Sleep Related Respiratory Disorders

Sleep Related Respiratory Disorders

Over the last twenty years, the management of sleep disorders has become recognised as a field of study in its own right. Advancements in the field are well documented, mainly due to the research undertaken at many dedicated clinics and departments throughout the world.

Sleep medicine is dedicated to the recognition, diagnosis and treatment of syndromes and diseases that affect sleep. Many of these syndromes and diseases are caused by, or linked to respiratory conditions.
Sleep-related Respiratory Disorders are actually more frequent and common than we imagine.

They affect about 2-4% of the adult population, mainly males around 40 - 50 years of age1 and are caused by a mechanical obstruction of the upper airways that interrupt or block the flow of air to the lungs whilst the patient is at rest. This results in a reduction of the oxygen content in the blood.
Theses disorders can manifest themselves in ways which include simple snoring, complete or partial respiratory interruptions and nocturnal apnoea and hypopnea.


Vivisol is one of the leading companies on the market for the diagnosis and home-based therapy of Sleep-related Respiratory Disorders.
We offer innovative diagnostic solutions based on the latest technology from portable cardio-respiratory systems to complete polysomnography systems.
For treatment we provide state of the art continuous positive pressure devices (CPAP, APAP, Bilevel, Adaptive Servo Ventilation and AutoBilevel)
Our service also includes personalised home-based therapeutic resources to constantly monitor compliance and the therapeutic follow-up care for the patient.

OSAS (OBSTRUCTIVE SLEEP APNEA SYNDROME)

Clinical data indicates that obstructive sleep apnoea syndrome is one of the more frequent causes of sleep-related disorders.
There are countless medium and long term complications, ranging from cardiovascular problems2-3 (increased risk of heart disease, hypertension, heart failure and heart attack) to brain disorders (chronic nocturnal brain oxygen deficiency).

Obstructive Sleep Apnoea Syndrome (OSAS) is a clinical condition characterised by numerous episodes of apnoea and hypopnea during each hour of sleep. Because each episode may result in the patient awakening, or partially awakening, the consequences are:

  • restless, superficial sleep that does not permit the person to feel rested
  • difficulty waking up due to lack of “high quality” sleep
  • mental lethargy/ diminished mental function
  • excessive sleepiness during the day and inability to function as normal at home, at work , at leisure.

To diagnose sleep apnoea, identify the root causes, and determine the method of treatment requires the help of a specialist.
Conditions that may be hidden or latent are frequently identified by the analysis of a patient’s sleep patterns. 

Breathe well for a good night’s sleep

VIVISOL has developed several services dedicated to the diagnosis and treatment of the Sleep Apnoea Syndrome.

OSAS DIAGNOSTICS

Vivisol has a complete range of equipment for the diagnosis of sleep-related respiratory disorders: from the simplest cardio-respiratory monitoring devices to advanced integrated polysomnography systems as utilised in the sleep laboratory.

VIVIDREAM:  THE SERVICE YOU’VE ALWAYS DREAMED OF

VIVISOL provides hospitals with apnoea recorders, polygraphs or complete polysomnographs, all devices that will help the doctor diagnose obstructive sleep apnoea syndrome.
It has been extensively demonstrated that the outcome of the polysomnographic exam is greatly influenced by the patient feeling serene and being at ease during the test.
This is why VIVISOL, using specifically trained and qualified personnel, have introduced the service of home-based polysomnography to produce an accurate analysis of the quality of sleep. The service is called Vividream, and operates as follows:
On request from the doctor, VIVISOL will send a specialised technician to the patient’s house to install the necessary equipment.

During the night, a polysomnograph will gather and store on a memory card the data necessary to make the diagnosis. The process entirewly replicates what would happen in a hospital.
The card is picked up the next morning by the technician in order to output and analyse the recorded data.
This analysis can be done by a lung specialist from VIVISOL or directly by hospital personnel, who have rapid access to the data and are hence able to prescribe the best treatment.

