Obstructive sleep apnea syndrome as one of the causes of Pickwickian syndrome

Recently, obstructive sleep apnea syndrome has been considered as one of the causes of the development of Pickwickian syndrome.

Pickwickian syndrome is a condition characterized by progressive respiratory failure. development of cor pulmonale, obesity and drowsiness.

Patients with Pickwickian syndrome complain of severe shortness of breath, aggravated by physical exertion, poor sleep at night, headache in the morning, drowsiness during the day and fatigue. Drowsiness is so pronounced that patients can fall asleep in the most inappropriate environment – during meals, at work, when examined by a doctor. These people also have respiratory failure with periods of apnea.

Pickwickian syndrome is characterized by a decrease in lung ventilation due to respiratory disorders that occur at night and during the day – the situation is aggravated by the high standing of the diaphragm due to obesity and the restriction of its excursion. There is a development of respiratory failure of a restrictive type as a result of a decrease in the respiratory surface of the lungs and the ability of the lung tissue to stretch. In patients with Pickwickian syndrome , hypoventilation is found at night and during wakefulness.

Obesity, characteristic of Pickwickian syndrome, is the cause of sleep apnea. The deposition of fat in the neck and face, in the peripharyngeal space is the main factor in the narrowing of the lumen of the upper respiratory tract. In addition, in obese individuals, the soft palate and the muscles of the pharynx lose their tone, relax and, sagging, make it even more difficult for air to pass through. In the case of complete closure of the airways at the level of the pharynx, breathing stops completely.

Obstructive sleep apnea is triggered by a number of factors and conditions. Obstructive sleep apnea was first described in patients with Pickwickian syndrome in 1965. These patients had regular episodes of nocturnal asphyxia . Somewhat later, cases of sudden death in a dream in patients with Pickwickian syndrome are described. In the same years, it was found that obesity is a risk factor for the development of obstructive sleep apnea. Considering obesity as a risk factor for obstructive sleep apnea, we can say that it leads to daytime hypoxemia, hypoventilation of the lungs and nocturnal respiratory disorders.

There is also an inverse relationship between these conditions – obstructive sleep apnea syndrome , not diagnosed in time, can cause Pickwickian syndrome and its progression. With frequent episodes of sleep apnea, chronic hypoxia develops, in which the production of hormones decreases. This applies to growth hormone and insulin involved in the metabolism of fats and carbohydrates.

The presence of a connection between these diseases dictates the need for diagnosing sleep disorders and their timely treatment. The lack of treatment for breathing disorders during sleep aggravates the course of not only Pickwickian syndrome, but also other diseases – arterial hypertension, coronary heart disease, cerebrovascular disease. CPAP therapy is aimed at eliminating the main cause of sleep apnea – the collapse of the airways. Forcing air into the respiratory tract under constant positive pressure eliminates breathing disorders that occur during sleep. Apparatus for CPAP therapy Prisma 20A and its predecessor Somnobalance E by Weinmann – Loewenstein (Germany) meet all quality requirements and provide an effective treatment process.

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