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What about Snoring? “我与你最近的距离，是隔着一个房间我还能听到你的打呼噜
What you need to know
Do you snore when you sleep? Snoring is generally treated as a topic of humor in most conversations. Despite the humor, snoring is not a joke and may represent a serious health condition.
Snoring is a very common sleep phenomenon. Snoring is caused by turbulent air flows and can be very loud in some individuals. It usually occurs during inspiration, but can also occur during expiration. Habitual snoring is common, occurring in 44 percent of males and 28 percent of females who are between 30 and 60 years of age. Vibrations caused by the secretions from the pharynx mucous membrane can create abrupt and unusual noises. When the airflow of upper respiratory tract is passed from the nasopharyngeal cavity, leading to the epiglottis (including pharyngeal palatal arch, uvula, soft palate, palatal tonsil, etc.) a wide range of “snoring” can occur.
Generally speaking, snoring below 60DB is normal, and above 60DB is defined as potentially serious. Mild snoring does not cause obvious symptoms of hypoxia. It is important to recognize the health conditions associated with snoring so that objective testing can be performed and treatment initiated. Heavy people can experience obstructive sleep apnea and this can be dangerous. Snoring loudness more than 80DB is often seen with patients with apnea and hypoxia. These persons do not get a good rest from their sleep and they prevent others around them from resting. Disruption of the bed partner's sleep may also be a significant problem that can cause the bed partner to have daytime sleepiness and lead to significant marital dissatisfaction. Let us discuss "obstructive sleep apnea syndrome" further.
Clinically, obstructive sleep apnea syndrome can be divided into three types: central, obstructive and mixed. Of these, the “blocking type” with upper airway narrowing is the most common. Obstructive sleep apnea syndrome can result from narrowing or blockage of any anatomical part of the upper respiratory tract. Therefore, the etiology of obstructive sleep apnea syndrome mostly revolves around the obstruction of the nasal cavity, nasopharyngeal cavity and throat.
Contributing factors for snoring include obesity which increases the burden on the respiratory and circulatory system. After falling asleep muscle tone is low, thus narrowing the pharynx, which leads to sleep apnea. As snoring can be a marker of pathologic upper airway narrowing, progression of snoring to obstructive sleep apnea (OSA) is of clinical importance. While rates of progression have not been well studied prospectively, the available evidence suggests that progression is very likely with weight gain.
Other nasal problems such as nasal septum deviation, nasal swelling, adenoid hypertrophy, throat problems (tonsils hypertrophy, soft palate hypertrophy), oral lesions, and other systemic lesions that can cause sleep apnea. Medical attention is needed to properly diagnose and find effective treatments.
Obstructive sleep apnea tends to occur at any age and can occur in both men and women. It can have a variety of symptoms. For adults, daytime symptoms such as drowsiness, fatigue, excessive sleepiness, headache, dizziness, memory loss, low work efficiency can be significant clues for obstructive sleep apnea. Nocturnal symptoms are usually noted as loud snoring and apnea, mouth breathing, sleep irregularities, night sweats, and even suffocation.
Without medical or surgical correction, long-term snoring can induce hypertension, heart disease, angina pectoris, and cardiac arrhythmias. These diseases can be serious and life-threatening.
Snoring adults may experience many minor health issues including complexion changes to a bitter yellow tone, rough skin texture, obesity, bad breath, bitter mouth, black eyes, and menstrual irregularities in women. For teenage children: sleep snoring and mouth breathing can lead to a "adenoidectomy face", inattention, affect the child's normal growth and study abilities.
People who are experiencing significant snoring should be seen for medical consultation. Having a comprehensive body check is needed. Receiving a specialized ENT specialist inspection is important. That evaluation should include sleep apnea monitoring. It is critical to assess whether there is sleep apnea hypopnea syndrome, determine the cause, and classify its severity. In order to provide healthy long term health benefits, severe cases may need surgery to thoroughly solve the problem.
Most cases of snoring with sleep apnea will not require surgery but can be treated with other medical interventions. Conservative therapies include smoking cessation, weight loss, alcohol avoidance several hours before bedtime, and sleeping in the lateral position. Other medications or devices may be needed but the good news is that effective treatment is available. Effective treatment will bring health benefits to the snorer and lots of relief to those who enjoy a much quieter night’s sleep.
