Sleep apnea is the interruption of breath during sleep, which lasts more than 10 seconds.
Sleep Apnea Syndrome (SAS) is considered to be the presence of a specific clinical symptomatology, along with the detection of a pathological number of episodes, obstructive apnea and hypopneas. The current name of the syndrome is an evolution of the so-called “Pickwick Syndrome”.
Types of sleep disorders:
1. Apnea
Interruption of breath (airflow) for more than 10 seconds
Types of apnea:
Central: Air flow interruption and lack of respiratory chest and ventricular movements
Obstructive: Interruption of the flow of air with breathing activity of either the chest or ventricle or both
Mixed: Apnea begins as Central & continues as Obstructive
2. Hypopnea
Reduction of airflow over 50% or corresponding reduction in chest and ventricular respiratory movements and decrease of saturation Hb over 4%.
3. Awakening
Recently, the American Sleep Disorder Study suggested adding the concept of arousal, meaning transition to a lighter sleep state or vigilance.
What does sleep apnea mean?
Every breath of the respiratory cycle for more than 10 seconds is characterized as (significant) sleep apnea.
Apnea occurs when the pharyngeal walls coincide, and breath is completely obstructed, as opposed to simple snoring, where airway obstruction is partial.
The number of apneas per hour of sleep is called an apnoic index, and is a measure of the severity of hypopnea syndrome. An index of less than 5 is conventionally accepted as normal.
Other criteria for the severity of hypopnea syndrome are the degree of desaturation of hemoglobin into oxygen, the percentage of time that hemoglobin remains desaturated, and of course the severity of the symptoms of the patient.
Hypnosis is also similar to the concept of apnea and its practical significance is the same as apnea.
The distinction of apneas in central type and obstructive type is of big diagnostic importance. Central type apneas is a respiratory center dysfunction and the obstructive type ones are due to coincidence and obstruction of the pharynx’s/larynx’s airway. Often these two types coexist.
What does sleep apnea syndrome mean? Is it the same as apneas?
Sometimes, while it is certain that there is heavy snoring with apnea, the patient does not show any symptoms. This is mainly, but not only, observed in elderly patients.
We refer to sleep apnea syndrome only when there are symptoms, as a result of snoring and apneas. In cases of simple heavy snoring, or even with apneas, but without symptoms and without desaturation of hemoglobin, we refer to Increased Airway Resistance Syndrome.
It is an innocent syndrome, but it needs monitoring, because it can at any time switch to a sleep apnea syndrome, so it will need to be treated. It is not uncommon in sleep apnea syndrome, for example, for the patient’s air supply to be interrupted for 20 seconds every minute !!!
It’s almost like strangling someone in doses or passing one third of sleeping time…
Treatment
According to the latest new findings, it is worth noting that the American Academy of Sleep Medicine recommends intra-oral applications as the first-line therapy for the treatment of mild to moderate sleep apnea and snoring, and for the most severe forms of the sufferers in whom CPAP Treatment has failed .