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Sleep apnoea: some cases should be investigated

Some cases of obstructive sleep apnoea syndrome should be investigated, due to the risk of complications or accidents.

Obstructive sleep apnoea syndrome is characterised by drowsiness during the day with regular episodes of cessation of breathing overnight lasting more than 10 seconds. Its frequency is not known, but it seems to occur more commonly in obese patients.

If patients are suffering from excessive sleepiness during the day and serious chronic obstructive pulmonary disease, it is worth investigating, at a specialist centre where sleep patterns are recorded, whether or not they are affected by obstructive sleep apnoea syndrome. The complications are difficult to assess but can be incapacitating and cause serious incidents: cardiovascular complications, aggravation of some respiratory disorders, increased risk of driving accidents, diminished brain performance, etc.

It would seem logical to recommend changes in behaviour, such as giving up smoking and alcohol, weight reduction and regular physical activity, although the effects have not been evaluated. Some devices delivering air via a mask at night, although restrictive, improve daily sleep and seem to be the most effective form of treatment. If this fails, a small number of patients may benefit from drug treatment with modafinil.

©Prescrire March 2007

Source: "Syndromes d’apnées obstructives du sommeil : attention à la somnolence diurne" Rev Prescrire 2007 ; 27 (281) : 201-206.

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