime fatigue or sleepiness, disruptive snoring, episodes of upper airway obstruction during sleep, and nocturnal hypoxemia. During sleep, the pharynx repeatedly collapses. The patient Does your snoring bother other people '' The presence of snoring, sleepiness, and tiredness are suggestive of sleep apnea.

Manifestations

The patient might exhibit an allergic salute, an upward thrust of the palm against the nares to relieve itching and open the nasal airways and a gaping expression from mouth breathing. Allergic shiners or Dennie's lines are wrinkles beneath the lower eyelid. Speech can have a nasal quality. In children, nasal irritation can result in nose picking and recurrent epistaxis. Sleep disruption is often associated with nasal obstruction and mouth breathing. Patients might have sleep apnea-like symptoms, including restless sleep, snoring, or nighttime coughing, associated with postnasal mucus drainage and mild hoarseness. The nasal mucosa is typically moist, with enlarged, pale turbinates and serous discharge. Because the sense of smell is impaired, appetite may be decreased. Maxillomandibular alignment problems (overbite or underbite) result from chronic symptoms.

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