Obstructive Sleep Apnea/Hypopnea Syndrome

Obstructive Sleep Apnea/Hypopnea Syndrome General Information

Obstructive Sleep Apnea/Hypopnea Syndrome is a disorder that affects 1 – 3% of the global population. Many studies proved that OSAHS represents a great factor risk for cardiovascular diseases, such as hypertension, myocardial infarction, stroke etc. The main characteristic of this disease is the recurrent episodes of truction during sleep and of upper airway collapse. Arousals from sleep and oxyhemoglobin desaturation are usually related with these obstruction episodes. Doctors use the term of Obstructive Sleep Apnea/Hypopnea Syndrome when they talk about excessive daytime sleepiness associated with those episodes. This disorder is relatively common, but most people do not recognize it. More than 70% of the cases in the USA are not diagnosed by the primary care physicians although it is not that rare there than in the other parts of the world. A study estimated that this syndrome affects 1% of the women and 3% of the men. In the other parts of the world the tests were made only on men and the highest rate was found in Australia and Israel, while in the other parts, the percentage is fewer than 5%. Also, some studies showed that young black people are more reliable to Obstructive Sleep Apnea/Hypopnea Syndrome than the white ones. The same results were found recently in the older groups. After menopause, the women are more predisposed to develop this syndrome. Those women who have OSAHS and are not at their menopause tend to be fatter and may develop cranial abnormalities. Also, the risk of getting OSAHS is increasing with the age.

Obstructive Sleep Apnea/Hypopnea Syndrome Symptoms

Obstructive Sleep Apnea/Hypopnea Syndrome Treatment

If a person manifests symptoms or signs of Obstructive Sleep Apnea/Hypopnea Syndrome he or she must go to a center for sleep disorders for a polysomnography or for being evaluated by a physician. The problems with sleeping may be caused by one or more disorders in many cases so that these consultations are absolutely necessary. A sleep study prior to surgery is required if the patient has habitual loud snoring and other manifestations of OSAHS. During the operation, the snoring problem may be resolved, but not the Obstructive Sleep Apnea/Hypopnea Syndrome too. The severity of the sleep disorder breathing indicates what treatment should be followed in Obstructive Sleep Apnea/Hypopnea Syndrome. Those patients who have a much more mild form of OSAHS can be treated with a bigger variety of therapies than those with a more serious type of disease. Unfortunately, the last ones dispose of a nasal CPAP device as treatment. CPAP has the most effective results in treating this syndrome and it is considered a standard method care. It is demonstrated that it improves cognitive functions, daytime sleepiness and mood in patients with mild manifestations of Obstructive Sleep Apnea/Hypopnea Syndrome.

The mechanism used decreases the arousals, makes the apneas and hypoapneas to disappear and brings the oxygen saturation to normal levels. CPAP actually prevents the collapsing of the soft tissues by dividing the upper airway. The exact indications for these devices are not yet totally determined. The patients eligible for a therapy using CPAP must have an AHI over 20. In the other case, CPAP need to be used if the person presents hypertension, EDS or some cardiovascular diseases. This method lowers the costs for health care and improves the quality of every-day living because it is proved that makes the blood pressure get lower in patients with a more severe form of OSAHS. Despite of the good results and effects, the surgical method is not a standard therapy because of the lack of long-term outcome studies. But as many other methods of treatment, this one has some secondary effects that are usually treated with antihistamines, humidification or nasal steroids. It causes almost all the time sinus congestion, dry mouth or leads to rhinitis. A strict adequate diet must be followed too when dealing with this syndrome, especially in the case of extremely fat persons. The obese patients are conducted to a dietitian that will provide him or her program with physical exercises and the appropriate diet in order to lose some weight. Recommended for the treatments are modafinil or protriptyline. The last one is a tricyclic antidepressant that is given in low doses to patients with mild signs or snoring. It is very efficient because decreases rapid aye movements during the sleep and increases the neuromuscular activity of the upper airway. People with residual sleepiness must follow a medication with these standard drugs. Some conservative measures specify sleeping on the both sides, the avoidance of the alcohol before going to bed and weight loss and must be a part of the medical treatment for Obstructive Sleep Apnea/Hypopnea Syndrome.