Apnea Syndrome Sueno I:Symptoms and Causes

The National Consensus Document on Syndrome apnea-hypopnea syndrome (SAHS ) of 2005 defined the SAHS as“a picture of excessive sleepiness, cognitive-behavioral, respiratory, cardiac disorders, metabolic or secondary to repeated episodes of obstruction of the upper airway (VAS ) during sleep inflammatory."

These episodes are measured with an apnea-hypopnea index ( AHI ). A IAH>5 associated with disease-related symptoms and unexplained by other causes, confirms the diagnosis.

The SAHS is a very prevalent disease in the general population that can cause deterioration of quality of life, hypertension, cardiovascular disease, cerebrovascular accidents, traffic and labor and is related to excess mortality.

In addition, it has been shown that patients not diagnosed double the consumption of health resources regarding diagnosed and treated. Therefore, considering the SAHS as a public health problem of the first magnitude. In Spain between 3 and 6% of the population suffers from symptomatic OSA and between 24 and 26 % had an AHI>54.

Causes

The pathophysiological mechanisms of SAHS are not fully known and suggests a multifactorial origin where interact anatomical and functional factors. The collapse of the upper airway would occur as a result of an imbalance of power between those that tend to close it and to keep it open.

As for risk factors, age, male gender and body mass index are most important. The prevalence of OSA increases with age, reaching triple in the elderly compared to the middle ages.

Also, the male/female ratio is in the middle ages 2-3/1, tending to equalize after menopause. Other variables that influence the appearance of SAHS or its aggravation are alcohol, snuff, sedatives, hypnotics, barbiturates and supine position. Other important factors are genetic, family and race.

Symptoms

The symptoms related to SAHS appear as a result of two fundamental facts:firstly, apneas, hypopneas and intermittent hypoxia and secondly, sleep disruption. The three main symptoms of OSAS are:

1. Chronic snoring:is the symptom of increased sensitivity ( its absence makes it unlikely the diagnosis of SAHS). However, most snorers do not have SAHS ( snore 40 % of men and 20 % of women in the general population )

2. witnessed apneas:is the symptom of greater specificity, which increases if observed repeatedly during the night and if prolonged

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3. Excessive daytime sleepiness or tendency to fall asleep involuntarily at inappropriate situations

Other common signs and symptoms in SAHS are:morning headache, frequent awakenings, nocturia, unrefreshing sleep, nocturnal asphyxial episodes, obesity, short wide neck and hypertension

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The SAHS causes limitations in working life of patients, with a number highest worker absenteeism and lower productivity.