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Obstructive Sleep Apnea
Obstructive Sleep Apnea
What is obstructive sleep apnea?
The most common sleep-related breathing disorder is obstructive sleep apnea syndrome (OSAS), which affects approximately 1 in 20 people in Belgium.
It is characterised by pauses in breathing lasting at least 10 seconds during sleep, caused by the collapse of the airways due to nighttime muscle relaxation. OSAS is often, but not always, accompanied by snoring. It affects sleep quality, leading to nighttime awakenings, non-restorative sleep, fatigue or daytime sleepiness. Over time, OSAS can have numerous physiological and/or psychological consequences, including cardiovascular, pulmonary, metabolic, psychiatric (depression) and cognitive effects (memory and concentration problems, etc.). Far from being harmless, OSAS significantly affects quality of life.
The main risk factors for this condition are smoking and being overweight.
Treatment
Diagnosis
The essential diagnostic test for this type of condition is a sleep study carried out at the Adult Sleep Functional Unit. This involves spending one night in hospital so that various sleep parameters can be recorded, allowing a comprehensive assessment of different sleep disorders, such as restless legs syndrome.
What happens during a sleep study?
You will generally arrive at the sleep laboratory at around 2 p.m. A member of staff will settle you into a private room. Before going to sleep, several sensors will be attached to your body and connected to the various monitoring devices. Depending on the circumstances, a camera may record you during the night. This allows the team to identify any abnormal movements (e.g. leg movements, parasomnias, etc.), ensure your safety in the event of a nighttime behavioural disorder, and reconnect a sensor that may have become detached while you were asleep. The following day, the extensive data collected are analysed. This analysis makes it possible to confirm the diagnosis of OSAS and/or identify any other potential sleep disorders. A further assessment by another medical specialist may sometimes be necessary.
Treatment
Depending on the cause, origin and severity of OSAS, various treatments are available:
- For people whose OSAS is caused by sleeping on their back, positional therapy may be recommended to correct their sleeping position.
- As being overweight and obesity are the main risk factors for OSAS, weight loss is always recommended for people concerned.
- Alcohol, smoking and muscle-relaxing medications (such as benzodiazepines) can also worsen OSAS. People concerned may therefore be referred to specialised care to help them reduce or stop using these substances.
- Continuous positive airway pressure (CPAP) involves wearing a (usually) nasal mask during the night to prevent apneas.
- A mandibular advancement device is generally indicated for mild to moderate OSAS (< 30 apneas per hour). This device is custom-made by ENT and oral medicine specialists.
- Maxillofacial surgery can be used to correct the position of the mandible (lower jaw) and maxilla (upper jaw), particularly in people with moderate to severe OSAS (> 30 apneas per hour).