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Snoring in women is not just related to hormones

● The apnea that occurs during sleep is carried out quietly, like a sinful hand in the night, tightly covering the mouth and nose of a sleeping patient.

● Women have a relatively narrow larynx and weak neck muscles, so they are more likely to snore while sleeping.

● The menstrual cycle, pregnancy, and menopause are the main periods when women's hormone levels fluctuate. Snoring in women is more common in both postmenopausal women and pregnant women.

Recently, two female snoring patients came to the expert clinic of the Third Medical Center of the PLA General Hospital, one is a young lady, who specializes in consulting snoring and is eager to have surgery to solve the problem; One was a woman in her 50s who accompanied her husband to see her snoring, but she was also diagnosed as a patient.

The young lady is a journalist, in her 30s, who often travels for work reasons, and has been repeatedly reported by her peers that she snores, affecting the rest of others, and is very embarrassed, and urgently asks for early surgery to completely solve the problem of snoring.

The woman in her 50s complained that her husband snored loudly, sometimes without panting for a long time, sometimes being awakened and sitting up, she was very worried and nervous, and often did not dare to sleep at night to look at her husband. The doctor examined the man and found that the main causes of his snoring were obesity, narrowing of the pharyngeal cavity, and hypertrophy of the tongue. Because his wife was also obese and the doctor asked her if she also snored, her husband looked dazed, she was stunned for a moment, but quickly gave a positive answer, she was not as bad as her husband's snoring, so she was ignored.

Snoring while sleeping, is it a good night's sleep?

Snoring is a sound that is caused by a tremor of the surrounding soft tissues caused by airflow through a distinctly narrowed airway during sleep. Under normal circumstances, during sleep, the body is in a state of lying flat and relaxed, and the muscles of the pharynx and larynx will naturally relax, but this relaxation will not cause the pharyngeal isthmus to collapse and the obvious narrowing of the respiratory tract, so there will be no snoring. This is not the case in the pathological case – snoring is accompanied by breath-holding, also known as "apnea", which leads to a lack of oxygen in the body, which can lead to a series of health problems in the long run.

Snoring has long seemed to be a symbol of men. Some scholars believe that in ancient times, male snoring thunder could scare away attacking beasts and protect women and children.

In contrast, female snoring is a completely different situation.

Words like "snoring" are rarely associated with women. However, preliminary statistics show that the number of female snorers accounts for one-third of male patients, which is not a minority. And studies have shown that women who snore have a significantly higher proportion of poor sleep quality than men. Women snoring will cause inferiority due to prejudice, so the damage is greater than that of men.

Snoring women are more likely to be obese; Snoring in young, non-obese women often attracts strange glances. Because of this, very few women are willing to admit that they snore, let alone seek medical attention, thus delaying the condition and causing many physical and psychological problems.

It can be seen that snoring in women should be taken more seriously than in men.

Is there a level of snoring? What requires medical intervention?

Simple snoring (snoring) and obstructive sleep apnea-hypopnea syndrome are both sleep-disordered breathing.

Simple snoring generally has little effect on your sleep, and if you breathe with your mouth open, you will feel dry in the morning. The higher the frequency of snoring, the louder it is, and the greater the impact on the person sleeping.

If snoring, mouth breathing is severe, breath holding, and waking up, these sleep-disordered breathing are collectively known as "obstructive sleep apnea-hypopnea syndrome". Breath-holding, the medical term is "apnea"; Breathing does not stop completely, but the volume of breathing decreases, which is called "hypoventilation". The duration of each apnea and hypopnea can be short, as short as a few seconds, as long as tens of seconds or even hundreds of seconds. Whether it is "apnea" or "hypopnea", it can cause the body to lack oxygen; It can occur at any time as long as you are asleep, and in the long run, it will cause irreversible damage to the body, including cardiovascular system diseases (hypertension, coronary heart disease, arrhythmia, etc.), nervous system diseases (Alzheimer's disease, cerebral infarction, cerebral hemorrhage, etc.), endocrine system diseases (diabetes, lipid metabolism disorders, obesity, etc.), and other increased risks.

Therefore, if you simply snore, you can choose to accept it, but once you have obstructive sleep apnea-hypopnea syndrome, it is important to intervene early to avoid serious consequences.

What does it mean to have 20 seconds of apnea during sleep?

When analyzing the sleep monitoring report for the patient and his family, the patient is often asked to do an experiment on the spot: first, tell the patient to hold his breath according to the apnea time reported by the monitoring; Then ask the patient to inhale, close their mouth, pinch their nostrils, and start the timer at the same time. In general, it is difficult for patients to hold their breath for a maximum of 20 seconds.

This is a condition in which you actively hold your breath while awake.

