Sleep Apnea

What is it and how it effects people and their lives

Sleep Apnea

Sleep apnea SAS (sleep apnea syndrome) is a sleep breathing disorder that is characterized by breathing pauses of 10 to 30 seconds or more, which can be repeated more than 10 times per hour. These apneas lead to micro-awakenings that strongly affect the quality of life. Everyone can be affected by this respiratory illness, including children, but some people are at greater risk than others, especially overweight men.

People suffering from sleep apnea are usually the last to realize it! It is often their spouse, awakened by snoring, who then observes the breathing pauses. They are often associated with feelings of choking and restless sleep, this could affect our day to day life for example:When you wake up, you still feel tired, your mouth is dry and you often have headaches, During the day, you lack energy, you feel sleepy and irritable, and you have trouble concentrating, Some patients also report a decline in their libido.

According to the office of Health Economics for the British Lung Foundation there is an estimateof the 1.5 million people to be living with OSA in the UK have the moderate to severe forms of the disorder.According to the same survey, among the adult population who have not been diagnosed, 26% of them have symptoms and risk factors for developing sleep apnea disorders. Men would be affected in a greater proportion than women at a ratio of about 3 to 1.

There are Three Types of Apneas:


Obstructive Apneas

Obstructive apneas are the most common, they result in a stop of the airflow, the obstruction of the upper airways, with preservation of thoraco-abdominal movements which are then in phase opposition. The amplitude of these movements increases progressively during apnea, the endothoracic (oesophageal) pressures can reach, at the end of apnea, less than 80 to less than 100 cm H2o (the normal is a few cms H2o). Despite this endothoracic depression, no flow, no matter how weak, occurs.


Central Apnea

Central apnea is rare, it is characterized by a stop of the respiratory control. The nasal or oral air flow as well as the chest and abdominal movements stop.


Mixed Apneas

Mixed apneas combine the two previous ones: apnea begins with a central mechanism followed by an obstructive mechanism.

Signs are often tolerated for a long time. The very loud snoring, annoying the entourage much more than the person concerned, interspersed with pauses with noisy ventilatory recovery, constitutes the main clinical sign. It is favored by fatigue, nightly intake of alcohol or benzodiazepines that lower muscle tone, as well as dorsal decubitus, chronic nasal obstruction and tonsillar hypertrophy.

Sleep apnea can be caused by many factors, including:

  • The shape of the face and neck: wide neck, receding or receding chin, narrow face
  • The size of the upper respiratory tract
  • A narrow pharynx – long palate
  • Size of adenoids and tonsils
  • Nasal obstruction / mouth breathing
  • age
  • Sex (men being more at risk)
  • Overweight
  • Respiratory allergies
  • The consumption of alcohol and / or drugs
  • Smoking

Treatment of sleep apnea syndrome depends on its severity, its impact on sleep and alertness, and its consequences on the cardiovascular system. Conservative measures (such as weight loss, abstinence from alcohol or sleeping pills in the evening) are always recommended.

In some cases, apnea occurs only when the patient sleeps on the back. In these cases, a positional treatment (using a specially designed vest that prevents sleeping on the back) can be used. Mandibular advancement prostheses (a double dental gutter that is worn during the night and allows the jaw to move forward during sleep) can be an interesting treatment, especially for moderate apnea syndromes.

In more severe cases, the standard treatment is CPAP (Continuous Positive Airway Pressure). It is a device that allows you to breathe air at a certain pressure in the airways, using a mask that covers the nose or nose and mouth. This pressure opposes the airway closure that causes apnea, and is the most effective treatment for sleep apnea syndrome.

A weight reduction of 10% decreases the syndrome by 25%.

Cardio-vascular complications, high blood pressure, stroke are consequences of SAS. Obesity is a factor favouring: a weight reduction of 10% reduces the SAS by 25%. Tobacco increases inflammation in the pharynx and promotes the occurrence of apnea. Finally, alcohol, like most sleeping pills or anxiolytics, reduces the activity of the pharyngeal muscles, thus promoting apnea during sleep. It is at this level that we must begin to act.

the CPP (Continuous Positive Pressure) is the reference treatment of the SAS. It prevents sagging soft tissue of the pharynx, which causes obstructive apnea during sleep. A flow of air generated by a ventilation machine is administered via a nasal or naso-oral silicone mask.