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href="/insuffisance-respiratoire/propos-de-linsuffisance-respiratoire" data-tag="event=button_click;click_category=header;click_sub_category=Insuffisance Respiratoire;click_label=A propos de l'insuffisance respiratoire;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">A propos de l'insuffisance respiratoire</a>
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href="/insuffisance-respiratoire/diagnostic-et-examen-de-linsuffisance-respiratoire" data-tag="event=button_click;click_category=header;click_sub_category=Insuffisance Respiratoire;click_label=Diagnostic et examen de l'insuffisance respiratoire;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Diagnostic et examen de l'insuffisance respiratoire</a>
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href="/insuffisance-respiratoire/laccompagnement-orkyn" data-tag="event=button_click;click_category=header;click_sub_category=Insuffisance Respiratoire;click_label=L'accompagnement ORKYN';page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">L'accompagnement ORKYN'</a>
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href="/diabete/propos-du-diabete" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=À propos du diabète;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">À propos du diabète</a>
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href="/diabete/comment-diagnostiquer-le-diabete" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=Le diagnostic du diabète;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Le diagnostic du diabète</a>
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href="/diabete/les-traitements-du-diabete" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=Les traitements du diabète;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Les traitements du diabète</a>
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href="/diabete/mise-sous-pompe-insuline-en-ambulatoire" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=Mise sous pompe à insuline en ambulatoire;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Mise sous pompe à insuline en ambulatoire</a>
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href="/diabete/accompagnement-orkyn-de-ladulte-sous-pompe-insuline" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=Accompagnement ORKYN' de l'adulte sous pompe à insuline;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Accompagnement ORKYN' de l'adulte sous pompe à insuline</a>
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href="/diabete/accompagnement-orkyn-enfant-et-adolescent-sous-pompe-insuline" data-tag="event=button_click;click_category=header;click_sub_category=Diabète;click_label=Accompagnement ORKYN' : enfant et adolescent sous pompe à insuline;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Accompagnement ORKYN' : enfant et adolescent sous pompe à insuline</a>
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href="/maladie-de-parkinson/comment-evolue-la-maladie-de-parkinson" data-tag="event=button_click;click_category=header;click_sub_category=Maladie de Parkinson;click_label=Evolution de la maladie de Parkinson;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Evolution de la maladie de Parkinson</a>
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href="/maladie-de-parkinson/laccompagnement-orkyn" data-tag="event=button_click;click_category=header;click_sub_category=Maladie de Parkinson;click_label=L'accompagnement ORKYN';page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">L'accompagnement ORKYN'</a>
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data-tag="event=button_click;click_category=header;click_label=dysfonctionnement_systeme_immunitaire;page_type=[page_type];page_theme=[page_theme];page_category_1=[page_category_1];page_category_2=[page_category_2];page_category_3=[page_category_3];page_category_4=[page_category_4];profile_type=[profile_type];page_name=[page_name];region=[region];country=[country];activity=[activity];brand=[brand];">Dysfonctionnement système immunitaire</button>
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Notre accompagnement du traitement par perfusion d’immunoglobuline
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Comprendre le système immunitaire
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Qu’est-ce qu’une maladie auto-immune ?
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Que signifie être immunodéprimé ?