The VIVIDREAM process

The Vividream service has several important benefits for everyone involved.
The primary advantage for the medical team is the possibility to monitor their patients without involving a hospital stay or worrying about the technical aspects associated with monitoring.
The doctor’s professional expertise and use of their time is maximised.
The fact that the tests are carried out in the home environment is likely to make the results (and outcome) more relevant, viable and realistic.
And the patient is happier: he or she can stay home during the diagnosis, in a situation of peace and privacy in a familiar environment.

OSAS TREATMENT

The home-based treatment of this condition is carried out utilising a range of ventilation devices which can eliminate obstructive apnoea.

VIVISOL uses several categories of equipment to fulfil this function:

  • CPAP (continuous positive air pressure) devices:
    Provide continuous positive pressure in the airways and prevent them from collapsing and causing apnoea.
  • AUTOCPAP
    A ventilator with auto-regulating continuous positive pressure which monitors the patient’s breathing frequency, airway pressure etc.
    It has the capacity to detect any changes, and increase or decrease the pressure automatically;
  • BILEVEL
    A more advanced ventilator, characterised by two levels of pressure, one at inhalation and one at expiration, for patients who suffer from more serious disorders, or simply prefer this instead of CPAP therapy.
    Because it has a lower exhalation pressure, it is therefore more tolerable. For this reason it is generally advisable for people with OSAS combined with obesity.
  • AUTOBILEVEL
    automatic Bilevel ventilator able to adapt constantly to the patient’s inhalation and exhalation pressure values.
    It therefore responds to the patient’s changing needs during the night.
    This device is particularly indicated for:
    - OSAS patients with variations of the pressure needed which depend on position/REM sleep and other nightly variations,
    - Patients with isolated central components and
    - Patients with Obesity Hypoventilation Syndrome (OHS). 
  • Adaptive Servo Ventilator:
    self-regulating pressure ventilator for treating periodic nocturnal breathing conditions such as Cheyne Stokes, and for patients with Sleep-related Respiratory Disorders and Heart Failure.

 

The supply process:

Upon receipt of a prescription for any of the above, (CPAP, AUTOCPAP, Bi-level and ASV) a VIVISOL technician will attend the patient’s home as soon as possible to deliver the required equipment. He will regulate the pressure and set the relevant timings/ramp levels on the device according to the doctor’s prescription, and will provide the patient with either a nasal or an oral/nasal mask. We always select the best option to ensure the optimum in the functionality of the equipment, patient comfort and convenience.

The technician will demonstrate to the patient how to connect up the equipment and use it correctly, and answer any queries they may have relating to our service.

VIVISOL provides ongoing support for the resolution of technical issues, responding to the patient, their clinician or indeed anyone having a legitimate interest in the patient’s care or wellbeing.

VIVISOL are also actively engaged in the design and provision of monitoring services to fight SIDS, a syndrome that unexpectedly takes the lives of children under one year of age. The causes of this condition are still difficult to identify, but there are a series of behaviours and risk factors that seriously affect the possibility that SIDS will occur. Therefore, it is vitally important to monitor the health conditions of babies who are at risk.

For this reason, VIVISOL designs systems that register the cardiac and pulmonary functions of the baby. These systems allow doctors to constantly monitor the patient’s health conditions and prevent SIDS from occurring.

bibliography

1)     Young T;Peppard P.E; Gottlieb D.J;
Epidemiology of obstructive sleep apnea: A population health perspective.
Am J Respir Care Med 2002; 165: 1217-39
 

2)     McNicholas  W.T; Bonsignore M.R;
Sleep Apnoea as an independent risk factor for cardiovascular disease: Current evidence, basic mechanisms and research priorities.
Eur Respir J 2007: 29:1-23
 

3)     Faccenda J.F; Mackay T.W; Boon N.A; Douglas N.J.
Randomised placebo controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea-hypopnea syndrome
Am J Resp Crit Care Med 2001: 163:344-8