Sleep apnea is a sleep disorder characterized by pauses in breathing (apnea), or a reduction in airflow (hypopnea). Along with insomnia, it is one of the most common causes of sleep disorders.
Breathing pauses can last 10 seconds or longer and occur several times during the night with varying frequency. Doctors consider it problematic when there are more than five events per hour. In severe cases, it can occur up to 30 times per hour.
Approximately 9% of men and 4% of women suffer from moderate to severe obstructive sleep apnea (15 apnea or hypopnea events per hour of sleep). This percentage can be as high as 30 to 80% for individuals suffering from high blood pressure, heart conditions, or diabetes. It is estimated that between 1 and 3% of children suffer from obstructive sleep apnea. The symptoms are generally similar to those observed in adults.
Each pause in breathing reduces the amount of oxygen supplied to the brain (hypoxia), and each sudden awakening increases blood pressure and heart rate. In the short term, these apnea events disturb sleep and mainly result in non-restorative sleep (waking up tired), headaches, or drowsiness during the day. In the long term, if left untreated, sleep apnea can have serious health consequences.
There are two types of sleep apnea. The most common is obstructive sleep apnea (OSA), which occurs when the soft tissues at the back of the throat collapse and momentarily block the upper airway during sleep. Even though the individual makes an effort to breathe, the airway obstruction prevents air from flowing into the lungs.
The other type, though much less common, is central sleep apnea (CSA). It occurs when the brain fails to signal the airway muscles to breathe. This type of apnea mainly occurs in individuals with severe illnesses such as heart disease or neurological disorders. It can also occur in individuals who have suffered a stroke or are morbidly obese.
Most people who suffer from sleep apnea do not realize their breathing stops during the night. However, apnea can cause "micro-awakenings" that can affect the quality of sleep. The most common symptoms are therefore those resulting from fragmented, poor quality sleep, such as:
- Waking up with a dry mouth
- Waking up with a headache
- Waking up exhausted and feeling excessively tired throughout the day
- Frequent and uncontrolled drowsiness
- Forgetfulness and difficulty concentrating
- Irritability, depression
- Decreased libido
- Heavy snoring
- Sensations of choking or gasping during sleep
- Enuresis (bedwetting) in children
- Night sweats
If you have a combination of any of these factors, it is a clear sign that you should see your doctor so that you can be screened for sleep apnea. Do you have any of these symptoms? Take our online test or get a doctor-prescribed diagnostic test.
There are a number of factors that increase the risk of sleep apnea, particularly:
- Obesity It causes narrowing of the airways
- Age The frequency of sleep apnea doubles or triples after 65
- Gender Men are two to three times more likely to suffer from apnea than women
- Neck circumference
- Genetic factors Family history of sleep apnea
- Narrowed airways Enlarged tongue or tonsils, receding chin, excessive tissue in the throat
- High blood pressure
- Type 2 diabetes The prevalence of obstructive sleep apnea syndrome can reach 23% in diabetics
- Nasal obstruction For example, individuals who often have a stuffy nose due to allergies are more likely to develop sleep apnea
- Alcohol consumption It causes throat muscles to relax, thereby increasing the frequency and duration of sleep apnea
- Use of tranquilizers They worsen sleep apnea the same way alcohol does
- Sleeping on your back This position increases snoring and the likelihood of apnea during the night
The more factors that apply to your personal situation, the higher the probability that you suffer from sleep apnea. Obstructive sleep apnea can be easily diagnosed through a home test.
In the short-term, sleep apnea can cause fatigue, headaches, and irritability that can reduce your quality of life and your daily efficiency. It can also disturb your bed partner, as it is often accompanied by heavy snoring.
If left untreated, the lack of sleep caused by apnea is likely to result in excessive daytime drowsiness, leading to two to seven times as many work and car related accidents and putting you and those around you at risk.
Sleep apnea can also lead to other severe chronic illnesses such as cardiovascular diseases (high blood pressure, stroke, heart attack, cardiac arrhythmia, heart failure), depression, diabetes, sexual dysfunction, and obesity.
According to some studies, the estimated life expectancy for a patient with untreated obstructive sleep apnea is 58 years, compared to the average life expectancy of 78 years for men and 83 years for women.
The Prévimed online test includes a checklist of the various symptoms as well as two questionnaires recognized by health professionals. This 3-step test identifies individuals who suffer from sleep apnea, thus allowing them to control their condition with the appropriate treatment. More than 80% of individuals who suffer from moderate to severe sleep apnea do not even know they have it!
The only way to accurately diagnose sleep apnea is through a sleep study. There are three types of studies available.
Overnight home oximetry or saturation measures blood oxygen levels and calculates the number of desaturation events. It is a useful screening tool; however, more detailed sleep testing may be required in certain cases.
Home respiratory polygraphy is a commonly used test that provides simple and effective results to confirm obstructive sleep apnea. This home test records your breathing patterns, heart rate, and blood oxygen level as well as abdominal and thoracic movements throughout the night.
Prévimed uses the ALICE PDX diagnostic system, a small device that is placed on the chest to help establish the degree of sleep apnea, whether light, moderate, or severe .
An in-laboratory polysomnography is required in rare cases where breathing pauses are not clearly detected but a sleep disorder is suspected. This is a more comprehensive examination that also records brain activity in order to identify the various stages of sleep.
* A medical prescription is required for all diagnostic exams.