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Les différents traitements possibles
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Les déficits immunitaires primitifs
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Le déficit immunitaire commun variable (DICV)
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Les déficits immunitaires secondaires
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Le myélome multiple
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<p class="subtitle-l-regular text-primary">L'apnée du sommeil est un trouble respiratoire du sommeil qui se caractérise par des pauses respiratoires de 10 à 30 secondes, voire plus, pouvant se répéter plus de 10 fois par heure. Ces apnées entraînent des micro-réveils qui retentissent fortement sur la qualité de vie. Tout le monde peut être touché par cette maladie respiratoire, y compris les enfants, mais certaines personnes sont plus à risque que d'autres, notamment les hommes en surpoids.</p>
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Apnée mixte
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Apnée obstructive du sommeil (SAOS)
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<h2 class="heading-s-bold identity-primary">Apnée obstructive du sommeil (SAOS)</h2>
<p><strong>Le syndrome d'apnée obstructive du sommeil</strong> est lié à un rétrécissement du pharynx, provoqué par un relâchement de ses muscles, qui empêche l'air de circuler normalement.<br>
Lorsque l'obstruction est partielle, l'air passe encore mais avec difficultés (on parle <strong>d'hypopnée</strong>), donnant lieu à des ronflements importants.</p>
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<p class="heading-l-bold number text-primary">90%</p>
<p class="subtitle-l-regular subtitle-number text-primary">des apnées sont des SAOS</p>
<p class="desc body-m-regular text-primary"> </p>
</div>
</div>
</div>
</div>
<div class="text">
<div class="wysiwyg">En cas d'obstruction totale, l'air ne peut plus passer, provoquant une <strong>apnée</strong>. Le cœur tourne alors à plein régime pour fournir au cerveau l'oxygène dont il est privé. En réaction, ce dernier induit une contraction réflexe des muscles du pharynx afin de libérer les voies respiratoires et permettre à la personne de respirer à nouveau, ce qui a pour effet de provoquer des <strong>micro-réveils</strong>. S'ils sont rarement ressentis, <strong>leurs conséquences sont réelles</strong>.</div>
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Apnée centrale du sommeil
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<h2 class="heading-s-bold identity-primary">Apnée centrale du sommeil</h2>
<p>Dans cette forme <strong>beaucoup plus rare</strong> d'apnée du sommeil, le mécanisme en cause n'est pas un relâchement des muscles du pharynx mais une dysfonction de la commande respiratoire au <strong>niveau cérébral</strong>.</p>
<p>Le cerveau omet d'émettre le signal indiquant aux muscles impliqués dans la respiration de se contracter, empêchant ainsi la respiration de se faire. La cause n'est donc pas mécanique mais <strong>neurologique</strong>. Un accident vasculaire cérébral ou une insuffisance cardiaque peuvent être à l'origine d'une apnée centrale du sommeil.</p>
<p class="highlighted-p subtitle-l-regular">L'apnée centrale pure est relativement rare, elle est plus volontiers associée à un syndrome d'apnée obstructive du sommeil.</p>
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Apnée mixte
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<h2 class="heading-s-bold identity-primary">Apnée mixte</h2>
<p>L'apnée mixte associe les deux formes d'apnée précédentes, le syndrome d'apnée obstructive du sommeil et l'apnée centrale du sommeil.</p>
<p class="highlighted-p subtitle-l-regular">Généralement, l'apnée débute par une apnée centrale à laquelle succède un mécanisme obstructif.</p>
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<div id="p3021" class="wysiwyg al-margin-regular paragraph paragraph--type--wysiwyg-full paragraph--view-mode--default">
<h2 class="heading-s-bold identity-primary">Les symptômes et signes de l'apnée du sommeil</h2>
<p>Les personnes souffrants d'apnées du sommeil sont généralement <strong>les dernières à s'en rendre compte !</strong><br>
C'est souvent leur conjoint(e), réveillé(e) par les ronflements, qui constate alors les pauses respiratoires. Elles sont associées, bien souvent, à des sensations d'étouffement et à un sommeil agité.</p>
<p>A ces symptômes nocturnes viennent s'ajouter des <strong>signes diurnes évocateurs</strong>, devant lesquels le diagnostic de l'apnée du sommeil doit être recherché : </p>
<ul>
<li>Au réveil, vous vous sentez encore <strong>fatigué</strong>, vous avez la <strong>bouche sèche</strong> et souffrez souvent de <strong>maux de tête</strong>,</li>
