Description
Les troubles respiratoires du sommeil désignent un ensemble de troubles respiratoires anormaux pendant le sommeil. Ces troubles affectent le fonctionnement quotidien et le bien-être. Il existe plusieurs types de TRS, notamment la résistance des voies aériennes supérieures, l'hypopnée, l'apnée, la catathrénie et les ronflements importants. Les personnes souffrant de TRS peuvent également présenter des symptômes diurnes entraînant des troubles du sommeil. On peut également observer de la somnolence, une humeur dépressive, de l'irritabilité et des troubles cognitifs.
Résumé
- Sleep is a vital, dynamic physiological state necessary for health and well-being. Prioritizing adequate sleep, ideally seven hours, is crucial for immune system support, cardiovascular health, and overall healing. Good sleep is defined by regular bedtimes and awakening times, a conducive sleep environment (dark, quiet, comfortable temperature), and avoiding daytime naps, alcohol, caffeine, and late-night exercise.
- Sleep consists of multiple stages, including NREM (stages 1-4) and REM sleep, each serving a distinct purpose. Stages 3 and 4 of NREM sleep, or "slow-wave sleep," are the most restorative, promoting healing processes. REM sleep is associated with learning, memory consolidation, and dreaming. Disruptions to sleep staging can indicate various sleep disorders.
- Several factors can contribute to poor sleep quality, including alcohol, sleeping pills, jet lag, shift work, screen use, caffeine, and extreme temperatures. During sleep, the body undergoes changes, such as increased parasympathetic tone, decreased heart rate and blood pressure, reduced ventilation, and altered hormone secretion.
- Sleep deprivation leads to decreased alertness, increased irritability, impaired concentration, and an elevated risk of anxiety, depression, accidents, and cardiovascular problems. Chronic sleep loss can disrupt cognitive function and increase the likelihood of developing metabolic syndrome and type 2 diabetes.
- Sleep-disordered breathing (SDB) encompasses various conditions, including primary snoring, obstructive sleep apnea (OSA), central sleep apnea, and nocturnal hypoventilation. OSA, characterized by airway collapse during sleep, can lead to micro-arousals, sleep fragmentation, and decreased oxygen saturation, increasing the risk of cardiovascular events.
- Risk factors for OSA include obesity, male gender, increased age, alcohol consumption, and family history. Common symptoms of OSA are snoring, frequent urination, irregular breathing during sleep, night sweats, and daytime sleepiness. OSA is also prevalent in other diseases such as heart failure, resistant hypertension, atrial fibrillation, stroke, depression, and type 2 diabetes.
- Screening for OSA involves assessing symptoms and using questionnaires like the STOP-Bang. Diagnostic tests include polysomnography (PSG) performed in a sleep lab (Type 1) or home sleep testing (HST) using various devices (Types 2-4). The apnea-hypopnea index (AHI), calculated as the number of apneas and hypopneas per hour of sleep, determines the severity of OSA.
- Management of OSA involves lifestyle modifications, surgical interventions, mandibular repositioning devices (MRDs), and positive airway pressure (PAP) therapy. PAP therapy, including CPAP, APAP, and bilevel PAP, delivers continuous pressure to keep the airways open. Remote monitoring can improve treatment adherence through patient education, optimization, and telemonitoring.
Exemple de certificat
À propos des intervenants
Dr Deepak Muthreja
Pneumologue interventionnel consultant, hôpitaux Vivek, Nagpur
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