Nervenheilkunde 2021; 40(07): 517-526
DOI: 10.1055/a-1444-5956
Schwerpunkt

Schlafbezogene Atmungsstörungen

Was sollte der Neurologe wissen?Sleep-disordered breathingWhat is important for neurologists to know?
Matthias Boentert
1   Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster und Klinik für Innere Medizin, Bereich Neurologie, UKM-Marienhospital Steinfurt
› Author Affiliations

ZUSAMMENFASSUNG

Schlafbezogene Atmungsstörungen (SBAS) haben einen hohen bevölkerungsmedizinischen Stellenwert. Sie sind nicht nur mit bekannten Risikofaktoren wie Alter oder Adipositas assoziiert, sondern treten häufig auch im Rahmen neurologischer Erkrankungen auf und spielen eine große Rolle für die Krankheitslast und Prognose betroffener Menschen. Dieser Artikel skizziert die Pathophysiologie der verschiedenen SBAS und ihren spezifischen Stellenwert bei wichtigen neurologischen Krankheitsbildern. Ferner werden die für Neurologen relevanten Grundprinzipien von Diagnostik und Therapie dargestellt.

ABSTRACT

Sleep-disordered breathing (SDB) is of utmost importance in general medicine and highly prevalent in the normal population. Apart from known risk factors such as age or obesity, SDB is frequently associated with neurological disease and plays a major role for disease burden and overall prognosis of affected people. This review article outlines the pathophysiology of SDB and its disease-specific relevance in distinct neurological conditions. Furthermore, basic principles of diagnosis and treatment are discussed from a neurological perspective.



