Chronic Rhoncopathy

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The term Chronic Rhoncopathy(CR), coined by Chouard. in 1986, is more commonly known as Chronic Snoring. It can present in three different clinical forms which all have snoring in common, but have different clinical implications: Simple Snoring (SS), Upper Airway Resistance Syndrome (UARS) and Obstructive Sleep Apnea/Hyponea Syndrome (OSAHS). Currently, the most important respiratory disorders are included in what many authors have termed "Sleep-Related Respiratory Disorders" (SRD) that encompass the variety of pathological manifestations from simple snoring to severe cases of OSAHS. The current trend is to consider Sleep- Related Respiratory Disorders as a category indivisible, with different clinical manifestations but a common pathogenesis; the increasing resistance of the Upper Airway (UA) to airflow. The SRD pathophysiology evolves depending on the degree of severity and with regards to dentistry, has similar treatment options: intra-oral appliances. The SRD can be defined conceptually as a clinical progression from Simple Snoring, where there is little resistance to airflow in the upper airway and is relatively innocuous, to Upper Airway Resistance Syndrome (UARS), defined as the intermediate stage, to Obstructive Sleep Apnea/Hyponea Syndrome (OSAHS), where the blockage is severe resulting in altered oxygenation (hypoxemia and hypercapnia) along with daytime and nocturnal symptoms which can have a substantial detrimental effect on health.

SIMPLE SNORING UARS OSAHS
Relatively innocuous Snoring Snoring
Scarce UA resistance Micro-awakening Micro-awakening
Daytime hypersomnia Daytime hypersomnia
Respiratory pauses
Oxygen desaturation
Morbility and mortality

According to the information currently available, snoring should be considered an illness of variable severity, but never as a normal event or even linked to restful sleep, an idea that for centuries has been present in the collective imagination. The link between snoring and restful sleep have been reflected numerous times in literature; Joe the "Fat Boy", a sleepy servant of Charles Dickens in "The Posthumous Papers of the Pickwick Club" (1837), or the Red King in "Through the Looking Glass" by Lewis Carroll described as follows:

After a pause, Alice began, 'Well! They were both very unpleasant characters—' Here she checked herself in some alarm, at hearing something that sounded to her like the puffing of a large steam-engine in the wood near them, though she feared it was more likely to be a wild beast. 'Are there any lions or tigers about here?' she asked timidly. 'It's only the Red King snoring,' said Tweedledee."

Probably the best example and in turn one of the most cited texts on snoring is this scene from "Don Quixote" that illustrate perfectly the association between snoring and sleep as being benign and enjoyable:

Scarcely had the fair Aurora given bright Phoebus room, with the heat of his warm rays, to dry up the liquid pearls on his golden hair, when Don Quixote, shaking off sloth from his drowsy members, got upon his feet, and called to his squire Sancho Panza, who still lay snoring; which being perceived by Don Quixote, before he would awaken him, he said, "O happy thou, above all that live on the face of the earth, who, neither envying, nor being envied, sleepest on with tranquility of soul! neither do enchanters persecute nor enchantments affright thee."

References to sleep in a classic like Don Quixote have been analysed and extrapolated to the scientific field and many studies consider Cervantes' work as giving a comprehensive medical description of all kinds of illnesses. One of the most interesting investigations is that conducted by Iranzo on sleep disorders in "Don Quixote." According to the authors, Cervantes included masterful descriptions of several sleep disorders like insomnia, the negative effects of sleep deprivation, snoring and Rapid-eye-movement Sleep Behaviour Disorder thus demonstrating their advanced knowledge in medicine.

sleep apnea and snoring About Sleep Apnea and Snoring

Sleep apnea is a serious breathing disorder, potentially deadly, that affects 4% of the population. Patients with untreated apnea have increased mortality rates, being four times more likely to suffer accidents at work and when driving. Due to these factors their quality of life is substantially and worryingly reduced.

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Sleep Apnea Tests

Useful instruments for the auto observation of abnormal behaviours during sleep.

Those questionnaires help you to observe the existence and/or gravity of sleep apnea through a sequence of questions that the patient has to valuate, in certain cases, with the help of family members or life partners.

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