Sleep apnea complete guide | VivaRespire

Understanding Sleep Apnea: A Complete Guide

Sleep apnea is one of the most common and most under-diagnosed sleep disorders. In Belgium, it is estimated that about 1 in 5 people suffer from it - the vast majority without knowing it. This guide explains everything you need to know: definition, types, symptoms, consequences, diagnosis and treatment.

What is sleep apnea?

Sleep apnea - or Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) - is a disorder characterized by repeated pauses in breathing during sleep. These breathing pauses, called apneas, generally last between 10 and 30 seconds, sometimes longer.

During an apnea, the brain detects the drop in blood oxygen and sends an alarm signal: the patient briefly wakes up - usually without remembering it - to resume breathing. This cycle can repeat dozens or even hundreds of times per night, fragmenting sleep and preventing any normal recovery.

Most patients have no memory of these nocturnal micro-arousals. They often consult for chronic fatigue or concentration problems, never associating these symptoms with their sleep.

The three types of sleep apnea

Obstructive sleep apnea (OSA) - 90% of cases: throat muscles relax during sleep, blocking the airways. Respiratory effort is maintained but air no longer passes. This is the most common form, treated by CPAP.
Central sleep apnea: the brain does not send the correct signals to the breathing muscles. The airways are clear, but respiratory effort is absent. Rarer, it sometimes requires ASV ventilation.
Mixed apnea: begins as a central apnea and evolves into an obstructive component. Rarer and more complex to treat.

Symptoms of sleep apnea

Loud and regular snoring - present in ~95% of apnea patients
Breathing pauses observed by the sleep partner - the most specific sign
Chronic fatigue upon waking despite 7 to 8 hours of sleep
Excessive daytime sleepiness - involuntary dozing during the day
Morning headaches related to nocturnal hypoxia
Concentration and memory difficulties, brain fog
Nocturia - frequent nighttime urination
Waking with a choking sensation

In women, sleep apnea presents differently: less snoring, more chronic fatigue, insomnia and depressive symptoms. It is frequently under-diagnosed as a result. Menopause significantly increases the risk.

Causes and risk factors

Anatomical factors: narrow or receded jaw, enlarged tonsils, large tongue, short wide neck, deviated nasal septum
Behavioral factors: overweight and obesity, alcohol consumption, sedatives or sleeping pills, smoking, sleeping on the back
Physiological factors: reduced muscle tone of the airways, chronic inflammation, nasal congestion, gastro-oesophageal reflux
Non-modifiable factors: age (increased risk after 50), male sex, menopause in women, genetics and facial morphology

Health consequences

Cardiovascular risks (high): hypertension (30% of apnea patients), atrial fibrillation (4× higher risk in severe apnea), heart failure, heart attack, stroke. Up to 83% of patients with drug-resistant hypertension have untreated sleep apnea.
Cognitive disorders: concentration and memory difficulties, mood disturbances, irritability, increased risk of depression.
Diabetes and metabolism: worsened insulin resistance, increased risk of type 2 diabetes, weight gain due to hormonal disruption.
Accidents and sleepiness: daytime sleepiness multiplies the risk of road accidents by 3 to 7 - with legal implications for professional drivers.

Diagnosis: the AHI index

Diagnosis is based on measuring the AHI (Apnea-Hypopnea Index) - the number of apneas and hypopneas per hour of sleep.

AHI	Severity	Note
< 5 /h	Normal	No significant apnea
5 to 15 /h	Mild apnea	Treatment based on symptoms
15 to 30 /h	Moderate apnea	Treatment recommended
> 30 /h	Severe apnea	Urgent treatment

The AHI is measured through two main tests: ambulatory polygraphy (at home) and polysomnography (in a sleep center, more comprehensive). Both are covered by Belgian health insurance.

Available treatments

CPAP (Continuous Positive Airway Pressure) is the gold standard treatment for moderate to severe obstructive sleep apnea. The device delivers pressurized air through a mask to keep the airways open during sleep. It eliminates apneas, snoring, and improves quality of life from the first weeks.

Other treatments are available depending on patient profile: mandibular advancement device (MAD), positional therapy, surgery, and weight loss.

In Belgium, the INAMI/RIZIV convention provides CPAP equipment through an approved sleep center - the patient never owns the device. VivaRespire offers an alternative: purchasing your CPAP directly so you own it. For more information on the convention: CPAP reimbursement in Belgium.

Why buy your CPAP from VivaRespire?

VivaRespire is a Belgian CPAP equipment specialist. Unlike the INAMI convention where you use a device provided by an approved center, at VivaRespire you own your device. Benefits: free choice of model, no observance constraints linked to the convention, equipment available immediately with no waiting list.

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