Publication History

Article published online:
09 July 2021

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  • Literatur

  • 1 American Academy of Sleep Medicine. International Classification of Sleep Disorders IL: American Academy of Sleep Medicine 3rd ed (ICSD-3) Diagnostic and coding manual Westchester. 2014
  • 2 Nieto FJ, Young TB, Lind BK. et al Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000; 283: 1829-1836
  • 3 Fietze I, Laharnar N, Obst A. et al Prevalence and association analysis of obstructive sleep apnea with gender and age differences – Results of SHIP-Trend. J Sleep Res 2019; 28: e12770
  • 4 Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet Lond Engl 2014; 383: 736-747
  • 5 Tuomilehto HPI, Seppä JM, Partinen MM. et al Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med 2009; 179: 320-327
  • 6 Patil SP, Ayappa IA, Caples SM. et al Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 2019; 15: 335-343
  • 7 Verse T, Dreher A, Heiser C. et al [S2e-guideline: „ENT-specific therapy of obstructive sleep apnea in adults“ short version : Sleep Medicine Task Force of the German Society for Otorhinolaryngology, Head and Neck Surgery]. HNO 2016; 64: 310-319
  • 8 Zaghi S, Holty J-EC, Certal V. et al Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea: A Meta-analysis. JAMA Otolaryngol – Head Neck Surg 2016; 142: 58-66
  • 9 Randerath W, Verbraecken J, Andreas S. et al Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep. Eur Respir J 2017: 49
  • 10 Eckert DJ, Jordan AS, Merchia P. et al Central sleep apnea: Pathophysiology and treatment. Chest 2007; 131: 595-607
  • 11 Van Ryswyk E, Antic NA. Opioids and Sleep-Disordered Breathing. Chest 2016; 150: 934-944
  • 12 Coniglio AC, Mentz RJ. Sleep Breathing Disorders in Heart Failure. Heart Fail Clin 2020; 16: 45-51
  • 13 Nigam G, Pathak C, Riaz M. A systematic review of central sleep apnea in adult patients with chronic kidney disease. Sleep Breath Schlaf Atm 2016; 20: 957-964
  • 14 Duning T, Deppe M, Brand E. et al Brainstem involvement as a cause of central sleep apnea: pattern of microstructural cerebral damage in patients with cerebral microangiopathy. PloS One 2013; 8: e60304
  • 15 Flinta I, Ponikowski P. Relationship between central sleep apnea and Cheyne-Stokes Respiration. Int J Cardiol 2016; 206 Suppl S8-12
  • 16 Maloney MA, Kun SS, Keens TG. et al Congenital central hypoventilation syndrome: diagnosis and management. Expert Rev Respir Med 2018; 12: 283-292
  • 17 Cowie MR, Woehrle H, Wegscheider K. et al Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure. N Engl J Med 2015; 373: 1095-1105
  • 18 Masa JF, Pépin J-L, Borel J-C. et al Obesity hypoventilation syndrome. Eur Respir Rev Off J Eur Respir Soc 2019: 28
  • 19 Windisch W, Dreher M, Geiseler J. et al [Guidelines for Non-Invasive and Invasive Home Mechanical Ventilation for Treatment of Chronic Respiratory Failure – Update 2017]. Pneumologie 2017; 71: 722-795
  • 20 Berry RB, Budhiraja R, Gottlieb DJ. et al Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8: 597-619
  • 21 Jackson ML, Howard ME, Barnes M. Cognition and daytime functioning in sleep-related breathing disorders. Prog Brain Res 2011; 190: 53-68
  • 22 Mun JK, Choi SJ, Kang M-R. et al Sleep and libido in men with obstructive sleep apnea syndrome. Sleep Med 2018; 52: 158-162
  • 23 Acker J, Richter K, Piehl A. et al Obstructive sleep apnea (OSA) and clinical depression-prevalence in a sleep center. Sleep Breath Schlaf Atm 2017; 21: 311-318
  • 24 Chiu H-Y, Chen P-Y, Chuang L-P. et al Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Med Rev 2017; 36: 57-70
  • 25 Nuckton TJ, Glidden DV, Browner WS. et al Physical examination: Mallampati score as an independent predictor of obstructive sleep apnea. Sleep 2006; 29: 903-908
  • 26 Laveneziana P, Albuquerque A, Aliverti A. et al ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J 2019: 53
  • 27 Kabitz HJ, Walterspacher S, Mellies U. et al [Recommendations for respiratory muscle testing]. Pneumologie 2014; 68: 307-314
  • 28 Quanjer PH, Stanojevic S, Cole TJ. et al Multi-ethnic reference values for spirometry for the 3–95 yr age range: the global lung function 2012 equations. Eur Respir J 2012; 40: 1324-1343
  • 29 Mellies U, Ragette R, Schwake C. et al Daytime predictors of sleep disordered breathing in children and adolescents with neuromuscular disorders. Neuromuscul Disord 2003; 13: 123-128
  • 30 Ragette R, Mellies U, Schwake C. et al Patterns and predictors of sleep disordered breathing in primary myopathies. Thorax 2002; 57: 724-728
  • 31 Evans JA, Whitelaw WA. The assessment of maximal respiratory mouth pressures in adults. Respir Care 2009; 54: 1348-1359
  • 32 Uldry C, Fitting JW. Maximal values of sniff nasal inspiratory pressure in healthy subjects. Thorax 1995; 50: 371-375
  • 33 Chatwin M, Simonds AK. Long-Term Mechanical Insufflation-Exsufflation Cough Assistance in Neuromuscular Disease: Patterns of Use and Lessons for Application. Respir Care 2020; 65: 135-143
  • 34 Kushida CA, Littner MR, Morgenthaler T. et al Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 2005; 28: 499-521
  • 35 Mayer G, Arzt M, Braumann B. et al German S3 Guideline Nonrestorative Sleep/Sleep Disorders, chapter „Sleep-Related Breathing Disorders in Adults,“ short version: German Sleep Society (Deutsche Gesellschaft fur Schlafforschung und Schlafmedizin, DGSM). Somnologie Berl 2017; 21: 290-301
  • 36 BUB-Richtlinie/Anlage A (Polygraphie und Polysomnographie) – Gemeinsamer Bundesausschuss. Im Internet. https://www.g-ba.de/beschluesse/146/ Stand: 08.03.2021
  • 37 Boentert M, Glatz C, Helmle C. et al Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2017
