Bad sleep Mood swings due to nocturnal breathing

Breathing and snoring prevent a healthy, deep sleep. Not infrequently, so-called sleep apnea causes the symptoms, which can even be life-threatening. The news agency "dpa" spoke with the person affected Olaf Schweren about the disease and accompanied him to the sleep laboratory of the Robert Koch Clinic in Leipzig.

In the sleep lab, doctors find out about the breathing breathers
In the sleep laboratory, it gets stressful for the sisters from 10 pm. Because then all patients have to be prepared for the night. They are "wired" so that the doctors can monitor their sleep habits as well as possible. In addition to many values ​​such as oxygen saturation, patients are also filmed with a camera. A microphone also records the snoring sounds. This total monitoring is necessary to determine if a patient who has trouble sleeping actually has sleep apnea, a condition that significantly increases the risk of heart attack and stroke.

Even Olaf Schweren, two electrodes are glued to the legs and nine attached to the head. He must also wear a chest belt and a waist belt. Using a pulse oximeter, a clip on the index finger, the oxygen saturation in the blood is measured. For six hours, the patient should sleep in a single room. Meanwhile, the nurses sit in the technology center of the sleep laboratory in front of eight monitors, where all the data is collected. The next morning, the evaluation is done by the doctors.

Patients with sleep apnea often suspect nothing of their problems
"I did not really have a problem," says the 56-year-old professional driver. "But everyone around me had a problem!" Heavy snores heavily and sleeps badly. That's why he is often tired during the day. Up to a stomach operation he weighed 116 kilograms. "My wife has always pushed me:" Go to the doctor, "he says.

Thomas Köhnlein, chief physician of the Robert Koch Clinic, is an expert in so-called sleep apnea syndrome. "Breath drops during sleep are often observed very reliably by the spouses," he explains in an interview with the news agency. But, "Patients tend to underestimate that," he says.

Before they make an appointment in the sleep laboratory, lung or ENT doctors have already performed preliminary examinations. Only if sleep apnea is suspected, they will be sent to sleep to sleep.

Nocturnal breathing can be life-threatening
According to the German Society for Sleep Medicine, about two to four percent of the population in Germany suffers from the dangerous respiratory failure during sleep. Board member Hans-Günter Weeß reports to the news agency that sleep apnea syndrome is the second most common of over 50 known sleep disorders. The serious consequences of sleep deprivation included daytime sleepiness with difficulty falling asleep, difficulty concentrating, loss of performance and a long-term increased risk of stroke and heart attack. The respiratory misfires would come about through a tired musculature in the pharynx, Kohnlein said.

Especially overweight people often suffered from sleep apnea, as the fat on the pharyngeal muscles. Breath drops could last for up to 30 seconds. During this time, too little oxygen gets into the brain. This in turn reacts with an alarm and wake-up reaction, which the person concerned does not consciously notice. Often he can not remember it the next morning. Since the respiratory misfires usually occur many times during the night, the sleep apnea victims are repeatedly torn from the blow. A healthy dream and deep sleep is no longer possible.

Treatment of nocturnal sleep disturbances due to respiratory failure
In order to prevent the nocturnal breathing interruptions, the patients should usually wear a so-called CPAP mask while they are sleeping. This is similar to a small breathing mask and is connected via a hose to a compressor. The mask is still the "gold standard", explains Weeß. "The compressor generates an overpressure, so that the respiratory passages no longer close and the respiratory misfires disappear. The patients will thus find themselves in a restful sleep. "

The CPAP mask must be put on every night. But most patients would manage well, explains Köhnlein. "75 percent are still loyal to therapy after one year. This is not a bad result. "The patients would usually notice a significant improvement through the device. "It's a bit like glasses with these masks. At first you are stunned, but after a month you have gotten used to it. "

Monika Schmidt, a patient who has received a CPAP mask after a stay in the sleep laboratory reports to the news agency about her ordeal. "I've had a problem with snoring and breathing mishaps for ten years. I am prematurely killed, I have to recover from sleeping, "said the 71-year-old pensioner. Also, she had suffered from concentration problems and dizzy spells. In the sleep laboratory 22 breathing misfires per hour were measured in the woman. Schmidt wants to sleep in the future only with the mask.

Surgery is necessary only in severe cases of sleep apnea
In severe cases, surgery may be necessary to eliminate the respiratory failure. For example, doctors can tighten or shorten the soft palate. Also, the tongue length and the tongue base can be changed in one operation.

Currently, a relatively new procedure is being tested in clinical trials worldwide, the so-called tongue pacemaker. Patients will be treated with a neurostimulator under the skin just below the collarbone. A cable that leads to the costal arch measures and transmits the respiratory rate via the diaphragm movements. Another cable carrying an electrode is placed to the hypoglossal nerve, which activates the tongue muscles. When the patient inhales, the tongue pacemaker sends an impulse to the lingual nerve, causing the tongue muscles to contract. As a result, the respiratory tract remains free. The patient can switch the device on and off in the evening via a remote control. (Ag)