Sleep disturbance is one of the most common complaints found in patients who visited the doctor. It is estimated that each year 20% -40% of adults have difficulty sleeping and 17% of them in serious trouble.The prevalence of sleep disorders tend to increase every year, it is also in accordance with increasing age and various causes. Research shows that sleep disorders increase the incidence of various diseases kardioserebrovaskuler. This is mainly related to disturbances in breathing during sleep (sleep disorder breathing).
Breathing disorders during sleep
There are 2 kinds of breathing patterns during sleep disturbance, ie Hypoapnea and apnea. Hypoapnea characterized by airway narrowing 50% -80% for more than 10 seconds and a decline in oxygen saturation of more than 3%.
While sleep apnea is characterized by the narrowing of the airways more than 80% for more than 10 seconds and a decline in oxygen saturation of more than 3%.
There are three types of sleep apnea is central sleep apnea, upper airway obstructive apnea, and forms a mixture of both.
Sleep apnea is a breathing disorder that occurs during sleep, which lasted for more than 10 seconds. Pathological sleep apnea say if the patient experienced episodes of apnea, at least five times in one hour or 30 episodes of apnea during the night. These periodic movements during chest and abdominal wall is very dominant.
Central apnea is common in old age, characterized by intermittent reduction in respiratory capacity due to decreased oxygen saturation. Central apnea is characterized by cessation of airflow and respiratory effort during sleep periodically, so that the movement of the chest and abdominal wall disappeared. It is possible damage to the brain stem or hiperkapnia.
Upper airway obstructive during sleep characterized by increased respiration during apnea, increased effort and chest muscles with the aim of the abdominal wall to force air in through the obstruction. This more severe disruption if the REM phase. Respiratory disorders are characterized by gasping for breath or snoring during sleep.
Snoring is a sound place 3-6 times and then disappeared, and repeated every 20-50 seconds. Apnea attacks when the patient does not snore. As a result of hypoxia or hipercapnea, causing more active respiration is activated by the formation retikularis and medullary respiratory center, with the result that the patient awake and respiration back to normal reflexes.
Both at the central or obstructive apnea, the patient is often awakened repeatedly at night, which is sometimes difficult to fall asleep again. These disorders are often characterized by headache or feeling uncomfortable in the morning. In children is often associated with congenital respiratory disorders. In the adult respiratory obstruction septal defect, hypothyroidism, or bradikardi, heart disorders, hypertension, and stroke.
OSA (obstructive sleep apnea) and stroke
Obstructive sleep disturbance is one form of stroke risk factors are new. Recent studies Dräger (2007) showed no increased risk of stroke by 2.52 times in people with sleep apnea. It is also associated with increased risk of hypertension in OSA patients.
OSA is often found in stroke patients who managed to live, as much as 63% of those who survive, having this disorder. More evidence has shown the existence of a causal link between sleep apnea and stroke.
Excessive fatigue during the day associated with sleep apnea can affect the results of post-stroke recovery. Excessive fatigue during the day can reduce the ability and motivation of stroke patients to continue to run the recovery program. As a result, training for recovery is not done regularly, inhibition of recovery and the results will be much worse.
How to handle?
Before looking for diagnosing the cause of a sleep disturbance, should be determined beforehand danlamanya type of sleep disturbance (duration of sleep disorder), by knowing the type and duration of sleep disturbance. In addition to helping identify the cause also can provide adequate treatment.
The diagnosis of sleep disorders facility established in the Laboratory-Based Treatment Overnight Sleep Study (Polysomnography Complete). The medical team will formulate guidelines appropriate measures the degree of sleep disturbance, patient selection, overall health status, and patient expectations.
