Montpellier: sleep apnea, surgery as an alternative to the oxygen mask

The Montpellier Mutualist Institute, Beau Soleil Clinic, candidate for sleep apnea surgery.

Almost everyone suffers from sleep apnea, but recurrence throughout the night is highly dependent on medical management. An information day for ENT surgeons was recently organized at the Beau Soleil Clinic. The aim is to show possible solutions for patients who cannot wear the oxygen mask or the lower jaw orthosis at night. In particular, the possibility of surgical intervention.

“An operation always comes as a second intention, says Doctor Vincent Trevillot, ENT at Beau Soleil Clinic and specialist in severe sleep apnea syndrome. The reference treatment remains continuous ventilation (CPAP) through a mask worn at night or a mandibular orthosis.” Solutions that have proven themselves but are not accepted by some patients “depending on the nocturnal movements that can interfere with the correct wearing of a mask or prosthesis”.

Identify sleep apnea

There are several types of surgical interventions: “Procedures on the palate that tighten the tissue. Neurostimulation of the hypoglossal nerve, a nerve that advances the tongue, is also in full development,” Details the specialist. But this last development is not yet practiced in France.

To assess the tendency to sleep apnea, a measurement is required: “We equip the patient to measure respiration, heart rate and oxygen saturation overnight.” The device records the number of apneas per hour during the sleep phase (see attachment). Return to the clinic the next day to analyze the data: “So we can interpret”. For the otolaryngologist, the main risk of people suffering from sleep apnea is sleepiness. But also cardiovascular risks: “It’s a bit more controversial”he clarifies.

The degrees of sleep apnea

Sleep apnea syndrome is calculated as the frequency of respiratory blockages per hour during a night’s sleep. Above 30, the index is severe. Between 15 and 30 it is moderate. In the last case, with comorbidities, the treatment can be supported. Some nocturnal apneas remain normal “up to 5 per hour”. Eight patients were operated on as part of the research at Beau Soleil. Last month, this therapy principle was accepted by the High Health Authority. support should follow.

Hence the interest in accurate medical follow-up, as protocols are not the same depending on age: “You can’t treat someone at 86 like someone at 40. But we will always provide a protocol.” The first audible sign of a possible sleep apnea syndrome is snoring.

Recognize the first disorders in children

Respiratory Health France, together with Sleep of Marmotte, a fun and educational tool, is committed to raising awareness of sleep disorders in children, especially sleep apnea.” . Frédéric le Guillou, President of Santé Respiraire France. The diagnostic process is often an obstacle course for parents.” According to the association, between 2 and 5% of children are affected by sleep apnea syndromes, 30% are affected by a respiratory allergy, which is partly responsible for certain sleep disorders. To help parents and children, there is the free Marmot Sleep app (also in book form) with games, quizzes, interactive animations, FAQ, guides for parents to support children in their illness. one of dr Madiha Ellaffi, pneumologist and allergist, developed the tool.

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