Recent studies have established a link between arterial hypertension and the presence of obstructive sleep apnea syndrome (OSA, or sleep apnea disease) in patients.
Each cessation of breathing in the syndrome of obstructive sleep apnea leads to a short-term drop in the saturation (saturation) of blood hemoglobin with oxygen. Hundreds of such stops can be observed overnight, which leads to significant oxygen starvation. So, during an episode of apnea, lasting about 50-60 seconds, there is a drop in saturation from 90% to 60% and below. For comparison, we can say that in a person who performs a volitional breath-hold, saturation decreases only by 5-7%, and then the person cannot stand it and begins to breathe.
Of course, such changes cannot pass without a trace for the body. The state of chronic lack of oxygen causes the development of arterial hypertension, since under the action of anxiety hormones released by the adrenal glands at the moments of “suffocation”, vasospasm occurs and the power of the heart increases. In addition to high blood pressure, patients complain of increased daytime sleepiness, headache, irritability, and heart rhythm disturbances. Intense attempts to breathe, which the sleeper unconsciously makes at the moment of stopping breathing, aggravate the condition and entail an even greater increase in pressure.
It has been established that both in healthy people and in patients with “usual” arterial hypertension, pressure decreases during night sleep. Arterial hypertension caused by obstructive sleep apnea syndrome has a number of features. Most often, this is nocturnal or morning arterial hypertension with a predominant increase in diastolic pressure (when measuring pressure, this is the second, “lower” figure). The second feature is that such arterial hypertension is difficult to treat with drugs.
In the presence of arterial hypertension (especially resistant to treatment), attacks of myocardial ischemia (angina pectoris), and heart rhythm disturbances at night, cardiologists should suspect obstructive sleep apnea in a patient and diagnose it. Patients should also pay attention to their well-being. If a person has a headache at night and in the morning, they feel interruptions in the work of the heart, chest pains and the actual symptoms of OSA, it is worth visiting a doctor and talking about your concerns.
computer pulse oximetry has become widespread , which allows you to monitor blood oxygen saturation (saturation) during a night’s sleep. This is a simple and affordable research method that can be carried out to identify severe forms of sleep apnea. Cardiorespiratory monitoring and polysomnography make it possible to establish a more accurate diagnosis and differentiate obstructive sleep apnea from central sleep apnea (caused not by airway collapse, but by disorders of the respiratory center of the brain) . All these examinations can be carried out at the Sleep Medicine Center at the Rehabilitation Clinic in Khamovniki. At the request of the patient, some studies can be carried out at home.
To cure hypertension caused by sleep apnea, you need to treat the apnea itself. In most cases, OSAS is treated with CPAP (constant positive airway pressure ventilation). This method of treatment is carried out using a special apparatus and can effectively eliminate hypoxia, and therefore, all cardiovascular manifestations of obstructive sleep apnea syndrome: arterial hypertension, heart rhythm and conduction disturbances, coronary heart disease.
The airways during CPAP therapy are “inflated” by air constantly supplied by a compressor through a flexible tube and nasal mask, which prevents them from collapsing and causing respiratory arrest.
CPAP therapy slows down the development of cardiovascular diseases, relieves the symptoms of obstructive sleep apnea. For such patients, there is the possibility of personal clinical and technical support for CPAP therapy at home. With great success for the treatment of sleep apnea and related arterial hypertension, coronary heart disease, the Prisma 20A device is used.
There is also a device for CPAP therapy Somnobalance E – a representative of the previous generation of devices from the same company ( Weinmann – Loewenstein , Germany). It can also be used to treat obstructive sleep apnea, although it is somewhat inferior to Prisma devices in a number of characteristics .
The latest development of Weinmann (Germany) is a new line of CPAP devices Prisma Line . Their use allows the most effective and comfortable treatment of the entire spectrum of respiratory disorders in patients with obstructive sleep apnea syndrome.