<li>Au cours de la journée, vous <strong>manquez d'énergie</strong>, vous vous sentez <strong>somnolent</strong> et <strong>irritable</strong>, et vous avez <strong>du mal à vous concentrer</strong>,</li>
<li>Certains patients évoquent également une <strong>baisse de leur libido</strong>.</li>
</ul>
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<div
class="subtitle-l-regular text-secondary">Ronflement</div>
<span
class="subtitle-accordion body-m-regular text-tertiary">Quelles sont les causes du ronflement ? Quel lien entre ronflement et apnée du sommeil ? Comment arrêter de ronfler ? </span>
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<h2 class="heading-s-bold identity-primary"> Qu'est-ce que le ronflement ?</h2>
<p class="highlighted-p subtitle-l-regular">40 à 50% des adultes de plus de 50 ans ronflent de manière régulière</p>
<p>Nuisance fréquente, le ronflement est plus fréquent chez l'homme d'âge moyen que chez la femme du même âge. A la ménopause, le ronflement devient aussi fréquent pour les deux sexes. A noter qu'il peut survenir aussi chez l'enfant. Le ronflement peut atteindre une intensité de 90 à 100 dB équivalent au passage d'un camion à proximité, et avoir des conséquences sociales importantes dans les relations avec le conjoint et l'entourage. Les ronflements peuvent aller de pair avec une apnée du sommeil légère, en effet, le ronfleur arrête par moment de respirer pendant la nuit (« pauses respiratoires »).</p>
<h2 class="heading-s-bold identity-primary">Les causes du ronflement</h2>
<h4 class="subtitle-m-bold identity-primary">Pourquoi ronfle-t-on?</h4>
<p>Pendant le sommeil, tous vos muscles se relâchent, entraînant le recul de la langue au niveau du pharynx. L’espace au niveau des voies respiratoires rétrécit alors et entraîne une baisse de la quantité d’air inspirée allant aux poumons. Pour continuer à alimenter les poumons en oxygène et éviter l’asphyxie, il y a un phénomène de compensation inconscient qui tente d'accélèrer le flux d'air par une respiration plus forte. C'est cette accélération qui entraîne la vibration de certains tissus de la gorge et produit le ronflement.</p>
<p>Parfois l’obstruction du pharynx est complète et provoque un arrêt respiratoire. Il s'agit alors d'une apnée du sommeil. Elle peut durer 10 secondes ou plus et se répéter plusieurs dizaines ou centaines de fois par nuit. On parlera alors de Syndrome d’Apnée Obstructive du Sommeil (SAOS).</p>
<p>Le ronflement peut être aussi lié à des situations particulières : congestion nasale, une cloison nasale déviée, position en dormant (sur le dos notamment) ou consommation de boissons alcoolisées avant de se coucher.</p>
<h2 class="heading-s-bold identity-primary">Quel lien entre ronflement et apnée du sommeil ?</h2>
<p>Le fort ronflement est un des symptômes de l’apnée du sommeil. Parfois, l’obstruction du pharynx est complète et provoque un arrêt respiratoire. C’est ce que l’on appelle une apnée du sommeil. L’apnée du sommeil peut durer 10 secondes ou plus. Ce phénomène peut se répéter plusieurs dizaines ou centaines de fois par nuit ; on parlera alors de Syndrome d’Apnée Obstructive du Sommeil (SAOS) ou rhonchopathie chronique. L’apnée obstructive du sommeil entraîne une désorganisation du sommeil et des véritables réveils au cours du sommeil paradoxal et du sommeil profond avec des répercussions importantes sur la santé.</p>
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<div
class="highlighted-p subtitle-l-regular">Le surpoids, l'obésité, des antécédents familiaux de syndrome d'apnée du sommeil, et l'âge constituent des facteurs de risque reconnus de l'apnée du sommeil, en particulier celui du syndrome d'apnée obstructive du sommeil, chez l'adulte. La ménopause et la grossesse constituent également des facteurs de risque d'apnée obstructive du sommeil.</div>
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<div id="p9416" class="wysiwyg al-margin-regular paragraph paragraph--type--wysiwyg-full paragraph--view-mode--default">
<h2 class="heading-s-bold identity-primary">Les conséquences de l'apnée du sommeil</h2>
<p><span><span><span><span><span><span>Rarement ressentis, les micro-éveils provoqués par les apnées du sommeil peuvent avoir de sérieuses conséquences sur la santé, altérant considérablement la qualité de vie et exposant à un risque accru de maladies cardiovasculaires.</span></span></span></span></span></span></p>
<h4 class="identity-primary subtitle-m-bold"><span><span><span><span><span><span>Altération de la qualité de vie & risque accru de maladies cardiovasculaires.</span></span></span></span></span></span></h4>
