Sleep breathing disorder diagnostics

Complete the questionnaire below and check if your observations are correct and you would need an examination at the sleep breathing disorder clinic.

Obstructive sleep apnoea is one of the most common sleep breathing disorders and has a profound effect on the quality (as well as safety) of our lives.

The most common symptoms of obstructive sleep apnoea:

• Snoring is a very disturbing symptom and a warning of the body before a pause in breathing (so-called sleep apnoea). Patients are sometimes unaware of these pauses, most often they are reported by their bed partners, who may be very frightened by these breathing disruptions.
• Common short-term breathing disruptions that last for 10 seconds or more, several times per night.
• A feeling of being suffocated and catching the breath while sleeping
• Sweating
• Frequent urination during the night

With chronical sleep disorder, there may be additional health problems, which are manifested during the day:

• restless and shallow sleep
• increased sleepiness that prevents normal productivity at work, at home and in your spare time
• concentration and memory disorders
• headache
• irritability
• in high-risk occupations, the possibility of accidents at work is also increased (e.g. professional drivers, air traffic controllers, railway workers, workers performing altitude work…)

WHO ARE THE PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA?

Obstructive sleep apnoea affects 4% of adults. It’s a chronic disease, but it’s not very well known. 70% of the patients are men, who are more likely to exhibit the disorder after the age of 40, and postmenopausal women. A high risk of incidence is also posed by:

• being overweight or obese (BMI higher than 35 – body weight in kilograms divided by body height square in metres)
• respiratory tract irregularities (jaws, adenoid, soft tissues),
• smoking
• alcohol consumption, especially before going to bed,
• working at night time,
• shift work

The incidence of obstructive sleep apnoea globally is increasing and is reaching epidemic proportions in the western world. The increase in the numbers is due to increasing weight of the population. Patients with obstructive sleep apnoea are at risk for developing cardiovascular and metabolic diseases and are often undiagnosed.

Waiting times for the first sleep breathing disorder examination in Slovenia are more than 2 years. With us, you can now have an examination, diagnostics and trial treatment within 1–2 months. The examination is carried out by prof. Matjaž Fležar, M.D., internal medicine and pulmonology specialist, who has established a sleep breathing disorders treatment system in Slovenia and has been working in the field of pulmonology for 30 years.

HOW IS OBSTRUCTIVE SLEEP APNOEA DIAGNOSED?

First, you will fill out a special questionnaire on breathing disorders in your sleep, with the help of which your doctor determines whether you are a suitable candidate for further diagnostic treatment. If you are, we will perform a polygraphy. This is an examination that observes the presence of an obstructive sleep apnoea (OSAS) i.e. lack of oxygen due to an obstruction, and is performed at the patient’s home. The examination is comfortable because you sleep at home in your bed while the measurements are taken. We teach you how to properly install a polygraph before the measurement.

Polygraphy measures the oxygen saturation in the blood, the air flow, and chest and abdomen movements. Most polygraphs also record body position and pulse.

After the polygraph has been performed, your doctor calls you over the phone and sends you the results to your address. You will discuss in detail with the doctor whether treatment is required or not, and if necessary, there will also be a short examination.

POLYGRAPHY CONFIRMED SLEEP BREATHING DISORDERS, WHAT TO DO NOW?

When polygraphy confirms the sleep breathing disorder, talk to your doctor about the trial treatment with CPAP. CPAP titration is the most effective method of obstructive sleep apnoea treatment. You will receive a special titration mask that you will use while sleeping and it will supply you with a sufficient amount of oxygen. You will perform the experimental treatment at home for three nights, and before that you will receive the mask and all the necessary information about therapeutic titration device.

If your treatment proves effective, you will be advised to use it permanently.

POSITIVE EFFECTS OF TREATMENT

Immediate positive effects of treatment are observed in patients in whom CPAP titration therapy is effective. They no longer snore in their sleep, nor do they wake up due to breathing disruptions. As they sleep much better, they wake up rested in the morning and do not feel sleepy during the day. The patients’ arrhythmia calms down, their hormonal balance is restored. They also start to lose excess weight.

WHEN CAN WE NOT DIAGNOSE OBSTRUCTIVE SLEEP APNOEA?

Diagnosis is not possible if you have any of the major associated diseases (heart failure, neuromuscular disease, moderate to severe pulmonary disease). Home polygraphy is also not a suitable diagnostic method if some other possible sleep disorder is suspected and it is not a suitable method for general population screening. An exception to these restrictions are the patients in whom polysomnography in the laboratory would be difficult to perform due to e.g. immobility or security issues. Home polygraphy is an appropriate evaluation method for the treatment of obstructive sleep apnoea when a patient is not being treated with CPAP (oral aids, surgery, weight loss).

If there is a suspicion of other sleep breathing disorders or other sleep disorders, we will refer you to another diagnostic method – polysomnography. Polysomnography in a sleep disturbance laboratory should also be performed if the polygraph test is negative or technically inadequate (up to 20% of the polygraphs).