Obstructive sleep apnea syndrome (OSAS)
Obstructive sleep apnea syndrome (OSAS) is a common but underdiagnosed condition despite potentially serious consequences. It occurs in both adults and children.
What is sleep apnea?
Sleep apnea is characterized by frequent pauses in breathing during sleep. Pauses can be due to respiratory arrest (apnea) or simply a decrease in airflow (hypopnea). In adults, apnea is defined as the cessation of breathing for at least 10 seconds. With each apnea or hypopnea, the level of oxygen in the blood drops sharply. As a result, the brain receives a signal that wakes the person from sleep and breathing resumes, often with noise. Because these events can occur hundreds of times per night, sleep is highly fragmented and of poor quality. These people are usually unaware of these awakenings during sleep but complain of being very drowsy during the day.
What is OSAS (Obstructive Sleep Apnea Syndrome)?
The most common form of sleep apnea is obstructive sleep apnea. During the waking period and normally during sleep, the neck muscles keep the upper airways open and thus air enters the lungs. In OSAS, the muscles of the neck and tongue relax excessively during sleep, causing the upper airways to close, despite respiratory effort.
What are the risk factors for OSAS?
Although OSAS can occur in men and women of any age, it is more common in middle-aged and obese men who have a neck circumference greater than 42 cm. However, OSAS can also occur in people of normal weight, who have certain anatomical abnormalities in the neck (enlarged tonsils or tongue or abnormal positioning of the mandible or jaw). Recent studies have shown that this syndrome frequently occurs in patients with congestive heart failure. Family history of OSAS and alcohol consumption are risk factors.
How does OSAS manifest itself?
You may not know that you have difficulty breathing during sleep; often your family members will be the first to notice certain signs or symptoms. If your answer is YES to any of the following questions, you may have obstructive sleep apnea syndrome.
- Are you told that you snore a lot and loudly?
- Has your spouse told you to stop breathing while you sleep?
- You don’t get a restful sleep and you feel tired or dizzy during the day?
- Are you sleepy or do you fall asleep easily during the day?
- Do you wake up breathing hard, panting, as if choking?
OSAS can have serious consequences?
YES. Detected late and left untreated, OSAS can significantly impair quality of life and cause several potentially serious pathologies:
- high blood pressure
- myocardial infarction
- arrhythmias during sleep and sudden death
- weight gain
- pre-diabetes, diabetes
- disturbances in attention, memory, and concentration
- irritability, mood swings, depression
- libido disorders
Due to excessive daytime sleepiness and disturbances in attention and concentration, accidents caused by falling asleep at the wheel and accidents at work can occur. OSAS can also become a couple problem: the seriously ill patient only sleeps, eats and goes to the toilet. Plus, snoring is annoying in all its forms, and you end up sleeping in different rooms.
What test needs to be done to confirm OSAS?
If you suspect you have OSAS, we recommend a consultation at our clinic. You will decide which type of test is best for you and whether it will be done in a sleep lab, which is part of a hospital, or at your home.
On the night of the diagnosis, the patient sleeps with a polygraph which allows the recording of the following parameters: air flow in the nose, oxygen level in the blood, thoracic respiratory effort, heart rate, snoring and body position.
In our clinic, the polysomnograph is used, a device that further explores sleep.
The recordings are painless and will be done during a normal night. The result will be analyzed by a specialist (pneumologist) who will determine if you suffer from sleep apnea, its severity and what treatment would be indicated.
Once it is established that you have obstructive sleep apnea, move on to the second stage: the therapy night during which the respiratory prosthesis is tested. This time, by connecting to a device called CPAP (Continuous Positive Airway Pressure), you will be breathing continuous positive airway pressure which works and keeps the upper airways open. The response from patients is spectacular and, in the morning, when they wake up they say they have not slept so well since childhood!
How is SASO treated?
Treatment aims to restore regular breathing during sleep and achieve restful sleep.
The only effective treatment for the condition is using the Continuous Positive Airway Pressure (CPAP) device. Through a mask, the patient inhales air through the nose under continuous positive pressure. There are new CPAP models that can easily reduce pressure during exhalation, increasing patient comfort and compliance. In addition, the latest devices constantly change the air pressure, constantly adapting it to the patient’s breathing performance.