What if it was sleep apnea syndrome?
Nocturnal snoring and daytime sleepiness: these are the two main symptoms[1] of obstructive sleep apnea-hypopnea syndrome (OSAHS).
These stops (apneas) or decreases (hypopneas) in ventilation generally last from 10 to 30 seconds and are repeated at least five times an hour. They can occur a hundred or more times a night. The result is micro-awakenings, poorer sleep and a degraded quality of life: morning headaches, irritability, memory and attention problems, reduced libido[4], increased risk of road accidents[5]…
In the longer term, these nocturnal respiratory disorders are associated with an increased risk of various pathologies, including cardiovascular (stroke in particular), metabolic and neurocognitive diseases, as well as cancer[6].
Did you know?
We spend a third of our lives asleep! By the age of 75, we’ll have slept for an average of 25 years [7].
What are the risk factors?
- The main factors favoring these disorders include obesity and overweight, anatomical peculiarities (e.g. backward chin), smoking, the use of certain sedatives, alcohol consumption, especially before bedtime, and the menopause[9].
- Men are twice as likely to suffer from sleep apnea as women[8] and the risk increases with age.
How is it diagnosed and treated?
- The first thing to do in the event of symptoms suggestive of sleep apnea (poor sleep, snoring, drowsiness, etc.) is to talk to your GP. He or she can then refer you to a sleep specialist for a diagnosis, based on a recording of nocturnal breathing (ventilatory polygraphy) or sleep (polysomnography)[10].
- Continuous positive airway pressure (CPAP) is the reference treatment for patients with moderate to severe OSA*[11] with mandibular advancement orthoses (MAOs) as an alternative.
- CPAP treatment involves fitting a mask that blows air into the airways to prevent closure of the pharynx[12]. This therapeutic modality has proved effective in reducing daytime sleepiness, the risk of road accidents and the apnea-hypopnea index (AHI). In the long term, it also reduces cardiovascular morbidity and mortality in patients whose compliance is at least 4 hours per night[13].
- In all cases, whatever the severity of the syndrome, hygienic and dietary measures are recommended: avoidance of alcohol in the evening, weight loss, increased physical activity, etc.
* CPAP is recommended as first-line treatment when the apnea-hypopnea index (AHI) is greater than 30, or between 15 and 30 in the presence of poor-quality sleep or associated severe cardiovascular disease.
Publications :
• Published by SRETT :
Loc Le Xuan, Bernard Fleury, Philippe Salamitou (2015).
New method for evaluation of CPAP AHI measurement accuracy.
European Respiratory Journal 2015 46: PA3378; DOI: 10.1183/13993003.congress-2015.PA3378
• Other publications :
Hoet F, W. Libert W, Sanida C, et al. (2017).
Telemonitoring in continuous positive airway pressure-treated patients improves delay to first intervention and early compliance: a randomized trial
Sleep Medicine, Volume 39, November 2017, Pages 77-83.
REFERENCES
[2] https://www.inserm.fr/dossier/apnee-sommeil/
https://www.msdmanuals.com/fr/professional/troubles-pulmonaires/apn%C3%A9e-du-sommeil/apn%C3%A9e-obstructive-du-sommeil
https://pubmed.ncbi.nlm.nih.gov/32286648/
[3] https://www.ameli.fr/assure/sante/themes/apnee-du-sommeil/comprendre-apnee-sommeil ; Eckert D.J., Phenotypic approaches to obstructive sleep apnoea – New pathways for targeted therapy. Sleep Med Rev, 2018. 37: p. 45-59.
[4] https://sante.gouv.fr/IMG/pdf/Sommeil_un_carnet_pour_mieux_comprendre.pdf
[5] Bonsignore, M.R., et al., European Respiratory Society statement on sleep apnoea, sleepiness and driving risk. Eur Respir J, 2021. 57(2). ; Benjafield et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respiratory Medicine 2019. http://dx.doi.org/10.1016/S2213-2600(19)30198-5.
[6] Eckert D.J., Phenotypic approaches to obstructive sleep apnoea – New pathways for targeted therapy. Sleep Med Rev, 2018. 37: p. 45-59.
[7] https://www.sommeilsante.asso.fr/
https://www.francebleu.fr/infos/sante-sciences/chiffre-du-jour-nous-passons-un-tiers-de-notre-vie-a-dormir-1553165333
https://crts.fr/sommeil-un-tiers-de-notre-vie-a-dormir
[8] https://pubmed.ncbi.nlm.nih.gov/32286648
[9] https://sante.gouv.fr/IMG/pdf/Sommeil_un_carnet_pour_mieux_comprendre.pdf
https://www.ameli.fr/assure/sante/themes/apnee-du-sommeil/comprendre-apnee-sommeil
https://www.inserm.fr/dossier/apnee-sommeil/
[10] https://www.ameli.fr/assure/sante/themes/apnee-du-sommeil/symptomes-diagnostic-evolution
[11] https://www.has-sante.fr/jcms/c_1761160/fr/apnees-du-sommeil-de-nouvelles-recommandations-de-prise-en-charge-des-patients
[12] https://sante.gouv.fr/IMG/pdf/Sommeil_un_carnet_pour_mieux_comprendre.pdf
[13] https://www.has-sante.fr/upload/docs/application/pdf/2014-11/sahos_-_fiche_de_bon_usage.pdf ; Bonsignore, M.R., et al., European Respiratory Society statement on sleep apnoea, sleepiness and driving risk. Eur Respir J, 2021. 57(2).