The apnea that occurs during sleep is carried out quietly, like a sinful hand in the night, tightly covering the mouth and nose of a sleeping patient. Compared with the waking state, people can tolerate apnea for a longer period of time when they are in deep sleep, but when they reach a certain level, the patient will be awakened, which is generally "micro-awakening", which is manifested by the patient breathing, twisting or turning over, lying on his side and sleeping.

During deep sleep, the body and brain are in a state of complete relaxation, which is of great significance for restoring physical and mental strength. Moreover, deep sleep is very necessary to stabilize mood, restore energy, balance the mind, and enhance immune function.

With the recurrence of apnea and micro-arousal during sleep, the normal sleep cycle of the patient is constantly interrupted, and the sleep quality is affected, resulting in poor mental state and daytime sleepiness in the morning of the second day.

What are the causes of snoring in women? What is the relationship with hormones?

Snoring in women has the same causes as men, and it also has its own special gender factors.

Causes are the same in men and women, including anatomical factors, obesity, smoking and alcohol consumption, allergic rhinitis, etc.

Anatomical factors include tonsillar hypertrophy, nasal septum deviation, etc.; Obesity causes fat to accumulate in the neck, which compresses the airways; Tobacco and alcohol can irritate the mucous membranes of the throat and nose, leading to narrowing of the airways; Allergic rhinitis caused by allergens (allergens) such as dust mites and pollen, resulting in nasal congestion. All of the above factors increase the risk of snoring.

In terms of anatomy, women have a relatively narrow larynx and weaker neck muscles, making them more likely to snore while sleeping.

The biggest difference between women and men about the causes of snoring is the difference and change in sex hormones.

The menstrual cycle, pregnancy, and menopause are the main periods when women's hormone levels fluctuate. Snoring in women is more common in both postmenopausal women and pregnant women.

Changes in estrogen and progesterone have an impact on sleep structure and sleep quality. Estrogen can reduce REM (rapid eye movement sleep) sleep, and acting on blood vessels can cause nasal congestion. Progestogens can increase ventilatory drive.

Among estrogens, estradiol is the most active estrogen, and its physiological role is the most important. Receptors for estradiol are present in respiratory muscle groups, which have a protective mechanism for the genioglossal muscle. The genioglossus muscle is the muscle that pulls the tongue forward, it opens the airway at the back of the tongue, improves ventilation, and eliminates or reduces snoring. Snoring women have lower estrogen levels and weakened mental tongue muscles, which is the most important reason why postmenopausal or menopausal women are more likely to snore.

The incidence of new-onset snoring in women during pregnancy is 15%~20%, and the increase in body fluids and estrogen acting on blood vessels cause nasal congestion, resulting in airway narrowing and obstruction of ventilation, causing snoring.

Menopausal women with low levels of estrogen and progesterone during menopause are more likely to snore, hold their breath, breathe irregularly, and even wake up to sleep-related events.

What kind of harm does sleep snoring bring to women?

Endocrine disorders, poor blood circulation. Irregular menstruation, early onset of menopause or menopause, or prolonged menopause;

Changes in appearance. Eye bags, dark circles, yellowish complexion, loose skin, and obesity due to decreased sleep quality;

Psychological changes. Poor sleep at night, lack of energy during the day, memory loss, formation of autistic, withdrawn, anxious personality or emotion, and disharmony in interpersonal relationships;

Causes other diseases. Such as hypertension, coronary heart disease, diabetes, hyperlipidemia, etc.

To prevent snoring, you should do the following:

Maintain a healthy weight: Maintain a healthy weight and reduce neck fat accumulation through a reasonable diet and exercise;

Change sleeping position: Try sleeping on your side and avoid lying on your back to reduce the obstruction of the airway by a tongue drop;

Quit smoking and limit alcohol: avoid irritating the throat and nasal mucosa due to smoking and excessive alcohol consumption;

Patients with allergic rhinitis should avoid contact with allergens: keep the room clean, change bed sheets and covers regularly, use bedding that protects against dust mites;

Seek professional help: If snoring seriously affects sleep quality and quality of life, it is recommended to seek medical attention and seek help from a professional doctor.

Women should pay more attention to their sleep, not only about beauty, but also about the whole family.

How to detect and prevent sleep snoring has a set of effective, scientific and reasonable diagnosis and treatment procedures. After a specialist physical examination, including sleep apnea monitoring, in the hospital, the doctor can give individualized medical guidance based on the results of the monitoring.

(Sun Hanjun is the director of the Department of Otolaryngology-Head and Neck Surgery of the PLA General Hospital, and is stationed in the Third Medical Center of the Department of Otolaryngology-Head and Neck Surgery; Liang Jiusi is the attending physician)

Source: China Women's Daily