It can be said, and it is not an exaggeration, that Víctor Marsal (66 years old and from Barcelona) had his life changed about four years ago. Fortunately for good. Back then, when he got up in the morning he felt tired. So much so that he fell asleep when he got behind the wheel. The same thing happened to him when he was in a meeting (he is a businessman). He did not know what caused this marked fatigue. One day he explained what was happening to a friend of his, a doctor by profession, and he advised him to see a professional: he suspected that he might have obstructive sleep disorder (OSA). There he began to see the light.
This man from Barcelona is one of the approximately 700,000 people in Spain who receive treatment for OSA, a highly underdiagnosed pathology: it is estimated that only 25% of those who suffer from it are diagnosed. This means that the real number of affected amounts to two million people. Sufferers experience interruptions in breathing (barely) while they sleep.
"For it to be considered pathological apnea, the patient must stop breathing for more than ten seconds and more than six times per hour," explains Dr. Raúl Pérez, medical adviser to Esteve Teijin, a company that supplies CatSalut to La Vanguardia. 53% of home respiratory therapies in Catalonia.
There are different treatments depending on the severity of the condition. "A patient who stops breathing 5 times an hour is not the same as one who does so 10, 15, 20 or 30," argues Pérez.
Victor had an apnea a minute. "When they detected it at the clinic I went to, where I spent the whole night, they saw that it was doing 60 an hour," he wields. “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 trivial 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-arousals, of which they are not aware-, this pathology can lead to other consequences. And all due to the decrease in the entry of air and consequently the oxygen available in the body.
“These drops in oxygen during the night can lead to, if not treated, cardiac disorders and increased blood pressure. There are even cases of diabetes,” says Dr. Pérez. The affected person is also more likely to suffer a brain stroke. "There are very serious cases of people who stop breathing up to 130 times per hour," he stresses.
As a general rule, patients who are above 30 interruptions per hour are prescribed a CPAP (mechanical ventilation device). This contraption has "a turbine that sends air at a determined constant pressure (it is different for each patient) which causes the airway to open to allow air to pass in a fluid and normal way, correcting apneas", argues Adriana Pascuas , responsible for the patient care service at Esteve Teijin.
The CPAP is connected to the current and emits a constant sound, although attenuated. “They are pretty quiet. They have been improving over time”, wields Pascuas.
The mask that incorporates the CPAP adapts to the person, generating 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 at first. "At first it was uncomfortable," admits Víctor, although he affirms that little by little he got used to it. Above all, because he noticed the beneficial effects "from day one". “I discovered glory. I was driving and I didn't fall asleep. Before he had to take a nap, yes or yes, he even had an armchair in the office to do it daily. If not, he had no energy. 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 wake up tired."
His wife is also delighted. “Since using the CPAP, she sleeps without earplugs.” She admits that the machine “makes some noise,” but says she has gotten used to it. So has she. “That little noise is heavenly music to my wife compared to my snoring. Plus I suffered with my apneas, it seemed that I was drowning”.
She says that she is now undergoing treatment to lose weight. "Overweight is very important in this pathology", emphasizes Dr. Pérez. “The accumulation of fat in the upper respiratory tract (soft palate, high pharynx…) causes the thickness of all these structures to increase. And a small fall of the tongue back, for example, with a little fat pressing, makes the respiratory obstruction even more important. “If the patients lowered their body mass index –adds the doctor- their symptoms would probably improve and in some cases they could even withdraw the CPAP”.
Statistics say that men suffer from OSA more than women (between two and three times more). It has to do - asserts Pérez - with lifestyles. “The number pretty much evens out when they enter menopause,” he adds. Children can also suffer from OSA, but in a small percentage: they represent 5% of those affected.
Of the 135,000 patients with a respiratory problem that Esteve Teijin treats in total (they offer home service not only in Catalonia, but also in Galicia, Navarra, Palencia, Aragón...), some 94,000 suffer from OSA (70%), of which 39,000 are found in Catalonia.
