Sleep Apnea

What types of sleep apnea are there?

What are the symptoms?

Sleep apnea occurs at night as well as during the day, due to the chronic fragmentation of sleep it causes:

• Loud, habitual snoring, often reported by bed partner
• Breathing pauses observed during sleep, sometimes followed by a choking sound or noisy recovery
• Excessive daytime sleepiness, even after an apparently normal night's sleep
• Persistent fatigue on waking, feeling of unrefreshing sleep
• Morning headaches, especially in the frontal region
• Difficulty concentrating, memory problems, irritability
• nocturia (waking up at night to urinate), often unrecognized as a symptom of apnea
• Waking up with a feeling of suffocation or palpitations

What are the risk factors?

• Overweight and obesity: accumulation of adipose tissue around the upper airways
• Male: risk about twice as high as in women before menopause
• Advanced age: prevalence increases significantly after age 50
• Menopause: loss of the protective effect of estrogen and progesterone on pharyngeal muscle tone
• Airway anatomy: wide neck, retrognathic jaw, large tonsils, deviated nasal septum
• Consumption of alcohol, sedatives or sleeping pills: further relaxation of pharyngeal muscles
• Active smoking: inflammation and edema of the upper airways
• Family history of sleep apnea
• Untreated hypothyroidism, acromegaly

How is the diagnosis made?

Diagnosis is based on objective recording of sleep and nocturnal breathing. Two types of examination are used, depending on the clinical context:

What is the apnea-hypopnea index (AHI)?

AHI is the average number of apneas and hypopneas (partial reductions in respiratory flow) per hour of sleep. It is the main indicator of severity used to classify the syndrome and guide treatment decisions:

What are the treatment options?

Management is individualized according to the severity of the syndrome, the person's clinical profile and preferences. Several therapeutic approaches are available:

• Continuous positive airway pressure (CPAP): reference treatment for moderate to severe forms, keeps the airways open during sleep with a continuous flow of air via a nasal or face mask.
• Mandibular advancement orthosis (MAO): custom-made dental device that advances the lower jaw to clear the airway, effective in mild to moderate forms.
• Hygienic dietary measures: weight loss, reduction or elimination of alcohol, smoking cessation, avoidance of sedatives and sleeping pills, sleeping position (avoid supine position).
• ENT surgery: in selected cases (tonsillar hypertrophy, septal deviation, anatomical malformations), surgical correction may be considered.
• Hypoglossal nerve stimulation: an emerging option for moderate to severe forms of asthma when CPAP is intolerable

Sleep apnea and driving

Excessive daytime sleepiness associated with untreated sleep apnea significantly increases the risk of road accidents. In Quebec, certain professions involving the driving of heavy vehicles or public transport are subject to specific regulatory obligations concerning the screening and treatment of this syndrome. It is advisable to discuss this with your doctor.

Consult at Clinique Omicron

Clinique Omicron's doctors, at our locations in Quebec, can assess your symptoms, prescribe a home respiratory polygraph and refer you to the specialized resources best suited to your situation. If you snore heavily, experience persistent fatigue on waking or suffer from daytime sleepiness, a medical consultation is the first step towards effective diagnosis and management.

The content of this page is provided for informational purposes only and is not intended to replace the advice of a qualified healthcare professional. Consult a physician for any symptoms, questions or decisions you may have regarding your health.