The apnoea is an apnoea. Different diseases (the asthmatic status, whooping cough, pneumonia), a hyperventilation of lungs at overbreathing, poisoning with some toxic substances can become the reason of the termination of respiratory movements. Also sometimes mean any breath holding by the term of an apnoea. Conscious breath holding is base of all theory and practice of diving without the special respiratory equipment. The person is one of the few mammals capable to a conscious apnoea.
Unexercised people are capable to hold the breath for a while up to 30-40 seconds. The diver practicing diving sometimes is capable not to breathe 5-6 minutes.
Most the particularly important for medicine becomes today a syndrome of an apnoea which is characterized by apnoeas in a dream. Can be the cause of this state or narrowing of respiratory tracts during sleep, or disturbances of regulation of breath by structures of the central nervous system.
At an obstructive apnoea in a dream the stomatopharynx is fallen down under the influence of negative pressure in respiratory system at a breath. The apnoea in a dream is followed by the breath termination on average for 20-30 seconds though sometimes this interval increases up to 3 minutes. Such episodes can repeat to several hundred times in a night and every time of people for a moment wakes up. The contributing factors to an apnoea in a dream at adults are adenoides, anomalies of bones of a skull in a front part, a macroglossia, an acromegalia and giantism, nervous and muscular diseases, and hypofunction of a thyroid gland. But the majority has patients no of these diseases, and alcohol intake and obesity becomes the reason of obstruction. Alcohol reduces a tone of muscles of a throat, especially at a combination to chronic cold and inborn narrowness of a stomatopharynx.
Apnoea are a cause of infringement of a dream and air hunger at night. The clinical picture of a disease at adults is usually presented by day drowsiness, a memory impairment, decrease in intelligence, pulmonary hypertensia, disturbances from heart, interruptions of a heart rhythm, increase in arterial pressure, a hyperglobulia. At adults and children the heaviest complication of a syndrome of an apnoea is the full apnoea, disturbances of a heart rhythm and death of the patient.
Sometimes patients do not know a long time about a problem as they after morning awakening of reminiscence of an apnoea in a dream are absent. Close relatives can tell such patients about apnoea episodes at night. The clinical picture of a syndrome of an apnoea accrues slowly therefore many connect complaints with the general aging of an organism or other reasons. It is possible to suspect an apnoea syndrome at a combination of snore and day drowsiness. Observation of the patient in a dream can confirm the diagnosis. However the somnografiya is considered a reference method of diagnosis. During the research the electroencephalogram, an electromyography and registration of the movements of eyes in the constant mode are carried out. The additional equipment allows to monitorirovat concentration of oxygen in blood during a dream. Indications to this expensive inspection can be considered: the expressed drowsiness during the day, pulmonary hypertensia, a hyperglobulia. At already made diagnosis of an apnoea the somnografiya allows to carry out assessment of efficiency of the carried-out therapy and to pick up the breath mode under constant positive pressure if necessary.
In simple cases treatment of a syndrome of an apnoea consists of decrease in body weight to norm, refusal of alcohol, treatment of chronic cold. All patients are recommended to sleep on one side. Selecting treatment of an apnoea, it is necessary to estimate risk factors and whenever possible to exclude their influence. In hard cases patients are hospitalized for inspection and selection of tool treatment.
Efficiently therapies mask breath under constant positive pressure by means of the special device is considered most. Of course, it is difficult to most of patients to get used to inconveniences of such treatment of an apnoea. A part of patients is strongly disturbed by noise of the device, it is difficult to others to fall asleep with a respiratory mask on a face. The medical industry releases modern devices where the discomfort for the patient is minimized. One more direction in therapy — the mechanical fixing devices which are inserted into a mouth for promotion of a mandible forward. In exceptional extremely hard cases operation of imposing of a tracheostoma can be made for treatment of an apnoea. The indication for such intervention arrhythmia and threat of an apnoea is considered.
The apnoea occurs at children rather seldom. On the other hand, at infantile age heavy episodes of an apnoea of the mixed character which can become a cause of death of the child are possible. Fatal cases take place generally at night. More children of the first years the lives having inborn dysfunctions of the central nervous system of any expressiveness are subject to an apnoea. Parents sometimes accidentally fix disturbances of breath at the child during a night and day dream. At this moment skin color becomes cyanotic, reflex twitchings of muscles are possible, and the respiratory movements of a thorax are absent. When progressing a hypoxia the loss of consciousness develops.
Adults can give help — to wake the child, to make massage of a thorax, an artificial respiration and to call the pediatrician on the house. For prevention of an apnoea at children it is regularly necessary to air the apartment, not to overheat the child, to put the kid to bed without pillow within the first year of life. The large role is played by fight against viral diseases, breastfeeding and the child's dream in one room with mother. If at the child the apnoea episode is already recorded, it needs to be inspected carefully in the conditions of a hospital. There are special sensors of breath which establish in a bed of the baby. At a stop of respiratory movements the device gives a signal to parents. Treatment of a heavy syndrome of an apnoea at children is possible as by means of mask breath with positive pressure, and by means of medicines. In process of the child's growing, danger of developing of an apnoea and death of the child sharply decreases. Does not follow parents it is excessive to concentrate attention on breath of the baby not to provoke at itself development of a neurosis-like state and neurotization of the kid. Remember that the child can have a breath and normal superficial, accelerated or slowed down. At the healthy child about one year pauses in breath less than 10 seconds and an uneven respiratory rhythm are admissible.
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