Illustration of a woman sleeping.
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Pixabay
This Friday is Sleep Day.
The opportunity to recall the importance of full and calm nights to better get through this period.
But while some know that their insomnia has to do with their stress, others ignore that their chronic fatigue may be due to sleep apnea.
A disease difficult to diagnose due to a lack of sleep specialists and centers where examinations can be carried out.
But new developments should help raise awareness and better diagnose this pathology, which affects 5% of adults in France.
This year of confinement has rhyme with insomnia and fatigue for many French people.
Especially young people.
According to an Opinion Way * survey for Heyme, 55% of them said they had sleep problems, and 38% linked these problems to stress.
Certainly, the lack of sport, the fresh air and, for some, psychological distress do not help to fall into the arms of Morpheus.
But how do you know if, beyond the context, you do not suffer from sleep apnea?
From when do we speak of pathology?
Sleep apnea affects about 5% of the adult population, and 80% of patients go undiagnosed.
Because at night, if all goes well, we sleep;
complicated, therefore, to realize that we are taking breathing breaks ... "It's a fairly insidious disease, which makes it difficult for the subject to perceive, assures Pierre Escourrou, cardiologist and somnologist at the interdisciplinary medical center for sleep in Paris.
Usually people don't relate daytime problems to nighttime.
"
While everyone does apnea in a reasonable way at night, only some suffer from it on a daily basis.
"It becomes pathological when the obstruction of the upper airways occurs for a minimum of 10 seconds and repeatedly (at least five times per hour)", specifies Gilles Besnainou, ENT in Paris (8th) specialist in sleep apnea.
Consequence: we wake up pasty… "The main complication is drowsiness," resumes Gilles Besnainou.
Particularly while driving: a quarter of accidents are due to sleep apnea.
»Second risk, hypertension and cardiovascular disease.
"Stopping breathing will cause a drop in oxygen in the blood," explains Pierre Escourrou.
As the heart is less oxygenated, this creates an atheroma deposit in the arteries, which can block the vessels.
»And therefore increases the risk of stroke and heart attack.
The signs that should alert
Hence the interest of checking that you do not suffer from this pathology.
The first person to see is probably not your GP, but the person (if there is one) who shares your diaper.
Because if your snoring stops for ten seconds, your partner may be surprised (even happy).
“Sleep apnea is often a partner's diagnosis!
“, Laughs moreover the ENT.
It also happens that your unconscious puts you on the track: "Apneics often have nightmares of suffocation, drowning", continues the latter.
Or wake up with a start and breathless.
If the apnea is light, it is less obvious to put your finger on it.
Other signals can then put on the track.
"The patient may wake up with headaches, with the impression of not having slept, or he gets up to pee two to three times a night," continues Gilles Besnainou.
Because when you have apnea, you secrete a diuretic hormone ”
Overweight people who smoke and snore are more affected by this pathology.
"Weight gain is an aggravating factor, because the fat will be deposited in the throat and narrow the respiratory system," explains ENT.
What also plays a role is alcohol, a good meal and sleeping pills, because they relax the muscles of the pharynx.
"
New features to improve screening and follow-up
What is the procedure to follow to verify that you are not concerned?
Go and spend a night in a sleep center, electrodes on the body, to see where your problems with insomnia or chronic fatigue are coming from.
"The problem is that we do not have many centers in France, with suddenly a
delay in taking charge, regrets Pierre Escourrou.
Especially in this period of the Covid-19 epidemic, many are avoiding the hospital… ”And blame the ambient anxiety on their sleep problems.
Some can still perform the examinations on an outpatient basis.
While obtaining this diagnosis remains complex, screening should improve soon.
“Until recently, there were no sleep specialists,” explains Pierre Escourrou.
In the medical curriculum, this specialty was created in 2017 and lasts four years.
The first promotion is therefore expected soon in the cabinets.
Another novelty: connected objects are multiplying to watch over our nights.
Iphone applications, headband, night mask, Scanwatch watch, Withings underlay offer
screening
of breathing, pulse, sleep phases… Some - not all - have been scientifically validated.
“We cannot consider that the result is a certainty, warns Pierre Escourrou.
But they can be used to screen and give a first assessment.
This makes it possible to objectify the apnea.
"
As long as you are not disturbed by your cell phone or an object that sends waves from the nightstand ... "The less intrusive, the better", recognizes the specialist.
Which points to another interest: these connected objects record your settings for several nights, in real life.
Which is more representative than a single night in a sleep center.
"The disease is not constant from one night to the next," warns the cardiologist.
We can suppose that more and more people who wonder about their sleep will be able, thanks to these tools, to have objective elements to bring to the doctor.
"The monitoring of treatments could also be improved:" with data collected over several weeks, this will make it possible to see if they are effective ".
Enough to sleep soundly?
* Heyme and OpinionWay survey carried out on a sample of 1,005 students aged 16 and over, representative of this population from September 21 to 29, 2020.
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