Sleep apneas, how to correct them?

The frequency of SAHS ranges between 2 and 4% of the general population, being more frequent in men than in women (4% and 2% of men and women over 40 years old respectively). In up to 80% of cases there is an associated problem of overweight.

Sleep apnea is a transient interruption of the respiratory rhythm which in most cases is due to obstructive mechanisms in the upper airway related to snoring.

The recurrent occurrence of apnea episodes in a patient, together with the health disturbances resulting from these apneas, is called sleep apnea-hypopnea syndrome (SAHS).

Do I suffer from sleep apnea?

Sleep apnea is defined by the existence of breathing stops of more than 10 seconds during which an effort of the thoracic and diaphragmatic musculature can be observed trying to overcome the obstruction.

  • Sometimes the apnea episodes awaken the patient abruptly with a distressing sensation of suffocation,
  • At other times, it is the partner of the person with SAHS who detects these respiratory arrests.
  • However, it is not uncommon for patients with SAHS to be unaware of the existence of the disease until the associated symptoms of daytime sleepiness, arterial hypertension, headache or cardiac pathology appear.

When SAHS is suspected, the patient is indicated to undergo polysomnography. In this test different sensors analyze the respiratory rhythm, oxygen level and other parameters that allow us to accurately diagnose the alteration.

Sleep apnea, consequences

Episodes of apnea have several effects on the body of the sufferer. The first consequence, of almost immediate appearance, is the

  • Alteration in the normal structure of sleep: the patient with SAHS does not rest properly, wakes up with a feeling of lack of sleep and often with headache.
  • Daytime drowsiness and the patient may fall asleep in any situation, including driving, with the consequent risk of accidents.
  • The appearance of behavioral changes, irritability, anxiety and depression are also frequent.
  • Changes in oxygen levels during the night, together with changes in heart rate and cardiovascular dynamics during apnea episodes, are responsible for the appearance of arterial hypertension, cardiovascular and cerebrovascular pathology.
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The first treatment measure in a significant number of cases is weight reduction. Certain substances such as alcohol or tobacco favor the appearance of apneas.

In some cases there are anatomical alterations that favor the obstruction to the passage of air. A deviated nasal septum, allergic rhinitis or nasal polyposis can favor snoring and secondarily apnea.

In the same way, very voluminous tonsils or tongue, or an excessively thick and elongated palate may be responsible for obstruction and apneas.

Surgery in these cases can be decisive since the elimination of the factors that facilitate obstruction can eradicate apneas and even snoring.

Sleep apneas, treatment

Airway pressure generators are globally the most widespread therapy in the treatment. CPAP (Continuous Positive Airway Pressure) and its variants make it possible to keep the airway permeable thanks to the introduction of a constant or fluctuating pressure air flow during sleep.

The response in many cases is very satisfactory, however some patients will require surgical treatment due to poor tolerance to the system due to anatomical alterations. There are different surgical techniques on the nostrils and pharynx, which can completely solve the problem.

Mandibular advancement splints are devices that allow to increase the air space behind the tongue in patients with retrognathia (retracted jaw) solving the obstruction without the need of surgery.

An unavoidable principle in the treatment of apneas that the patient has to admit is that, although the symptoms are not very bothersome, the long-term consequences make it necessary to treat to solve the disease.