Sleep apnea is difficult to diagnose. Untreated, it can have real consequences for the quality of life and health: it is essential to detect it and to put in place an adapted treatment. Sleep apnea is an involuntary stop of breathing, the “apnea,” occurring during sleep. It usually occurs in overweight people, the elderly, or snoring people. These breathing breaks by definition last more than 10 seconds and can reach more than 30 seconds. They occur several times a night, at a variable frequency.
Consider that
Doctors consider that they are problematic when there are more than 5 per hour. In severe cases, they occur up to more than 30 times per hour. This apnea disturbs sleep and is mainly reflected in fatigue on awakening, headaches, or drowsiness during the day.
Why is it important to diagnose sleep apnea?
Sleep apnea is a disease that you should not take lightly. In addition to the fatigue that it causes, it can indeed have severe consequences on health. In the long-term, poor oxygenation of the body can lead to heart problems, high blood pressure, and even the risk of infarction. It is vital to detect it and take care of it as soon as possible.
Sleep apnea-risk factor?
Sleep apnea affects men more than women, especially those overweight and snoring severely. Its frequency increases with age.
causes
In most cases, apnea due to relaxation of the tongue and muscles of the throat, which are not sufficiently tonic and block the passage of air during breathing. Thus, the person tries to breathe, but the air does not circulate because of the obstruction of the airways. That is why doctors talk about obstructive apnea or obstructive sleep apnea syndrome (OSAS). This excessive relaxation concerns, especially the elderly, whose muscles are less tonic. Obese people are also more prone to sleep apnea because excess fat in the neck decreases the size of the airways.
In rare cases
More rarely, this means a failure to function of the brain, which ceases to send the “order” to breathe to the respiratory muscles. In this case, unlike obstructive apnea, the person does not make any breathing effort. This type of apnea occurs mostly in people with a severe condition, such as heart disease (heart failure) or neurological disease (e.g., meningitis, Parkinson’s disease, etc.). They can also appear after a stroke or in cases of obesity very important. The use of sleeping pills, narcotics, or alcohol is also a risk factor.
Risk factors
In the short-term, sleep apnea causes fatigue, headaches, irritability, etc. It can also inconvenience the spouse because it is often accompanied by snoring sound.
In the long-term, if left untreated, sleep apnea has many health consequences:
1. Cardiovascular illnesses
Sleep apnea significantly increases the risk of cardiovascular disease by mechanisms that are not fully decoded. It is known, however, that each respiratory pause causes a deficit oxygenated of the brain (hypoxia), and that each sudden micro-awakening causes an increase in blood pressure and heart rate. In the long-term, apnea is linked with an increased risk of cardiovascular problems, such as hypertension, stroke, myocardial infarction (heart attack), heart rhythm disorders (cardiac arrhythmia), and heart failure. Finally, in cases of severe apnea, the risk of dying suddenly during sleep arise.
2. Depression
Lack of sleep, fatigue, need to take naps, and drowsiness is linked with sleep apnea.
They diminish your life quality, who often suffer from depression and isolation. A recent study has even shown a link between sleep apnea and cognitive impairment in older women.
3. Accidents
The lack of sleep induced by the apnea increases the risk of accidents, especially accidents at work and road. People with obstructive sleep apnea syndrome are 2 to 7 times more likely as a victim of a traffic accident.
4. Complications in surgery
Sleep apnea, especially if not yet diagnosed, the risk factor in general anesthesia would increase. Indeed, anesthetics can accentuate the relaxing of the muscles of the throat and thus aggravate apnea. Pain medication administered after surgery may also increase the risk of severe apnea. It is, therefore, important to tell your surgeon if you are suffering from sleep apnea.
Symptoms
If you suffer from several of these symptoms, you could suffer from sleep apnea:
- Fatigue intense even after nights of normal duration (8h) and from morning to waking
- Headache
- Drowsiness during the day
- Bad mood, irritability or even depression
- Memory loss
- Disorders of concentration
- Lower libido
- Hypertension
- Overweight
Your spouse may also suspect sleep apnea if you snore heavily and suffer from nocturnal breathing stops.
Treatment
How to cure sleep apnea?
Restoring a healthy lifestyle is sometimes enough to stop sleep apnea. A weight loss associated with the stop of smoking (tobacco) and alcohol can indeed restore quality sleep. Most of the cases, however, the doctor proposes to wear a mask overnight. The system works with a continuous positive airway ventilation system that delivers air, allowing better breathing and preventing apnea. When the use of the mask is not possible (e.g., when the noise of the mask is too troublesome or if the mask is not supported), surgery would be considered.
The operation carried out under general anesthesia, consists in releasing the respiratory tract by removing the gene (the uvula and part of the palate veil, possibly the tonsils). The results are promising, but sleep apnea can still return with time.
Medication
Although no medication can suppress sleep apnea, some treatments can help reduce apnea while treating the cause. Thus, if apnea is due to allergic rhinitis, nasal corticosteroids can reduce the number of apnea. Similarly, in patients with gastroesophageal reflux, that may aggravate apnea. Taking an antireflux drug (omeprazole) helps reduce apnea. Finally, if drowsiness is significant during the day despite CPAP treatment, stimulant drugs would be prescribed.
Dental devices
Dental appliances, for their part, use mainly the principle of mandibular advancement. Other devices holding the tongue in the anterior place are also available, but their use is rather small. By stabilizing the mandible in an advanced position, the upper respiratory tract reconfigured, facilitating the passage of air and eliminating episodes of respiratory obstruction.
Dental devices are particularly suitable for snoring
In cases of mild or moderate apnea, without too many symptoms. They can also be used in cases of severe apnea in APPC failure. A recent study comparing APPC to dental appliances in a group of severe cases concludes that the two treatment alternatives have comparable overall efficacy. Although APPC is more effective than a dental appliance, The dental device for several hours than the APPC makes the overall efficiency of these two treatment options comparable.
Continuous positive airway pressure (CPAP) treatment
It is a treatment of choice for sleep apnea. A device breathes air continuously through the nose, thanks to a mask that is worn at night. Several models of devices and masks are available. To choose this device, the term CPAP, which comes from the English “Continuous Positive Airway Pressure,” is often used.
The insulated air keeps the airways open continuously, which eliminates apnea. Although this treatment is extremely effective, it takes time to get used to sleeping with the mask. It may sound uncomfortable at first, but be patient. The reduction in symptoms is felt after 4 to 6 weeks, provided the mask is worn every night. This treatment improves your life quality, alertness, and memory of those affected, as well as lowering blood pressure associated with hypertension.
