Snoring is a big problem. Especially when there is also apnea: a pause in breathing of more than 10 seconds. The quality of sleep is very poor; it is actually difficult or impossible to get a deep enough sleep, the sleep apnea patient does not wake up rested and has a lot of sleepiness during the day. This means not just being tired, but also accidentally falling asleep during a conversation, reading a newspaper and sometimes even during activities such as driving a car. This can lead to dangerous situations, not only for the patient himself, but also for others!

How does sleep apnea develop?
ENT specialist Madeline Raveloot: “In a small number of people who snore, the pharynx is so narrow that the tongue, the soft palate with the uvula and/or the pharynx are occasionally sucked against each other, resulting in a total closure of the mouth. the airway develops: there is a respiratory arrest that can last as long as thirty seconds or longer.”

How are sleep apnea patients helped at Jan van Goyen Medical Center?
“We have established a patient-friendly way to study patients with suspected sleep and snoring problems. If this is the case, a nighttime sleep recording should be done to measure what happens when a patient is asleep. Patients are covered with various electrodes and sensors, with which we can register what happens with breathing, brain activity and oxygen levels while sleeping. In many clinics there is often a long waiting time. In addition, patients have to stay overnight in the hospital. At the Jan van Goyen Medical Center, the sleep registration takes place at home with the associated equipment. For example, patients do not have to go out on the street with electrodes glued to their heads and they can sleep at home in their own bed. Very patient-friendly, efficient and unique in Amsterdam.”

Are there many people who suffer from sleeping and snoring problems?
“It is above all a very topical problem. In the past, it could take up to eight years for someone with sleep and snoring problems to be properly diagnosed. It was often linked to, for example, depression or burnout, so that the real cause was overlooked. Nowadays people are much more aware of this. That's a good thing, because it can have serious consequences if you don't treat it."

“People are, for example, at a higher risk of cardiovascular disease and early dementia. And it can cause a loss of concentration with all its consequences. This can prevent accidents at work or in the car. ”

How do you find out that you have sleep apnea?
“It is possible that you wake up startled regularly. You may also get a lot of headaches in the morning or feel that your battery is not charged. Often, however, it is your environment that notices that you snore terribly and that you occasionally stop breathing.”

What can be done about it?
“That is difficult to say, because it depends, among other things, on the severity of the sleep and snoring problems, findings on physical examination and patient preference. You start – if applicable – by addressing the risk factors such as smoking, alcohol, weight, supine position and the use of sleeping medicines. We also have various treatment options. The most effective is a mask that blows open the upper upper airway while sleeping. However, some patients find this difficult to tolerate. Fortunately, there are alternatives for this, such as a mouthguard that pulls the lower jaw more forward, creating more space behind the tongue and at the larynx. There is also a device that uses vibrations to ensure that the patient no longer lies on his back. That can also solve the problems. Surgery in the head and neck area is also a possibility.”

Are these serious surgeries?
“That depends on the severity of the sleep apnea and where the breathing stops are caused in the upper upper airway. For example, we can only remove the tonsils, but in some cases we opt for a larger operation in the neck, in which we try to stimulate the tongue forward with a pacemaker during sleep.”
Would you like to know more about the disorders, diagnosis and treatment of sleep apnea? read it here.

Madeline Ravesloot
dr. Madeline Ravesloot

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