Abstract
Sleep Apnea syndrome (SAS) is a common sleep disorder with a prevalence ranging from 5.9% to 79.2% in European general populations over 35 years of age old but remains under diagnosed. Continuous positive airway Pressure (CPAP) remains the treatment reference for moderate to severe forms of SAS in 2019. CPAP benefits depend on sufficient patient adherence, which is conditioned by multiple factors, including interface related side effects (leakage and their consequences, among others).In this thesis, we demonstrate the feasibility of OSA screening with Jawac® signaling in the general population. The analysis of the long-term CPAP-treated patient results in the interface-vent cohort highlighted that side-effects reported by these patients (some associated with leakage) are associated with compliance and sleepiness, while machine data (residual apnea/hypopnea index and machine leakage) are not.This lack of association between machine data (that could be monitored as proposed in the ATS 2013 algorithm) and patient compliance was confirmed for the patient subgroup of the cohort respecting the machine criteria and interface equipment of the ATS 2013 algorithm.Collaborative work has also made it possible to address the issue of leaks reported by the machine under two other aspects. First of all, it has been shown that the auto- or constant mode of the CPAP has no effect on the level of the leak reported by the machine (while the oro-nasal interface and the pressure level machine have an impact). By studying determinants of leaks during a night of polygraphic recording, the heterogeneity of unintentional leak determinants at the individual was demonstrated. Finding a consensus for how to quantify leak patterns remains a challenge in the field.