Sleep Breathing Disorders
First created | 05/04/2009
Last edited |
- Ohayon MM, Guilleminault C, Priest RG, Caulet M. Snoring and breathing pauses during sleep: telephone interview survey of The United Kingdom population sample. Br Med J 1997; 314:860-3
Sleep disordered breathing encompasses a spectrum of conditions whose common feature is intermittent loss of upper airway patency associated with sleep.
These syndromes, which range from snoring to frank obstructive sleep apnea, have gained increasing recognition in the past 20 years. There has been evolution from a clinical focus on the most severe cases to a much wider spectrum of sleep disordered.
OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS)
The primary complaint is excessive daytime sleepiness or insomnia.
The sleep is characterized by several episodes of sleep apnea (episode of cessation of breathing during the sleep that lasts up to 10 seconds) caused by upper airway obstruction.
Patients with this syndrome have usually a long history of loud snoring. Upon wake up, they often feel the sleep was not refreshing. Morning headaches and dry mouth upon awakening are also frequently reported.
A growing body of the literature has shown that Obstructive Sleep Apnea Syndrome has serious consequences:
- excessive daytime sleepiness,
- increased risk of mortality,
- long term cardiovascular complications including increased risk of hypertension and
- high economical costs.
CENTRAL SLEEP APNEA SYNDROME (CSAS)
Like for OSAS, the primary complaint is excessive daytime sleepiness or insomnia.
The sleep is characterized by several episodes of sleep apnea caused by a cessation or decrease in the ventilatory effort during sleep.
Patients with this syndrome often complain of an inability to maintain sleep. It is not uncommon, these patients wake up during the night gasping for air or with a sensation of choking. During the daytime, they frequently report being tired, fatigued or sleepy.
UPPER AIRWAY RESISTANCE SYNDROME (UARS)
This disorder results from repeated increases in resistance to airflow within the upper airway that lead to brief arousals. It is often accompanied of daytime somnolence that motives the subject to consult a physician.
Currently, a diagnosis of UARS is appropriate for patients who:
- complain of daytime tiredness and/or daytime sleepiness
- have a classical thermistor-defined Apnea/Hypopnea Index < 5 events per hour and
- display an abnormal increased respiratory effort as measured by esophageal pressure monitoring during sleep which leads to repetitive arousals from EEG sleep.
Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002 Apr;6(2):97-111.