If you think you might suffer from Sleep Apnea Syndrome
You are only 5 steps away from your diagnosis:
- Show the results of your online test to your family doctor, your local FMG, or a pulmonologist, who will determine whether a sleep study is required.
- Make an appointment with our respiratory therapist (within 3 days maximum) for nocturnal saturation or home polygraphy.
- Bring your prescription with you when you come to our clinic. Our respiratory therapist will explain how the device works.
- Take the device home and sleep as usual.
- Return the equipment the following day. Your results will be sent to your doctor or pulmonologist, who will determine whether you suffer from sleep apnea. Your results are usually sent to you within 4 weeks.
Personalized treatment and appropriate follow-up
Once you are diagnosed and the appropriate treatment is chosen, Prévimed will keep you informed and support you throughout the process. Prévimed's customer approach is based on the success of your treatment.
The success of your treatment is at the heart of what we do. That is why our approach is based on active listening, understanding your needs, motivation, and education. We are partners in your sleep apnea treatment.
Initial Teaching and Testing Meeting
During the meeting, the respiratory therapist will explain your prescribed treatment and provide some tips and tricks to maximize its benefits on your quality of life and your health.
The operation, maintenance, and safe use based on the type of device prescribed by your doctor will also be discussed (CPAP machine, Auto CPAP (APAP) or Bi-level (BiPAP)).
Choosing the right mask and knowing how to adjust it correctly is essential to the success of the treatment. That is why our experienced respiratory therapist will take all the time needed, making sure you fully understand how to use it. The therapist will also advise you on the type of mask that best suits the shape of your face to ensure effective treatment.
We offer in-home service for persons with limited mobility.
Visit our online store to discover our full range of masks.
The respiratory therapist who met with you will follow-up within 3 weeks to ensure your treatment is going well and to verify that the choice of mask was satisfactory.
A therapeutic monitoring report will be given to you or sent directly to your attending physician following each visit.
An annual check-up will be conducted by our respiratory therapist to ensure the continued effectiveness of treatment.
Our respiratory therapist is always available should you experience any technical issues or problems adapting to the therapy. Our customers are provided with ongoing support to help them adjust to their therapy and thus avoid discontinuation of treatment.
We offer a free one-month trial period to ensure you select the mask that fits you best.
Enjoy peace of mind knowing that our technical staff is always available in time of need. Prévimed is one of the few companies in Canada that has a repair service for sleep apnea equipment.
Devices can be returned without commitment or penalty during the first three months of the rental-purchase option. You will only be charged for the months the device was used.
You may choose to pay the full balance on the fourth month following the three-month trial period.
You may choose to continue your monthly payments for nine months following the three-month trial period. You own the device after the twelfth payment.
By adopting simple lifestyle habits, you can reduce your apnea symptoms and improve the quality of your sleep. In mild cases, it may even help eliminate sleep apnea altogether. Some of these changes include: losing weight, sleeping on your side, raising the bed, avoiding sleeping pills and alcohol, quitting smoking, and treating your allergies.
Continuous Positive Pressure (CPP)
The most effective treatment for sleep apnea is unquestionably through a continuous Positive Airway Pressure device (CPP or CPAP). The device delivers a steady stream of air through a mask worn over the nose at night. There are various models of devices and masks available. The mask, which is fitted to the contours of your face, works by pushing a steady flow of air into the throat, keeping airways continuously open at all stages of the breathing cycle during sleep.
Although this treatment is highly effective, it does take some time to get used to sleeping with the mask. This might be uncomfortable at first, but it just takes patience. If you wear your mask nightly, you should see a decrease in symptoms within 4 to 6 weeks. This treatment can improve the patient's quality of life, alertness, and memory, as well as lower blood pressure in patients with associated hypertension.
Mandibular Advancement Device (MAD)
The Mandibular Advancement Device (MAD) is an alternative option for patients who reject or cannot tolerate the CPP device. This type of treatment is used to eliminate snoring and mild cases of obstructive sleep apnea. It is a made-to-measure medical device that forces the lower jaw forward and keeps the passages of the upper airway open during sleep. This option is not usually recommended by doctors as it can result in further complications.
Surgical solutions are available but rarely recommended as their success rates vary. As with any surgical procedure, potential risks and complications can occur.
Your doctor will prescribe one of the following devices:
CPP or CPAP Device
Continuous positive pressure in the airways with the lowest level of fixed pressure necessary to eliminate obstructions.
Auto CPP or APAP
Variable positive pressure in the airways, which adjusts automatically with each breath to provide you with the lowest air pressure necessary to keep airways open. Some patients do not tolerate variations in the level of pressure as it causes them to wake up during the night.
Bi-level Positive Airway Pressure or BiPAP
It provides two levels of pressure, one on inhalation and the other on exhalation. This treatment is recommended for those who cannot tolerate CPAP or who require assisted ventilation.
Each of the devices we distribute has additional comfort features such as the lowering of pressure at the beginning of each exhalation, allowing for better treatment tolerance on set-up, and the ramp feature, which gradually increases the pressure to the prescribed setting as you fall asleep.
Types of masks
To ensure successful treatment, we offer three types of masks from various manufacturers. The most important thing when choosing a mask is to make sure it is correctly adjusted, comfortable, and airtight so that it delivers the appropriate amount of air.
The nasal mask covers the patient's nose. This is the most popular mask.
The nasal pillow mask allows airflow directly into the nostrils. This type of mask is generally recommended for patients who are claustrophobic and do not tolerate other types of masks.
The facial mask that covers the nose and mouth is often recommended for patients who breathe with their mouth open.