However, respiratory abnormalities during sleep are common in the population. They can lead to significant health problems and have personal and social consequences. Obstructive sleep apnea is the most common form of apnea. Central apnea, mixed apnea and high upper airway resistance (HRVAS) are other forms of sleep breathing abnormalities, however they are less common.
More than 1 in 4 adults are at high risk of suffering from sleep apnea, but most of them are unaware they have it and therefore go untreated. In Quebec, approximately 1 person in 20 is diagnosed with obstructive sleep apnea (OSA), considering that 80% of people who suffer from it would not yet be diagnosed, it is estimated that 1 person in 10 would suffer from OSA, making it as common a disease as asthma, diabetes and high blood pressure. Sleep apnea affects men, women and even children.
Although it is a serious problem, it is easy to confuse with other issues such as depression, for example. It is therefore necessary to be attentive to the symptoms experienced.
50% of depressed people suffer from obstructive sleep apnea.
Causes
During normal sleep, the muscles that control the tongue, soft palate and pharyngeal walls keep the airways open. Breathing and sleep are then normal.
In people with sleep apnea, certain muscles in the throat relax causing drops in breathing and a drop in oxygen in the blood. In these people, the airways partially or completely block the passage of air during breathing.
Certain factors increase the risk of suffering from sleep apnea such as:
- Obesity;
- The shape of the face: receding or receding chin, narrow face, small jaw;
- The increased size of tonsils and adenoids;
- A high neck circumference;
- Family history;
- Age (> 50 years old);
- Gender (men being more at risk);
- Menopause;
- Respiratory allergies;
- The consumption of tobacco, sleeping pills and alcohol;
- Nasal obstruction requiring breathing through the mouth;
People at risk
If you are affected by the following medical conditions, you are at an increased risk of suffering from sleep apnea:
- Hypertension (high pressure);
- Depression;
- History of myocardial infarction;
- Atrial fibrillation (heart rhythm disorder);
- Diabetes;
- High cholesterol;
- Hypothyroidism.
Signs and Symptoms
It is important to note that a person with sleep apnea rarely has all of these symptoms and even, on occasion, very few symptoms.
- Agitated sleep;
- Choking or suffocation during sleep;
- Excessive sweating during sleep;
- Frequent trips to and from the bathroom during the night;
- Snoring*;
- Respiratory arrests observed by spouse;
- Non-restorative sleep, fatigue, excessive sleepiness during the day;
- Decreased energy level;
- Decreased alertness;
- Memory loss, lack of concentration and impaired judgement;
- Headache on waking;
- Irritability, mood swings and nervousness;
- Depression / anxiety;
- Low libido – erectile dysfunction;
- Behavioral disorder in children.
*Snoring is not a specific symptom of sleep apnea. It is possible to have sleep apnea without snoring. It is also possible to snore without having sleep apnea. Snoring can be used as an indicator, but is not diagnostic of sleep apnea.
What are the consequences of sleep apnea
Sleep apnea causes less restful sleep. This condition can cause, in the long term, serious complications for health and personal life, such as:
- An increased risk of cardiovascular diseases such as: arterial hypertension, angina, arrhythmias, myocardial infarction and stroke;
- Diabetes;
- Depression or anxiety;
- A decrease in vigilance and concentration and, consequently, an increase in the risk of road and work accidents;
- A divorce, a job loss, professional difficulties.
Diagnostic
Drowsiness assessment test (epworth)
Not everyone who suffers from sleep apnea is sleepy during the day. The drowsiness assessment test allows you to assess your likelihood of drowsiness or falling asleep in different circumstances of daily life, it gives a good reflection of excessive drowsiness. If you want to know your level of sleepiness, take this test. It may be interesting to repeat the test a few weeks after the start of your treatment in order to observe the improvement in your condition.
If your result is greater than 10 , you have marked daytime sleepiness. Speak with your doctor, an investigation would be necessary.
If your result is less than 10 , but you have some symptoms, it would be a good idea to discuss this with your doctor.
Access the tool interactive screening
Diagnostic examinations
In order to determine the need to prescribe a specific diagnostic test for sleep apnea, your doctor will assess your health condition, your symptoms and your medical history.
Sleep apnea can be diagnosed using the following three tests:
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Nocturnal oximetry
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Cardiorespiratory sleep polygraphy
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Laboratory polysomnography
The choice of test will depend on your state of health, the doctor will prescribe the one that suits you best. These are performed under medical prescription only and can be performed in a sleep laboratory in a hospital or at home. They can also be done in a private clinic (costs not covered by the RAMQ).
In children and adolescents, the diagnostic tests are no different from those carried out in adults.
Only the doctor who has examined and questioned you can prescribe the tests, make the diagnosis of sleep apnea and prescribe the appropriate treatment.
These diagnostic tests will aim to determine what type of sleep breathing abnormalities you suffer from, because the treatment differs from one type to another. There are 4 types of sleep breathing abnormalities:
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Obstructive apneas and hypopneas
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Apneas and central hypopneas
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Mixed apneas
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High Upper Airway Resistance (HRVAS)
Results
Following a diagnostic test showing that you suffer from sleep apnea, your doctor will be able to establish the degree of severity of your apnea according to the apnea/hypopnea index (AHI) calculated during the examination. . The latter represents the number of periods of apnea or hypopnea per hour of sleep.
Mild: 5 to 15 respiratory anomalies/hour*
Moderate: 15 to 30 respiratory anomalies/hour*
Severe: more than 30 respiratory anomalies/hour*
*According to the criteria established by the AASM
Treatments
There are several treatments for sleep apnea. Your doctor will prescribe the most appropriate type of treatment according to your diagnosis, taking into account the degree of severity of your apnea and, if necessary, the other illnesses from which you suffer.
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Continuous positive airway pressure (cpp) therapy
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Alternative treatments
Advice and prevention
Buying a ppc device
A CPAP machine and mask, including the coaching and instruction you need, can cost between $1500 and $2200. A wide range of products exist on the market. To obtain optimal comfort, do not hesitate to try the most recent ones. Find out about prices, warranties and after-sales service when you're ready to make a purchase.
For now, the purchase of a continuous positive pressure device is not reimbursable by the Quebec Health Insurance Plan, but the costs related to the treatment are eligible for the tax credit for medical expenses. Consult the Canada Revenue Agency, Revenu Québec or a tax advisor for more information.
Also check with your private insurance plan to see if the purchase of such a device is covered. Otherwise, ask your distributor if they offer a lease-to-own program, a financing plan or refurbished devices at a lower cost.
Download your list of relevant questions to ask the supplier (PDF)
Choose a quality service
Check if:
- The supplier is recognized by Accreditation Canada;
- The supplier sells devices certified by the Canadian Standards Association (CSA);
- The medical director is a sleep medicine specialist who is a member of the College of Physicians of Quebec (in the case of a private sleep laboratory).
It is not recommended to buy someone else's used device without first having it checked by a knowledgeable healthcare professional since the adjustment of the pressure will have to be made according to your prescription. Also, the use of third party equipment is not recommended due to the risk of infection involved.