Text/Chen Yuqi
"It was definitely angry to say that I wanted to divorce because of snoring, but during that time I felt that I couldn't sleep every day, and I couldn't get by." After two years of marriage, Li Na noticed that her husband's snoring was getting worse.
Many times, Rina sat up angrily, but her husband did not move, and he did not wake up no matter how he tossed.
Wear earplugs, stickers, two people with their heads and feet facing each other, wear a ventilator, use an anti-snoring pillow... Li Na has used all the methods that can be used, but has never found a complete solution. Sleeping in separate rooms is the last resort, but neither of them wants to use this trick emotionally.
There have been reports that the proportion of snoring people in the mainland is 52.4%, the highest decibel of snoring is 95 decibels, comparable to the sound of electric drills, and more than 25% of snorers have sleep apnea, of which more than 80% have not sought medical treatment.
In 2019, a paper published in The Lancet-Respiratory Disease showed that 1.361 billion adults aged 30 to 69 worldwide suffer from obstructive sleep apnea of varying degrees, of which China has the highest number of patients, reaching 176 million.
In order to solve the problem of snoring, more and more people are going to sleep clinics, buy ventilators, and wear masks to sleep.
Snoring like thunder
Also plagued by snoring are Zhang Mei and her husband Li Yang. The two have been married for more than 10 years, and after marriage, the weight of the husband has increased rapidly at a rate of 5 kilograms per year, and the weight is close to 125 kilograms. Coupled with the continuous socializing, after drinking, every night I go to bed snoring like thunder.
In the night when she was awakened by purring, Zhang Mei observed her husband's sleep. "After a purr, the sound suddenly stopped, he opened his mouth, I could only see his chest rising and falling, there was no sound." Zhang Mei put her hand on her husband's nose, did not feel the airflow of breath, she also counted mr. obsolete, a breath holding can last more than 40 seconds.
According to her observation, the husband's deep sleep time is very short. "Move him slightly from the side, and he'll open his eyes, or roll over and get a deep sleep for a few minutes at most." Therefore, during the day, Li Yang became particularly sleepy, feeling very tired every day when he returned home from work, and often wanted to sleep.
In addition to the pillow person, this problem also bothers the snorer himself. Zheng Ran's sleep quality has been poor, normal people can restore energy after 6 hours of sleep, for Zheng Ran can only achieve half the effect, easy to forget things during the day, slow reaction, "often sit and sit and fall asleep."
Because he always breathes with his mouth, Zheng Ran often has a dry mouth in the middle of the night, and over time, he develops into chronic pharyngitis, and he will also regurgitate stomach acid, and the mouth is sour, "just like using white vinegar to pour into the nose."
According to the "2018 Sleep Data Report" released by a sleep APP, the proportion of snoring population in the mainland is 52.4%, and the highest decibel of snoring is 95, which is comparable to the sound of electric drills. Professor Guo Xiheng, director of the Sleep Breathing Center of Beijing Chaoyang Hospital, has said that more than 25% of snorers have sleep apnea, and more than 80% of them have not sought medical treatment. Han Fang, director of the Respiratory Sleep Center of Peking University People's Hospital, once pointed out that the confirmed diagnosis rate of sleep breathing disorders is only 1%.
Image source: Life Times
The so-called sleep apnea, the full name is sleep apnea hypopnea syndrome, refers to the breathing disorder caused by the obstruction of upper airway stenosis or abnormal respiratory drive during sleep, of which obstructive sleep apnea (commonly known as snoring) is the most common.
Peng Wei is the attending physician of the Department of Otorhinolaryngology, Head and Neck Surgery of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, and after more than 10 years of medical practice, he has found that more and more people are beginning to realize that snoring is a disease, and the group of patients who seek medical treatment is getting younger and younger, and often encounter patients aged 20 to 30.
Peng Wei pointed out that when sleep snoring is accompanied by apnea, hypoxia and daytime sleepiness, it is necessary to consider whether to suffer from sleep apnea hypopnea syndrome.
He explained that under normal circumstances, the gas we breathe goes through the nasal, pharyngeal, laryngeal cavity, and then into the trachea and lungs. The narrowing of the nasal, pharyngeal and laryngeal passages caused by various reasons will lead to a decrease in the corresponding airway ventilation, the suction of the air flow is blocked to form a vortex, the soft tissues of the impact airways vibrate and snore, and cause insufficient ventilation and apnea.
Peng Wei's intuitive feeling is that the main group of people with snoring is the obese group, mostly men, and people with bad living habits such as staying up late, smoking, and drinking are also more likely to have snoring.
Peng Wei pointed out that if there is frequent apnea or insufficient ventilation during sleep, it will lead to a decrease in oxygen content in the blood, destroy the sleep structure, lead to daytime sleepiness, and cause systemic multi-system damage, including hypertension, arrhythmias, diabetes, and respiratory failure. When sleep is paused for too long, sudden death may also occur.
Resident Evil sleep
In 2010, Zheng Ran, who had been suffering from snoring for 5 years, walked into the sleep clinic under the advice of a doctor and slept in the hospital in a very sci-fi form.
Zheng Ran's face and body are pasted with various wires recording physiological parameters such as electroencephalograms, electroencephthalograms, and electromyography, and there are instruments monitoring blood oxygen on his fingers, and a bunch of cameras above the bed are staring at him.
