2024-03-04 07:35:26
Advertorial. Sensation of non-restorative sleep, insomnia, fatigue, memory problems? Maybe you have sleep apnea. The Somno-Gard centers located near Nîmes and Avignon are able to provide rapid diagnosis and multidisciplinary outpatient monitoring.
Since 2023, two Somno-Gard centers have been housed on the outskirts of Nîmes and Avignon within the multi-professional health centers (MSP) of Remoulins and Saze. At their head, Dr Ghassan Fayad, a doctor with valid training in sleep apnea, and Lydia Fayad, a nurse also trained in screening for sleep breathing disorders. The duo receives several dozen patients every day for screening or follow-up. According to the French Society of Sleep Medicine, “it is estimated that 8 in 10 people are not yet diagnosed”, indicates Dr Ghassan Fayad.
According to the French Society of Sleep Medicine, “it is estimated that 8 out of 10 people are not yet diagnosed”, indicates Dr Ghassan Fayad. • photo Marie Meunier
Sleep apnea is a sleep breathing disorder where the patient’s breathing becomes blocked during sleep several times an hour at the throat. The doctor compares: “Imagine that your neck behaves like a cardboard straw, when you suck into it it collapses on itself and gets stuck.“. Apneas cause micro-awakenings so that the patient does not completely suffocate. The problem is that he does not remember it and this can really alter his quality of life.
What are the advantages of Somno-Gard centers?
While sleep apnea is often treated in a sleep laboratory, clinic or hospital, Dr. Ghassan Fayad offers outpatient care with the latest generation devices and rapid appointment times, often a week. The consultations take place within the two MSPs of Remoulins and Saze, accessible to people with reduced mobility and provided with parking. Consultation rates are agreed to sector 1, with no excess fees. “We are not limited to screening, we also ensure all follow-up. Patients already fitted with hearing aids can also make an appointment with a letter from the attending physician.“, he emphasizes.
Who is affected by sleep apnea?
Having sleep apnea is normal to a certain extent, less than 5 per hour. But some people will do it 15 or 30 times an hour, or even more. “This will require support”, attests the doctor. Sleep apnea can affect all age groups, both men and women, although it is more common in men over 50. Sleep apnea syndrome is often linked to being overweight and other pathologies such as high blood pressure, heart rhythm disorders, diabetes, stroke, glaucoma, etc.
What signs should alert you?
Around 3 million people in France are thought to have sleep apnea without knowing it. Several signs can alert you like “snoring louder than the voice sometimes crossing the partitions, breathing pauses noted by the partner, a feeling of non-restorative sleep, restless sleep, insomnia, getting up at night to urinate, mouth dry in the morning, being overweight, feeling tired during the day, problems with mood, concentration, libido and memory… Patients may be very tired following lunch or not be able to keep up evening”, lists Dr. Fayad. Sleep apnea actually creates a chronic sleep debt that patients will seek to recover perpetually throughout the day without ever succeeding.
How to diagnose it?
It is possible to make an appointment in one of the two Somno-Gard centers via the Doctolib platform by clearly specifying the reason for consultation “Sleep apnea investigation by polygraphy or polysomnography”. During the first consultation, all the signs are identified, several measurements are taken, in order to estimate the probability of sleep apnea and the patient’s level of drowsiness… The following consultation, the patient will be equipped with a device and will spend the night with it. This can be a ventilatory polygraphy which provides information on the respiratory rate, drops in oxygen levels, or a polysomnography, a more advanced examination which was possible than in the sleep laboratory until now. “Today, we have equipment that is sufficiently ergonomic and powerful to carry out tests at home.”, assures the doctor.
All the data will be recorded by the machine then analyzed by the doctor the next day using software. • photo Marie Meunier
It collects other information such as the electrical activity of the brain, eye movements, heart movements, leg movements, etc. All the data will be recorded by the machine then analyzed by the doctor the next day using software. : “We will look for neurological and respiratory events, possible anomalies correlated with sleep apnea. The device will allow the doctor to assess the degree of sleep apnea, which can be mild, moderate or severe.. The result will finally be returned to the patient during a final consultation, the result sent to the attending physician and specialists, and the possible treatment explained.
What treatments?
“There are three main treatmentsexposes Dr Ghassan Fayad. The first being almost in all cases weight loss. If the patient does not know anyone, we offer support from the dieticians present at our MSPs (Morgan Callu on Remoulins and Lucie Mantione on Saze) to restore good habits if necessary. For moderate apnea with few symptoms, there are splints made with a 3D printer in collaboration with a dentist experienced in this field. These are mandibular advancement orthoses (MOA) which help breathing by clearing the upper airways.”
The third treatment may cause apprehension in the patient. This is continuous positive airway pressure (CPAP) treatment:This machine is delivered by a highly qualified team who will install the device in the patient’s home.. It will send air under pressure into the airways, preventing them from becoming blocked. “The patient will no longer go into apnea and good blood oxygenation is restored. The machine has the appearance of a big morning alarm clock from the 90s without the FM stations of course! It plugs into the mains and draws in ambient air to put it under pressure.”, describes the healthcare professional. Air is sent under pressure usually into the nose via a tube connected to a mask. Some effort is required the first few months to get used to it, but “When patients overcome the disadvantages of the machine, they end up feeling the beneficial effects it can have on them. 9/10 people adopt it.” In addition, CPAP treatment eliminates snoring which can reach between 90 and 105 decibels, the equivalent of a lawn mower at a distance of one meter.
What consequences can sleep apnea have?
“Imagine the state you would be in following a night’s sleep if someone had decided to wake you up 15, 30 or 40 times per hour“, explains Dr Fayad. In addition to snoring, sleep apnea promotes drowsiness due to sleep fragmentation, high blood pressure, diabetes… Dr Fayad figures: “It is estimated that people with severe sleep apnea have a risk of road or work accident, a risk of stroke or heart attack multiplied by two to three. It’s not nothing.” When we sleep, the oxygenation rate should be between 94 and 99%. In people with sleep apnea, this average rate can drop to around 93 to 90%, sometimes less. “These patients spend a third of their day lacking oxygen. However, the heart and the brain do not like to lack it. It’s like if the car’s air filter is clogged, you’re not going to take your vehicle up to 100,000 km”, metaphorizes the doctor.
How does the follow-up take place?
The people fitted with the device return for consultation four months later to analyze the data from the machine and possibly make some adjustments in conjunction with the service provider: “Today, all machines are equal. It is the human investment of the service provider’s technicians which is essential to have quality support, working with them is fascinating“. Monitoring is then done every year. “There are several hundred patients in the active queue who are fitted and followed over the years. Seeing the progress that most of them make in such a short time is a real source of motivation”, assesses the doctor.
Why are more and more appointments made regarding sleep apnea?
In addition to a certain lack of knowledge regarding the disease, its signs and symptoms, patients might previously harbor preconceptions and fears. “Screening was not necessarily accessible and the CPAP machines were bulky and noisy, which had a deterrent effect on patients who did not want to be screened, the delays were long. Today, screening is easier, treatment machines are light, easy to operate and quieter. You can even travel with“, included Ghassan Fayad.
More information on the Somno-Gard website by clicking here.
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