<p><span><span><span><span><span><span>Les apnées du sommeil s'accompagnent d'un ralentissement de la fréquence cardiaque tandis qu'une accélération du rythme est observée pendant la reprise respiratoire. Ces troubles du rythme cardiaque fatiguent le cœur et peuvent, à la longue, favoriser la survenue de maladies cardiovasculaires graves comme l'insuffisance cardiaque, la maladie coronarienne ou l'accident vasculaire cérébral (AVC). Une étude menée pendant 7 ans a montré qu'indépendamment des autres facteurs de risque, l'apnée obstructive du sommeil multiplie par 5 le risque de maladie coronarienne[1].</span></span></span></span></span></span></p>
<p><span><span><span><span><span><span>Par ailleurs, diabète de type 2 et syndrome d'apnée obstructive du sommeil seraient liés. Le risque de diabète de type 2 serait en effet majoré par le SAOS, tandis qu'à l'inverse, un SAOS aggraverait un diabète. Or le diabète est une maladie qui augmente le risque de crise cardiaque et d'AVC.</span></span></span></span></span></span></p>
<p><span><span><span><span><span><span>Enfin, le manque de sommeil dû à l'apnée du sommeil favorise la prise de poids en perturbant la sécrétion d'hormones impliquées dans la satiété. C'est un cercle vicieux puisque le surpoids entraîne ou aggrave une apnée du sommeil... qui stimule le surpoids. Ce dernier est aussi un facteur de risque de maladies cardiovasculaires.</span></span></span></span></span></span></p>
<p class="highlighted-p subtitle-l-regular"><span><span><span><span><span><span>PREMIÈRE CONSÉQUENCE PERCEPTIBLE DE L'APNÉE DU SOMMEIL : LA FATIGUE.</span></span></span></span></span></span></p>
<p><span><span><span><span><span><span>Les micro-éveils fragmentent le sommeil, qui n'est plus récupérateur. Résultat : vous est fatigué dès le réveil, vous luttez toute la journée pour rester éveillé et ne pas succomber à cette somnolence accablante. Vous pouvez devenir irritable, agressif, ce qui n'est pas sans conséquences sur vos relations conjugales et sociales.</span></span></span></span></span></span></p>
<p><span><span><span><span><span><span>S'ajoutent des difficultés de concentration, diminution des performances intellectuelles, un ralentissement des réflexes, particulièrement préjudiciable en cas de conduite. Sur le plan professionnel, absentéisme et arrêts maladie sont plus fréquents quand on souffre de SAOS [2].</span></span></span></span></span></span></p>
<p class="highlighted-p subtitle-l-regular"><span><span><span><span><span><span>Dans 1 cas sur 5, les symptômes d'apnée du sommeil entraînent une dépression</span></span></span></span></span></span></p>
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<h2 class="heading-s-bold identity-primary">L'apnée du sommeil chez l'enfant</h2>
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<div class="wysiwyg"><p>Les enfants peuvent eux aussi souffrir <strong>d'apnée du sommeil</strong> si leurs voies respiratoires sont réduites par certaines <strong>particularités anatomiques</strong> comme une grosse langue, un menton en retrait (rétrognathisme), un palais mou ou encore par des amygdales ou des végétations volumineuses.</p>
<p>Enfin, certaines situations sont connues pour favoriser les ronflements et les apnées, aussi bien en termes de fréquence que de durée : dormir sur le dos, prendre certains médicaments (somnifères, sédatifs), présenter une hypertension artérielle.</p></div>
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<li><a href="http://www.sfrms-sommeil.org/recherche/actualite-scientifique/archives-2013/le-saos-de-lenfant-congres-du-sommeil/" target="_blank">Le SAOS de l'enfant - SFRMS Congrès du Sommeil</a></li>
<li><a href="http://erj.ersjournals.com/content/28/3/596.long#sec-10" target="_blank">Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Y. Peker, J. Carlson, J. Hedner, European Respiratory Journal, septembre 2006</a></li>
<li><a href="http://www.ncbi.nlm.nih.gov/pubmed/8797408" target="_blank">Excessive daytime sleepiness at work and subjective work performance in the general population and among heavy snorers and patients with obstructive sleep apnea.Chest. 1996 Sep;110(3):659-63</a></li>
<li><a href="http://www.jle.com/fr/revues/nro/e-docs/syndrome_dapnees_du_sommeil_en_neurologie_chez_qui_et_comment_le_rechercher_comment_et_pourquoi_le_traiter__281511/article.phtml?tab=citer" target="_blank">Véronique Viot-Blanc. Syndrome d’apnées du sommeil en neurologie : chez qui et comment le rechercher ? Comment et pourquoi le traiter ?. Neurologie.com. 2009;1(3):79-83.</a></li>
<li><a href="http://www.inserm.fr/thematiques/physiopathologie-metabolisme-nutrition/dossiers-d-information/l-apnee-du-sommeil" target="_blank">Dossier Inserm "L'apnée du sommeil"</a></li>
<li><a href="http://www.ameli-sante.fr/apnee-du-sommeil/" target="_blank">Dossier Assurance Maladie "Apnée du sommeil"</a></li>
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