» You are here » The Problem » Chronic Rhoncopathy
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.
|Scarce UA resistance||Micro-awakening||Micro-awakening|
|Daytime hypersomnia||Daytime hypersomnia|
|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:
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:
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.