what are the ways to treat sleep disorders?

EUROPE 1 ACCOMPANES YOUThey are often mocked and sometimes minimized. But sleep disorders, such as snoring and more sleep apnea, should be taken very seriously, not just because it can inconvenience loved ones. They translate a sometimes dangerous tiredness (somnolence at the wheel, for example) and are synonymous sometimes of vital risks. Guest in the Health Magazine, on Europe 1, Dr. Yves-Victor Kamami, ENT in Paris and winner in 2010 of the American Academy of Otolaryngology, takes stock of the different pathologies and how to treat them.

What are snoring?

"Snoring is linked to a tissue vibration, to the passage of air, when there is a kind of narrowing of the airways," says Yves-Victor Kamimi. Snoring, which appears mostly from 40-50 years old in men, and ten years later in women, can be of two origins. It is of velar origin, that is to say at the level of the veil of the palate and the uvula, this small outgrowth of flesh that hangs at the entrance to the throat. Velar-type snoring is the most common and the most troublesome (it can reach 90 decibels, "the sound of a heavy weight in action"), as suggested by its traditional nickname of snoring pig.

The second type of snoring is of lingual origin, at the level of the tongue, with a snoring that is similar to a hissing sound. "It's the snoring that is often on the back, more than on the side, and this lingual snoring is linked to muscle relaxation, which can be related to fatigue or alcohol."

Radiofrequency and the laser, solutions to the snoring of velar origin

An appointment at an ENT allows to determine what type of snoring suffers the patient. In the case of "pig snoring", the most common (80% of cases), it can be treated in two ways.

"First of all there is radiofrequency, the use of a small device that allows you to tighten, like a face lift, the uvula," says Dr. Kamami. "The disadvantage of radiofrequency is that it is not definitive, every two years you have to do the operation again." The other technique, the laser, is to make a small slit middle of the uvula. This small operation of a quarter of an hour under local anesthesia, as at the dentist, allows to permanently remove the snoring of the uvula She continues to work as before, at the level of the voice as swallowing.

The orthosis against lingual snoring

The remedies are different regarding lingual snoring. "In case of lingual snoring, the orthosis is a device that is put in the mouth at night and will allow to advance the lower teeth compared to the top," says the ENT. "There are two types of orthoses, the orthosis of the pharmacist, which is not made to measure.When it is put in hot water, it will mold to the teeth of the palate. then, there is the orthosis of the dentist that will be made to measure, with an imprint, like the mouthguard boxers. "

Attention, the wearing of the orthosis can be sometimes painful and, to become familiar with the object, Dr. Kamami advises to "begin perhaps with the orthosis of the pharmacist, simpler but also much cheaper".

What is sleep apnea?

"Sleep apnea is like a diver who is in a marine position, stopping and blocking breathing," says Dr. Kamami. How do we know that our respiratory flow diminishes or stops during our sleep?

"The main way to find out is drowsiness, snoring is a warning signal, but if there is sleepiness in the daytime, many times, even during work, or driving, This should lead to an immediate consultation with an ENT doctor – who is better able to make the correct diagnosis – or a pulmonologist and sleep recorder.

What is it? "The patient sleeps at home and brings back the device that was given to him the next day, with all the oxygen curves in the blood, the heart rate, the recording curves of apneas and hypopneas. that is to say, the respiratory arrest for more than ten seconds, which shows how many times the person stops breathing. "

Important risks, precautions to take

Sleep apnea is to be taken very seriously. "There are indeed risks of sudden death during sleep, risk of stroke, and we now know that a large part of cases of hypertension, at least half, are caused by sleep apnea ", says Dr. Kamami. "I have a patient who, thanks to his treatment against sleep apnea, has stopped the one against hypertension." Several treatments are possible to fight against this syndrome of sleep apnea, or SAS.

"For very severe apneas, 30 hypopneas per hour, we will make available to the patient a positive pressure mask, which will allow to force the passage through the airways, all night while sleeping," says the ENT doctor. "They perform better today, with silent equipment, that will not wake the spouse, and the mask is not too invasive for the patient." But half of patients do not support it and can therefore offer them the orthosis, when it comes to a lingual snoring, laser or radio frequency when it comes to a snoring of velar origin.