World Sleep Day March 19

Sleep-disordered breathing is an umbrella term for several chronic conditions in which a person partially or completely stops breathing many times throughout the night. This results in daytime sleepiness or fatigue that interferes with a person’s ability to function. The most common form of sleep-disordered breathing is obstructive sleep apnoea.
More than half of the people who have this condition are overweight.
The most common signs of sleep-disordered breathing, snoring and daytime fatigue or sleepiness, are so common that they may not be recognized as abnormal. The condition is usually not detected during a routine doctor’s visit.

Diabetes and hypertension go hand in hand with sleep-disordered breathing

Untreated obstructive sleep apnea can have dangerous health consequences. A study published in 2009 found that moderate to severe obstructive sleep apnoea is associated with an increased risk of death from any cause in middle-aged adults, especially men. The study of more than 6,000 adults published in the journal PLoS Medicine found that study participants with severe sleep apnoea were at a 46 % higher risk of death compared with those who did not have the condition.
Untreated sleep apnea has not only been shown to increase the risk of high blood pressure and cardiovascular disease but is also associated with neurocognitive disturbances. The gas exchange abnormalities themselves as well as alterations in sleep architecture may cause daytime sleepiness and increase the risk of work- or driving-related accidents.

Treatment reduces health risks

The good news is: the syndrome, a potential risk factor for cardiovascular disease and diabetes, is treatable.
Treatment for sleep-disordered breathing not only helps reduce the severity of symptoms such as daytime sleepiness and snoring. Treatment also may positively impact on other problems linked to sleep-disordered breathing such as high blood pressure, and may even reduce the risk of heart disease, stroke, and diabetes.

After confirming the diagnosis by polysomnography, a comprehensive recording of biophysiological parameters during sleep, various treatment options are available.
Simple measures to restore regular breathing during sleep include lifestyle changes such as weight loss, smoking cessation and avoiding alcohol and sedatives
The most effective treatment for obstructive sleep apnoea is continuous positive airway pressure (CPAP) applied trough a device that delivers pressurised air to the upper airway through a mask; other options include mouthpieces to help keep the airways open during sleep, and surgery to widen breathing passages.

Children and sleep-disordered breathing

Sleep-disordered breathing is relatively frequent in children: about 3% exhibit the signs and symptoms before puberty. Children who merely snore, but who do not have gas exchange abnormalities or evidence of snore-associated alterations in sleep architecture, are considered to have primary snoring (PS), an extremely frequent condition affecting 10-12% of all school-aged children.
Enlarged tonsils may cause sleep-disordered breathing in children. The condition may become manifest as hyperactivity, and result in poor school performance and aggressiveness. Children with sleep apnoea also may experience bedwetting. The first choice of treatment for children with sleep apnoea usually is adenoidectomy, i.e. removal of the tonsils.

Sleep apnoea is a respiratory problem

The European Respiratory Society has played a major role in the recognition of sleep- disordered breathing and sleep apnoea syndrome as important public health problems and been instrumental in making a priority of raising awareness of the comorbidities associated with the conditions.
"Sleep disordered breathing is now recognised as being a major problem across Europe and the ERS is committed to increase our understanding of the disease and of the conditions associated with this pathology," stresses Professor Peter Calverley of the University of Liverpool, UK, an expert in the field of sleep-disorders and Head of the Scientific Assembly that includes a special research group dedicated to sleep and control of breathing at the European Respiratory Society.
(idw, 03/2010)

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