Schlafstörungen und Herzerkrankungen

Zusammenfassung

Die Prävalenz von schlafbezogenen Atmungsstörungen (SBAS) beträgt ca. 30 % bei Patienten mit einer koronaren Herzerkrankung, ca. 30 % bei Patienten mit Hypertonus, ca. 50 % bei Patienten mit Herzinsuffizienz und ca. 60 % bei Patienten mit Vorhofflimmern. Betrachtet man die medikamentös nicht einzustellenden Hypertoniker, lassen sich bei bis zu 80 % relevante SBAS nachweisen. Bei vielen kardiologischen Krankheitsbildern, insbesondere Herzinsuffizienz und Vorhofflimmern, ist der Gebrauch von Fragebögen zum Screening von SBAS nicht sensitiv genug, da das Symptom der Tagesschläfrigkeit bei diesen Patienten häufig fehlt. Zum Screening auf SBAS eignet sich die ambulant durchführbare kardiorespiratorische Polygraphie. Eine effektive Therapie der SBAS kann den Blutdruck reduzieren und Rhythmusstörungen verhindern. Ob eine Therapie schlafbezogener Atmungsstörungen das Überleben von Patienten mit einer koronaren Herzerkankung oder mit Herzinsuffizienz beeinflussen kann wird aktuell in größeren Studien untersucht.

Abstract

The prevalence of sleep-disordered breathing (SDB) is ca. 30 % in patients with coronary heart disease, ca. 30 % in patients with Hypertonus, ca. 50 % in patients with congestive heart failure and ca. 60 % in patients with atrial fibrillarion. In patients with resistent hypertension, prevalence of SDB is about 80 %. However, patients with SDB and associated cardiac disease like atrial fibrillation or congestive heart failure do not report daytime symptoms like excessive daytime sleepiness. Ambulatory cardiorespiratory polygraphy is used to screen for SDB in patients with cardiac disease. An effective treatment of SDB can reduced blood pressure and can avoid arrhythmias. The effect of treatment of SDB in patients with congestive heart failure is currently investigated in clinical randomized trials.

Schlüsselwörter

schlafbezogene Atmungsstörung - obstruktive Schlafapnoe - zentrale Schlafapnoe - Herzinsuffizienz - Vorhofflimmern - Hypertonie

Keywords

sleep-disorderd breathing - obstructive sleep apnea - central sleep apnea - heart failure - atrial fibrillation - hypertension

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