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Sleep apnea

What is sleep apnea ?

Sleep apnea is characterized by a temporary cessation of breathing during sleep. These stops, often a result of obstruction of the upper airway, become pathological if their duration exceeds 10 seconds and their frequency of occurrence is greater than 10 times per hour of sleep.

This pathology mainly affects men from about thirty years of age and concerns about 5% to 10% of this population.

Sleep apnea is the cause of micro-arousals (awakenings imperceptible by the patient) altering the patient’s quality of sleep and thus causing fatigue during the day, often associated with attention disorders.

This pathology considerably increases the risk of driving accidents due to excessive daytime sleepiness.

Sleep apnea syndrome can also lead to cardiovascular disorders, as a consequence of repeated decreases in the concentration of oxygen (SaO2) in the blood during the many respiratory interruptions.

According to studies, sleep apnea syndrome affects between 2% and 4% of the general population, many cases being neither diagnosed nor treated.

Types of sleep apnea

There are three types of apneas:

Obstructive apneas are the most frequent. They are caused by the obstruction of the upper airways. During these events, thoraco-abdominal movements persist.

Central apneas are so called because they are the result of a halt in respiratory control in the central nervous system. They are less frequent than obstructive apneas.

Mixed apneas associate a central apnea at the beginning of the event followed by an obstructive apnea at the end of event.

Sleep apnea risk factors

Several factors increase the risk of sleep apnea, in particular:

  • Obesity: causes a narrowing of the airways;
  • Age: The frequency of sleep apnea syndrome doubles or triples after the age of 65;
  • Gender: Men are 2 to 3 times more affected than women;
  • The circumference of the neck;
  • Genetic factors: Family history of sleep apnea syndrome;
  • Reduced airway: large tongue, oversized tonsils, recessed chin, excess flesh inside the throat;
  • Type 2 diabetes: For diabetics, the prevalence of obstructive sleep apnea syndrome can reach 23%;
  • Nasal obstruction: People who often have a stuffy nose, because of allergies for example, are more prone to sleep apnea;
  • Alcohol use: Causes a relaxation of the throat muscles which increases the frequency and duration of sleep apnea;
  • The use of sedatives: Aggravate apneas for the same reasons as alcohol;
  • Sleeping on the back: This position increases snoring and apnea overnight.

Sleep apnea treatment

Continuous Positive Airway Pressure (CPAP)

Currently, the treatment of choice is continuous positive airway pressure ventilation (CPAP). This medical device maintains sufficient pressure in the breathing tracts to prevent the formation of upper airway collapse. It blows air continuously through a face-mask that is worn overnight.

Effective treatment improves the quality of life (increased alertness) of patients and decreases blood pressure in the event of associated hypertension.

Mandibular advancement splint (MAS)

The Mandibular Advancement Splint (OAM) is an alternative to CPAP in case of refusal or intolerance to it. This type of treatment is used in cases of snoring and mild obstructive sleep apnea. It is a personalized medical device that keeps the lower jaw in a forward position during sleep, thus keeping the upper airways open.