“我与你最近的距离，是隔着一个房间我还能听到你的打呼噜声”
这不是玩笑，这是生活中真实的写照。
打鼾，是一种普遍存在的睡眠现象。鼾声，是睡眠期间上呼吸道气流通过时冲击咽粘膜边缘和粘膜表面的分泌物引起振动而产生的声音。起始部位是鼻咽腔，直达会厌（包括咽腭弓，悬雍垂，软腭，腭扁桃体等）。一般来说，60DB以下的鼾声属于正常现象，响度超过60DB以上，妨碍上呼吸道呼吸气流通过，影响他人休息时，就可以定义鼾症。鼾症较轻者，不引起明显的缺氧症状。重者可出现憋气，鼾声响度超过80DB，患者伴有不同程度的缺氧,我们可以称之为“阻塞型睡眠呼吸暂停综合征”。
临床上阻塞型睡眠呼吸暂停综合征可以分为三型：中枢型，阻塞型和混合型。其中，阻塞型最常见。上呼吸道任何解剖部位的狭窄或堵塞，都可导致阻塞型睡眠呼吸暂停综合征。所以，阻塞型睡眠呼吸暂停综合征的病因大多围绕着鼻腔，鼻咽腔，咽喉部位的阻塞问题而引起。比如，肥胖，脂肪蓄积过剩，会增加呼吸和循环系统的负担，入睡后肌张力低下，因而咽腔狭窄缩小，从而导致睡眠呼吸暂停。还有鼻部问题（鼻中隔偏曲，鼻腔肿物，腺样体肥大），咽喉问题（扁桃体肥大，软腭肥厚），口腔病变，以及其他全身性病变，均会引起睡眠呼吸暂停。
阻塞型睡眠呼吸暂停综合征好发于任何年龄，男女均可发病。
围绕“缺氧”，在不同人群中出现各种症状。
成人：白天症状：困倦疲劳，过度嗜睡，头疼头晕，记忆力减退，工作效率低下。
夜间症状：大声打鼾，呼吸暂停，张口呼吸，睡觉不踏实，盗汗，甚至窒息等。
长期睡觉打鼾容易诱发高血压，心绞痛、心律失常等疾病，严重者更有生命危险。
打鼾的女性：会造成面色苦黄、皮肤粗糙、肥胖臃肿、口臭口苦、眼周发黑，月经不调等。
青少年儿童：睡眠打鼾，张口呼吸会导致“腺样体面容”，注意力不集中，影响孩子正常的生长发育及学习。
因此，长期睡眠打鼾的人，应该及时到医院进行咨询，必要时需进行详细的全身检查和耳鼻喉专科检查，例如睡眠呼吸监测，评估是否存在睡眠呼吸暂停低通气综合征，并判断病因，分型及严重程度，以便进一步治疗，严重者可能要进行手术才能彻底解决问题。手术的原则主要是围绕“解决阻塞层面”而进行。
Yana WANG
MD, ENT Physician
Dr. Wang has nearly 20 years of clinical ENT experience. She specializes in the diagnosis and treatment of acute and chronic tonsillitis, adenoid hypertrophy, vocal cord mass, allergic rhinitis, rhinitis, sinusitis, nasal mass, otitis media, obstructive sleep apnea syndrome in children and adults, deafness and tinnitus and other related diseases. And she specializes in the diagnosis and surgical treatment of chronic tonsillitis in children and adults, adenoid hypertrophy in children, otitis media, nasal and sinus surgery under nasal endoscope, and snoring in adults and children. Dr. Wang has independently completed tens of thousands of large and medium-sized surgeries and has taught quality control work for many years.
Dr. Wang has published several papers in core journals and participated in the completion of a number of projects, among which she has won multiple awards in the Tianjin area for her medical, science and technology achievements. Dr. Wang served as the youth committee member of the laser branch of Tianjin Medical Association and the standing committee member of the youth physicians committee of Tianjin association of anti-aging.
王亚娜耳鼻咽喉科医生、主治医师
王亚娜医生2003年毕业于天津医科大学，在加入天津和睦家医院前，曾在天津市公安医院耳鼻喉科工作，期间多次参与国内学术会议。
王医生具有近20年的临床工作经验，专注于包括急慢性扁桃体炎、腺样体肥大、声带肿物、过敏性鼻炎、鼻炎鼻窦炎、鼻腔肿物、中耳炎、儿童及成人阻塞性睡眠呼吸暂停综合征、耳聋耳鸣等相关疾患的诊治。王医生擅长儿童及成人慢性扁桃体炎、儿童腺样体肥大、中耳炎，鼻内镜下鼻腔及鼻窦手术，成人及儿童鼾症的诊断及手术治疗，独立完成各类大中型手术上万例。王医生担任科室带教工作及质控工作多年。
王医生曾于核心期刊发表论文数篇，参与完成多项课题，其中获两项天津市科技成果奖。王医生曾获公安局个人三等功一次，获得天津市公安局嘉奖多次，并获得天津市优秀公安青年称号。王医生还任天津市医学会激光分会青年委员、天津市抗衰老学会中青年医师专委会 常委等相关职务。
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