Sleep Apnea Treatment

Snoring

The term chronic snoring (CS), et al coined by Chouard. in 1986, is present in three clinical forms of the same disease that have snoring in common, but with different clinical implications: simple snoring (SS), increased resistance syndrome of the upper airway (IRSUA) and obstructive sleep apnea (OSA). Currently, the most important respiratory disorders are included in what many authors have termed “Obstructive Breathing Sleep Disorders” (OBSD) that encompass the variety of pathological manifestations from simple snoring to severe cases of OSAHS. The current trend is to consider obstructive respiratory disorders as a category indivisible, with different clinical manifestations but a common pathogenesis, the increased resistance of the UA. The OBSD pathophysiology have evolved dependent on the degree of severity and in regard to dental practice, have the same treatment options, ie the intraoral appliances. The OBSD can be defined conceptually as a clinical development that includes primary snoring, relatively innocuous, where the resistance to airflow in the upper airway is limited, the syndrome of increased resistance of the upper airway IRSUA, defined as intermediate stage, and the apnea-hypopnea syndrome OSAHS, where the blockage is complete and results in altered oxygenation (hypoxemia and hypercapnia) and daytime and nocturnal symptoms, with a substantial commitment to health.

With the information currently available, the snoring should be considered as a disease of variable severity, but never as a normal event or even linked to a restful sleep, an idea that for centuries has been present in the collective imagination. These benefits during times that engulfed the phenomenon of snoring, have numerous reflections on the literature. Joe the Fat, the sleepy servant of Charles Dickens in "The Posthumous Papers of the Pickwick Club" (1837), or the Red King in "Alicia behind the mirror", that Lewis Carroll described as follows:

“But in saying this was contained, somewhat alarmed to hear something that sounded like the gasp of a locomotive in the woods, although what Alicia is truly afraid that this is a ferocious beast. By chance, are there any lions or tigers around here? –Asked timidly. –It's only the Red King snoring,– said TTweedledee is snoring so loudly, as if his head would fly every snore“.

Probably the best example and in turn, the most cited texts on the snoring, is this scene from –Don Quixote– that perfectly exemplifies the benign association between snoring and enjoyable sleep:

“Just the white dawn gave rise to the bright Phoebus, with the ardor of its warm rays, the liquid beads her golden hair mop, when Don Quixote, shaking the laziness of its members stood up and called his squire Sancho, who still snored, seeing which Don Quixote before he awoke, he said: O thou, blessed of those living on the face of the earth, for without envying or being envied, sleep with a peaceful spirit or chase you charming, or startle enchantments.”

References to sleep in a classic like Don Quixote have been analyzed and extrapolated to the scientific field with many studies on Cervantes' work, seen as a prescient and comprehensive treatise on medical descriptions of all kinds. One of the most interesting 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, the snoring or REM behaviour disorder demonstrating their advanced knowledge in medicine.