Jakarta, Sleep disturbance is one of the most common complaints found in patients who visit doctors. It is estimated that each year 20% -40% of adults have difficulty sleeping and 17% of them experienced serious problems.
Prevalence of sleep disorders each year tend to increase, 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 associated with breathing disorders during sleep (sleep disordered breathing).
Impaired breathing during sleep
There are 2 kinds of breathing disorders during sleep patterns, namely Hypoapnea and Apnea. Hypoapnea narrowing of the airways characterized by 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, which is central sleep apnea, upper airway obstructive apnea and a mixture of both.
Sleep apnea is a breathing disorder that occurs during sleep, which lasted for more than 10 seconds. It is said pathological sleep apnea if patients experienced episodes of apnea at least five times in one hour or 30 episodes of apnea during the night. During this periodic chest and abdominal wall movement is very dominant.
Central apnea often occurs in the elderly, characterized by intermittent reduction in the ability of respiration due to reduced oxygen saturation. Central apnea is characterized by a cessation of airflow and respiratory effort periodically during sleep, so that movement of chest and abdominal wall disappeared. It is possible damage to the brain stem or hypercapnia.
Respiratory illness (upper airway obstructive) during sleep characterized by increased respiration during apnea, increased effort chest and abdominal wall muscles with the aim of forcing air in through the obstruction. This disorder is more severe when you enter the REM phase. Respiratory disorders are characterized by gasping for breath or snoring during sleep.
Snoring is a sound lasts 3-6 times and then disappear and repeat every 20-50 seconds. Apnea attack when the patient does not snore. As a result of hypoxia or hipercapnea, causing more active respiration activated by the formation retikularis and medullary respiratory center, with the result that the patient is awake and respiration returned to normal in a reflex.
Whether the central or obstructive apnea, patients are often awakened repeatedly at night, which is sometimes difficult to fall asleep again. This disorder is often characterized by head pain or unpleasant feelings in the morning. In children with frequent respiratory tract congenital disorders. In the adult airway obstruction septal defect, hypothyroidism, or bradycardia, heart problems, hypertension, and stroke.
OSA (Obstructive Sleep Apnea) and stroke
Obstructive sleep disorder is one form of a new risk factor for stroke. Recent studies Drager (2007) showed no increased risk of stroke by 2.52 times in patients with sleep apnea. It is also associated with increased risk of hypertension in patients with OSA.
OSA is often found in people with stroke who managed to live, as much as 63% of those who survive, having this disorder. More and more evidence that has shown a causal relationship between sleep apnea and stroke.
Excessive fatigue during the day associated with sleep apnea can affect the results of post-stroke recovery. Excessive daytime fatigue may reduce the ability and motivation of stroke patients to continue to run the recovery program. As a result, the exercise to 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 disorder, should be determined beforehand danlamanya type of sleep disorder (duration of sleep disorder), by knowing the type and duration of sleep disorders. In addition to helping identify the cause also can provide adequate treatment.
Diagnosis of sleep disorders in facilities uphold Overnight Treatment Laboratory Based Sleep Study (Polysomnography Complete). The medical team will formulate appropriate measures the degree of treatment of sleep disorders, patient selection, overall health status, and patient expectations.
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