This test, called polysomnography, is the primary means of diagnosing sleep apnea. In addition, Zheng Ran also took X-rays, did lung examinations, and finally diagnosed severe sleep apnea syndrome.
The doctor told him that because his chin was relatively short, coupled with obesity, snoring appeared after falling asleep due to the relaxation of the body, the fat of the chin and neck pressed against the trachea. The doctor suggested that his problem needed to be solved by losing weight and wearing a ventilator.
So, Zheng Ran bought a ventilator. It only took him one night to get used to sleeping on a ventilator. "When I woke up, I felt like I was born again, and I really hadn't slept so well in a long time."
At the urging of his wife several times, in March this year, Li Yang also decided to go to the respiratory department. But unlike Zheng Ran, he can now take the monitoring device home and complete the sleep suspension monitoring at home.
The test results showed that his AHI (apnea hypopnea index, that is, the number of apneas plus hypopnea per hour of sleep) reached 84, while the standard value of AHI was less than 5, and the longest apnea lasted 80 seconds. Blood oxygen saturation is only 80%, while normal people have oxygen saturation greater than 95%.
Li Yang's sleep monitoring report (Source: Provided by the interviewee)
At present, the treatment of sleep apnea can be divided into two types: surgical and non-surgical. Peng Wei introduced that patients with clear indications for surgery can consider surgical treatment, but if they do not pay attention to changing bad living habits in the later stage, snoring will still appear again.
Non-surgical treatment includes general treatment, that is, weight loss, smoking and alcohol cessation and other adjustments to living habits; followed by non-invasive positive pressure ventilation therapy, which is often referred to as a ventilator, which is the most important treatment for adult snoring. The principle of the ventilator is to send a pressure air flow into the respiratory tract, like a hair dryer, to blow away the clogged and narrow soft tissues, thereby keeping the respiratory tract open.
After being diagnosed with severe sleep apnea syndrome, Zhang Mei and Li Yang spent nearly 17,000 yuan on the advice of doctors to buy a home double-level ventilator that can automatically adjust pressure, with humidification and heating functions.
On the first night of sleeping on a ventilator, Li Yang was very excited. He firmly fixed the nose mask with an elastic band to the mouth and nose, adjusted the pressure value and other parameters, opened the machine, and the strong air flow was sent along the gray plastic pipe, from the nasal cavity to the throat, flushing away from the blocked place of the respiratory tract.
Li Yang wanted to open his mouth to talk to his wife, and as soon as he opened his mouth, the air flow ran out, unable to speak normally for a long time.
Li Yang's ventilator nose cover (Source: Courtesy of the interviewee)
That night, Li Yang was basically "silent", and his wife could occasionally hear the sound of breathing and the sound of air flow from the machine. The next day's data showed that his apnea returned to normal, his blood oxygen reached 97%, and his mental state improved a lot.
Li Na, who also bought a ventilator for her husband, described her husband who wore a ventilator as "like in Resident Evil."
Multi-pronged approach
Like Li Yang and Zheng Ran, in order to solve the problem of snoring, more and more people are sleeping on ventilators.
The "2021 China Internet Respiratory Health Trend White Paper" shows that from 2018 to 2020, the consumption trend of online ventilators has grown steadily, with 98% of new customers accounting for 98% in 2020, and the post-80s and post-90s are the main buying groups.
Image source: 2021 China Internet Respiratory Health Trends White Paper
However, Peng Wei said that although the medical guidelines for snoring at home and abroad believe that ventilators are the preferred means of treating snoring, not everyone can tolerate and get used to it.
After Li Yang put on the ventilator, when he turned over in the middle of the night, the nose mask occasionally leaked air. During the use of the nose mask, Li Yang felt that one side of the nostrils was pressed and not comfortable enough, so he bought a large nose pillow and used it alternately with the nose mask. More than half a month later, Li Yang was slowly adapting to getting along with the ventilator.
The three wearing devices of the ventilator, from left to right, are the nose mask, the face shield, and the nose pillow (Source: Network)
One day at noon, Li Yang did not wear a ventilator during his lunch break, he turned over and over, how could not sleep, felt that he could not catch his breath, "choked up panic." Zhang Mei is a little worried that the ventilator will become dependent after a long time, and plans to ask the doctor when she goes to the hospital for a review in a month.
Li Na's ventilator was idle after only three months, and her husband never got used to sleeping with it. At first, Rina coaxed her husband, probably getting used to it for a few days, but later found out that her husband would secretly take off the ventilator in the middle of the night.
The price of household ventilators with higher sales volume ranges from 3,000 yuan to 20,000 yuan (Source: JD.com)
"Ventilators can only treat the symptoms, not the root causes." Peng Wei metaphorically shows that ventilators are just a means of adjunct treatment for snoring patients as glasses are for myopic patients.
Peng Wei pointed out that the causes of snoring are often complex, and no one treatment can treat all snoring patients, and no treatment can completely cure snoring. For snoring caused by obesity, weight loss is indeed the best and healthiest means of prevention and treatment.
In order to "cure the root cause", Li Yang is also working hard to lose weight, quit sugar, quit alcohol, and work and rest regularly. At the wine table, everyone knew about Li Yang's situation and stopped persuading the wine.
(At the request of the interviewees, Li Na, Zhang Mei and Li Yang are pseudonyms)
(Editor: Li Dan Proofreader: Yan Jingning)