Excessive daytime sleepiness (Eds) is the main symptom of obstructive sleep apnea syndrome (Osa) “an extremely widespread disease. Just think that in the world, it affects almost 1 billion people, about 7 million in Italy where only a little more than 250 thousand are under treatment“. It means that” every general practitioner has at least 200 patients with this type of pathology and about 100 have the full-blown form “. Like this Giuseppe Insalacopulmonologist and first researcher at the Institute of Translational Pharmacology of the CNR of Palermo, speaking today at the meeting with the press where a new drug available in Italy, pitolisant (Ozawade *), was presented, indicated to improve wakefulness and reduce Esd in adult patients with obstructive sleep apnea.
The sleep apnea syndrome “is characterized – continues Insalaco – by the so-called nocturnal and diurnal symptoms. In particular, at night habitual and persistent snoring, fragmented sleep with frequent awakenings, nocturia, ie the need to get up several times to urinate, and trunk sweating “manifest”. The symptoms defined as diurnal are: excessive sleepiness, asthenia, headache for 15 minutes upon awakening, the tendency to forget things and difficulty concentrating, mood disorders and dysfunctions in the sexual sphere. All these symptoms – underlines the specialist – occur gradually and gradually worsen the quality of life of patients suffering from this pathology “.
Furthermore, “if neglected – Insalaco specifies – Osa favors the onset of metabolic diseases such as type 2 diabeteshas negative effects on the cardiovascular system with consequences such as arterial hypertension, atrial fibrillation, chronic heart failure, atherosclerosis, coronary artery disease and stroke as well as influencing the immune system or increasing the risk of developing cancer “.
Obstructive sleep apneas are caused by “narrowing of the airways – explains Insalaco – and are characterized by pauses in breathing that cause alterations in the brain with micro-awakenings. In addition, the organism that makes respiratory efforts, to satisfy the need for oxygen, reduces the pressure of the chest on the heart, which stretches and is dilated. In this stressful condition – he adds – the heart releases a protein that has a diuretic effect into the circulation: for this reason there is the need to get up and urinate “. In the impossibility of having a restful sleep, “the symptoms of excessive sleepiness and fatigue of a disease that is associated with a greater risk of car accidents, at work and in the home environment, even 14 times higher, are explained”.
The main symptom that prompts patients to seek medical attention is snoring, but many also complain of excessive sleepiness during the day associated with fatigue. The diagnosis is instrumental and is made by neurologists and pulmonologists with specific tests to then obtain important parameters for the therapy to be set. The patient with sleep apnea, despite treatment with primary therapy, such as Cpap (Continous positive airway pressure), continuous positive airway pressure, or with other remedies such as positional therapy, mandibular advancement devices (Mad, Mandibular advancement device) or surgery, you may continue to feel drowsy and tired.
“The availability of a new therapy for patients with excessive residual daytime sleepiness despite primary therapy such as CPAP is great news. Moreover patients with obstructive sleep apnea syndrome cannot always tolerate CPAP – observes, in his speech, Luca Roberti, president of the Italian Apnea Association (Aps) – A treatment that can cure excessive daytime sleepiness in both cases is therefore a fundamental tool for specialists, neurologists and pulmonologists who are experts in medicine of the sleep. We must remember – he adds – how the risk of road accidents due to sleep deprivation increases significantly in patients with evident residual sleepiness. We therefore have one more weapon to protect road and work safety “.