Sleep Apnea: Detecting, Understanding, and Treating a Common Yet Undiagnosed Condition

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It is estimated that 3 million British people suffer from sleep apnea, with most of them going undiagnosed. Sleep apnea is usually suspected by a doctor when a patient consults for one of the underlying conditions it can cause when left untreated.

What Is Sleep Apnea and Who Does It Affect?

Sleep apnea is more common in the elderly and individuals who are overweight or obese, but it affects a significant portion of the population. Some family history and menopause can also be risk factors.

Generally defined as "forgetting to breathe," sleep apnea can be of two different types depending on the causes that trigger it. It is a sleep-related breathing disorder characterized by unconscious interruptions in breathing that can last on average from ten to 30 seconds and occur frequently during sleep. These interruptions lead to a partial awakening that the person is unaware of and will not remember. Sleep apnea significantly impairs sleep quality, with noteworthy consequences for one's quality of life. Symptoms such as drowsiness, morning fatigue, daytime fatigue, irritability, and snoring are challenging to identify because they are not specific to this condition. It's essential to emphasize that, although snoring is considered one of the symptoms of sleep apnea, it is not always present. In the case of recurrent snoring problems, only a precise diagnosis can distinguish it from sleep apnea. It's especially the combination with other symptoms that should alert healthcare professionals.

What Causes Sleep Apnea?

Central Sleep Apnea: The Brain "Forgets" to Breathe

There are two main causes of sleep apnea. Failure of the central nervous system can indeed cause a "forgetting to breathe," where the brain fails to send the necessary signal for respiratory control, resulting in the respiratory muscles not receiving the order to contract. This phenomenon is central sleep apnea, and it can result from conditions such as stroke or heart failure. Neurological management is recommended in such cases. However, this type of dysfunction represents a relatively rare form of sleep apnea.

Obstructive Sleep Apnea

Obstructive sleep apnea is the most common form of sleep apnea and can sometimes be combined with central sleep apnea.

It is a malfunction of the upper airways characterized by the relaxation of muscles controlling the tongue and the soft palate. It can be partial, characterized by snoring, or total, completely blocking the passage of air. Sleep apnea forces the heart to work harder to continue supplying the brain with oxygen. This is always followed by a phase of "micro-awakening," significantly impairing sleep quality.

How to Recognize Sleep Apnea?

The affected person usually does not realize it. Often, it's the partner who notices breathing pauses and restless sleep due to a brief sensation of suffocation. A doctor may recommend tests when a person complains of snoring, recurring headaches, drowsiness, a dry mouth, and chronic fatigue. In some cases, sleep apnea can also have a negative effect on libido. It is mainly these additional symptoms that will differentiate it from simple snoring.

Sleep apnea is often discovered "by chance," and it's essential to discuss it with a doctor if there are any doubts. Through a comprehensive patient interview, the doctor can assess the need for more specific examinations, which may include measuring brain activity. The most comprehensive and effective test is polysomnography, which is conducted in a sleep laboratory under the supervision of a sleep technician. There are other less detailed examinations that can be performed at home.

What Are the Dangers of Sleep Apnea?

By depriving a person of restorative sleep, sleep apnea can lead to or worsen multiple conditions such as osteoporosis, cardiovascular problems, high blood pressure, strokes, and certain forms of cancer. Recent medical research has highlighted the significant impact of sleep quantity and quality on various aspects of mental and physical health. This, combined with impaired quality of life, repeated fatigue, hazards of driving in such conditions, and several direct or indirect consequences of untreated sleep apnea, underscores the importance of early detection and management.

How Is Sleep Apnea Treated?

There are several types of treatments for sleep apnea. Once the diagnosis is confirmed, it is crucial to evaluate the various possibilities with a healthcare professional. Although medication for sleep apnea has evolved in recent years, there is still no single effective medication for treating it. Instead, a combination of medications may be used as a complementary treatment alongside other solutions. Several specialized devices offer effective and tailored responses. Continuous positive airway pressure (CPAP) is currently the most recognized method for severe forms of sleep apnea. It involves a ventilation system with an airflow generator placed near the bed and a mask connected by a tube. This device helps lift the tongue and clear the air passages. Advances in research have allowed CPAP providers to offer much more sophisticated, quieter, and discreet installations. While most patients who have tried CPAP acknowledge how much it has improved their lives, some may still be hesitant to use it. Psychological support and assistance from a competent team for individual adjustments are crucial for optimal use. When used correctly, this device is highly effective.

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