Sleep apnea, when breathing stops during sleep: what to do

About one in four adults suffer from obstructive sleep apnea syndrome. Mostly they are men but, unlike what many think, women can also have to do with it, especially after menopause. Not to mention that often this respiratory disorder of sleep, which can have serious repercussions under various aspects, it goes undiagnosed in a high percentage of cases.

What is sleep apnea syndrome?

a sleep disordered breathing characterized by repeated episodes of complete (apnea) or partial (hypopnea)
upper airway obstructionassociated with a decrease in blood oxygenation and sleep fragmentation — explains the professor Luigi Ferini Strambi, director of the Sleep Medicine Center, Vita-Salute San Raffaele University in Milan —. Reduced oxygenation can have negative effects on the cardiovascular system, increasing the risk of developing hypertension (more evident in men), atrial fibrillation, heart attack and stroke.

And speaking of the increase in blood pressure, some studies have shown that over 50% of subjects who have drug-resistant arterial hypertension (ie who do not respond to drug therapies) actually have an apnea syndrome. On the other side, fragmented sleep, linked to continuous micro-awakenings, instead the main accused of excessive daytime sleepiness That exposes you to a greater risk of car accidents (two to seven times more), work and home.

How do we realize that we suffer from it?

Snoring is the typical alarm bell of one partial obstruction of the airways and usually precedes the onset of episodes of complete apnea by years. Often those who suffer from this disorder do not notice anything and the partner detects breathing pauses. Other suggestive symptoms for this syndrome are: awakenings with a feeling of suffocationa restless night’s sleep, the need to get out of bed often during the night to go and urinate and there excessive night sweats.

Furthermore, on the following day, the patient may experience a feeling of non-refreshing night sleep, easy tiredness. Very frequent, and important for its potential danger, the development of excessive daytime sleepiness. Finally, other daytime disturbances include reduced libido and sexual impotence, headache especially in the morning hours, memory, concentration and attention disturbances, sometimes symptoms of depression.

What can be done?

To counter the syndrome you can adopt different strategies, from weight loss to surgery in very selected cases. For example, an overweight individual with mild syndrome may benefit from weight loss. Indeed, it is calculated that 10% of weight loss in favor of the reduction of fat in the upper respiratory tract, which favors apnoeas. Another approach valid for those who snore only in the supine position positional therapywhich consists of forcing the person to sleep on their side. The most effective and widespread non-surgical remedy is based on the use, every night, of specific ventilation devices, in particular with the positive pressure mask or CPAP.

Possible otorhinolaryngological surgical treatments (for example tonsillectomy and septoplasty) have the aim of improving the passage of air and specifically correcting the anatomical alterations. The patient to undergo surgery must be studied thoroughlyevaluating all possible sites of upper airway obstruction.