1. Definition
Sleep Apnea syndrome is a sleep disorder characterized by Apneic-Hyponeic periods lasting over 10 seconds which occur repeatedly < 10x/hour or 30x/night.
2. Classification
2.1. Central Apnea (5%)
Idiopathic apnea. The brain is prevented from signaling the muscles to breath, normally due to instability in the respiratory tract.
2.2 Obstructive Apnea (95%)
Caused by decreased tone of the pharynx and the soft palate (airway obstruction, maintained central drive, enhanced thoracic movements).
3. Risk factors
- Constitutional features (e.g. short neck, large tongue)
- Higher age
- Increased body weight
- Alcohol, narcotics before sleeping
- Exhaustion
4. Diagnosis
Polysomnography (PSG) is a comprehensive sleep study used to diagnose sleep disorders, including sleep apnea. It monitors multiple physiological parameters during sleep to assess sleep stages and detect abnormalities.
- EG (Electroencephalogram)
- EOG (Electrooculogram)
- EMG (Electromyogram)
- ECG (Electrocardiogram)
- Respiratory Channels:
- Airflow
- Effort Belts
- Pulse Oximetry
- Snoring Detection
- Body Position
5. Consequences
- Decreased pO2
- Pulmonary hypertension –> Cor Pulmonale chronicum –> Right ventricular failure
- Increased erythropoietin –> polyglobulia, higher blood viscosity –> Increase in blood pressure
- Increased pCO2
- Cerebral vasoconstriction –> Increased intracranial pressure –> Increased heart rate with bradycardia, Cushing reflex
- CO2 sensitivity decrease
- Respiratory Acidosis
- Heart failure
- Pulmonary Edema
- Sleep Fragmentation
6. Treatment
- PAP (Continuous Positive Airway Pressure)
- ASV (Adaptive Servo-Ventilation)
- Oxygen Therapy
- Oral Appliances