It can be said, and it is not an exaggeration, that VÃctor Marsal (66 years old and born in Barcelona) changed his life about four years ago. At that time, when he got up in the morning he felt tired, so much so that he fell asleep at the wheel. The same thing happened to him when he was in a meeting (he is an entrepreneur). He didn’t know what was causing this extreme tiredness. One day she explained what was happening to a friend of hers, a doctor by profession, and he advised her to see a professional: he suspected she might suffer from obstructive sleep apnea (OSA). There he began to see the light.
This Barcelona native is one of nearly 700,000 people in Spain who receive treatment for OSA, a very underdiagnosed pathology: only 25% of people who suffer from it are diagnosed. This means that the actual figure of those affected amounts to two million people. Those who suffer from it experience interruptions in breathing (apneas) while they sleep.
“For it to be considered a pathological apnea, the patient must stop breathing for more than ten seconds and more than six times per hour,” explains Dr. Raúl Pérez, medical advisor to Esteve Teijin, a company that supplies CatSalut with 53% of home respiratory therapies in Catalonia. There are different treatments depending on the severity of the picture. “A patient who stops breathing 5 times an hour is not the same as one who stops breathing 10, 15, 20 or 30”, argues Pérez.
Victor had one apnea per minute. “When they detected my AOS, they saw that I was doing 60 per hour”, he exclaims. “I broke all the records. The doctors who treated me were surprised that the apneas had not caused me more problems.”
This disease is not futile if it is not treated. Beyond the symptoms such as drowsiness and cognitive problems (lack of memory, attention…) due to lack of sleep – those affected suffer micro-awakenings of which they are not aware -, this pathology can lead to other consequences. And all because of the decrease in air intake and, consequently, the oxygen available in the body. “These drops in oxygen during the night can lead, if not treated, to cardiac disturbances and an increase in blood pressure. There are even cases of diabetes”, says Dr Pérez. The affected person is also more likely to suffer a stroke.
As a general rule, patients who are above 30 interruptions per hour are prescribed a CPAP (mechanical ventilation device). This device has “a turbine that sends air at a certain constant pressure that gets the airway to open up to make way for air in a fluid and normal way, correcting apneas”, argues Adriana Pascuas, responsible for Esteve Teijin patient care service. The CPAP is plugged in and emits a constant but muted sound. “They are quite silent. They have been improving over time”, asserts Pascuas. The mask that incorporates the CPAP adapts to the person and generates a kind of hermetic seal. The patient enjoys some freedom of movement: he can turn to both sides.
However, it is not easy to get used to it. “At first it was uncomfortable”, VÃctor admits, although he says that little by little he got used to it. Above all, because he noticed the beneficial effects “from the first day”. “I discovered glory. I was driving and I didn’t fall asleep. Before, yes or no, I had to take a nap, I even had an armchair in the office to take it. It has changed my life.”
The CPAP—which patients will generally have to use for life—is so beneficial to him that he takes it with him on trips (due to his profession, he spends many nights away from home). “If I travel for just one day, I don’t take it with me, but the next day I regret it. I get up tired”. His wife is also delighted. “Since I’ve been using the CPAP, he sleeps without earplugs.” He admits that the machine “makes a bit of noise”, but he says he has got used to it. She too. “This little noise is heavenly music to my wife compared to my snoring. In addition, I suffered with my apneas; it seemed like I was suffocating.”
“Being overweight is very important in this pathology,” emphasizes Dr. Pérez. “The accumulation of fat in the upper respiratory tract causes the structure to increase in thickness. And a small drop of the tongue backwards, for example, with a little bit of fat pressing, makes the respiratory obstruction even more important.
Statistics say that men suffer from OSA more than women (two to three times more). It has to do – says Pérez – with lifestyles. “The number almost equals when they enter menopause”, he adds. Children can also suffer from OSA, but in a small percentage: they account for 5% of those affected.
