Treatment of sleep apnea syndrome

Necessary treatment: Sleep apnea syndrome requires treatment because it aff ects cardiovascular and cerebrovascular morbidity and mortality and has imp ortant neurospychological consequences with the risk of accidents due to im paired wakefulness. The patientis quality of life is greatly altered. General measures: Patients should be informed of the risk due to the lack o f sleep, advised that alcohol tranquilizers and hypnotic drugs are contrain dicated, and counseled about loosing weight, the most difficult problem for obese patients. Positive pressure ventilation: Continuous positive pressure ventilation wit h a facial mask acts like a pneumatic prosthesis holding the airways open d uring sleep. Sleep can be reconstructed by eliminating the GC recorded path ological nocturnal events and thus reducing diurnal hypersomnia. Quality of life is improved and accidents related to diminished wakefulness are avoid ed. Death rate in treated patients is significantly lower than in non-treat ed patients. In France, the national health care system will reimburse posi tive pressure ventilation for sleep apnea syndromes recognized to cause mor e than 30 events per hour of recording or fragmented sleep due to respirato ry impairment. Other treatments: Indications for other PAM treatments in case of moderatel y severe sleep apnea syndrome (or if health care benefits are not recognize d for positive pressure ventilation) are currently debated. No PPC medicati on has been proven to be effective. Mandibular advancement ortheses are in the SAS development stage and require multidisiplinary cooperation to verif y their efficacy. Velar surgery has been proposed but is usually disappoint ing except for young patients actively participating in an integrated surgi cal treatment strategy.