  • 38 Mehra R, Benjamin EJ, Shahar E. et al Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med 2006; 173: 910-916
  • 39 Gami AS, Pressman G, Caples SM. et al Association of atrial fibrillation and obstructive sleep apnea. Circulation 2004; 110: 364-367
  • 40 Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ 2000; 320: 479-482
  • 41 Dziewas R, Ritter M, Usta N. et al Atherosclerosis and obstructive sleep apnea in patients with ischemic stroke. Cerebrovasc Dis Basel Switz 2007; 24: 122-126
  • 42 Arzt M, Young T, Finn L. et al Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med 2005; 172: 1447-1451
  • 43 Yaggi HK, Concato J, Kernan WN. et al Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-2041
  • 44 Young T, Finn L, Peppard PE. et al Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31: 1071-1078
  • 45 Turkington PM, Bamford J, Wanklyn P. et al Prevalence and predictors of upper airway obstruction in the first 24 hours after acute stroke. Stroke 2002; 33: 2037-2042
  • 46 Iranzo A, Santamaría J, Berenguer J. et al Prevalence and clinical importance of sleep apnea in the first night after cerebral infarction. Neurology 2002; 58: 911-916
  • 47 Seiler A, Camilo M, Korostovtseva L. et al Prevalence of sleep-disordered breathing after stroke and TIA: A meta-analysis. Neurology 2019; 92: e648-e654
  • 48 Mansukhani MP, Bellolio MF, Kolla BP. et al Worse outcome after stroke in patients with obstructive sleep apnea: an observational cohort study. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc 2011; 20: 401-405
  • 49 Sahlin C, Sandberg O, Gustafson Y. et al Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med 2008; 168: 297-301
  • 50 Bravata DM, Concato J, Fried T. et al Auto-titrating continuous positive airway pressure for patients with acute transient ischemic attack: a randomized feasibility trial. Stroke 2010; 41: 1464-1470
  • 51 Ryan CM, Bayley M, Green R. et al Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea. Stroke 2011; 42: 1062-1067
  • 52 Parra O, Sánchez-Armengol A, Bonnin M. et al Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial. Eur Respir J 2011; 37: 1128-1136
  • 53 Minnerup J, Ritter MA, Wersching H. et al Continuous positive airway pressure ventilation for acute ischemic stroke: a randomized feasibility study. Stroke 2012; 43: 1137-1139
  • 54 Hsu C-Y, Vennelle M, Li H-Y. et al Sleep-disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure. J Neurol Neurosurg Psychiatry 2006; 77: 1143-1149
  • 55 McEvoy RD, Antic NA, Heeley E. et al CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919-931
  • 56 Abuzaid AS, Al Ashry HS, Elbadawi A. et al Meta-Analysis of Cardiovascular Outcomes With Continuous Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea. Am J Cardiol 2017; 120: 693-699
  • 57 Sobreira-Neto MA, Pena-Pereira MA, Sobreira EST. et al Obstructive sleep apnea and Parkinson’s disease: characteristics and associated factors. Arq Neuropsiquiatr 2019; 77: 609-616
  • 58 Sobreira-Neto MA, Pena-Pereira MA, Sobreira EST. et al High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life. Eur Neurol 2017; 78: 330-337
  • 59 Cochen De Cock V, Benard-Serre N, Driss V. et al Supine sleep and obstructive sleep apnea syndrome in Parkinson’s disease. Sleep Med 2015; 16: 1497-1501
  • 60 Harmell AL, Neikrug AB, Palmer BW. et al Obstructive Sleep Apnea and Cognition in Parkinson’s disease. Sleep Med 2016; 21: 28-34
  • 61 Mery VP, Gros P, Lafontaine A-L. et al Reduced cognitive function in patients with Parkinson disease and obstructive sleep apnea. Neurology 2017; 88: 1120-1128
  • 62 Terzaghi M, Spelta L, Minafra B. et al Treating sleep apnea in Parkinson’s disease with C-PAP: feasibility concerns and effects on cognition and alertness. Sleep Med 2017; 33: 114-118
  • 63 Meng L, Benedetti A, Lafontaine A-L. et al Obstructive sleep apnea, CPAP therapy and Parkinson’s disease motor function: A longitudinal study. Parkinsonism Relat Disord 2020; 70: 45-50
  • 64 Kaminska M, Mery VP, Lafontaine A-L. et al Change in Cognition and Other Non-Motor Symptoms With Obstructive Sleep Apnea Treatment in Parkinson Disease. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 2018; 14: 819-828
  • 65 Bianchi ML, Losurdo A, Di Blasi C. et al Prevalence and clinical correlates of sleep disordered breathing in myotonic dystrophy types 1 and 2. Sleep Breath 2014; 18: 579-589
  • 66 Runte M, Spiesshoefer J, Heidbreder A. et al Sleep-related breathing disorders in facioscapulohumeral dystrophy. Sleep Breath 2019; 23: 899-906
  • 67 Romigi A, Albanese M, Placidi F. et al Sleep disorders in myotonic dystrophy type 2: a controlled polysomnographic study and self-reported questionnaires. Eur J Neurol 2014; 21: 929-934
  • 68 Polat M, Sakinci O, Ersoy B. et al Assessment of sleep-related breathing disorders in patients with duchenne muscular dystrophy. J Clin Med Res 2012; 4: 332-337
  • 69 Boentert M, Knop K, Schuhmacher C. et al Sleep disorders in Charcot-Marie-Tooth disease type 1. J Neurol Neurosurg Psychiatry 2014; 85: 319-325
  • 70 Langenbruch L, Perez-Mengual S, Glatz C. et al Disorders of sleep in spinal and bulbar muscular atrophy (Kennedy’s disease). Sleep Breath Schlaf Atm 2020
  • 71 Santos C, Braghiroli A, Mazzini L. et al Sleep-related breathing disorders in amyotrophic lateral sclerosis. Monaldi Arch Chest Dis 2003; 59: 160-165
  • 72 Nicolle MW, Rask S, Koopman WJ. et al Sleep apnea in patients with myasthenia gravis. Neurology 2006; 67: 140-142
  • 73 Chang ET, Certal V, Song SA. et al Dexmedetomidine versus propofol during drug-induced sleep endoscopy and sedation: a systematic review. Sleep Breath Schlaf Atm 2017; 21: 727-735
  • 74 Farr E, D’Andrea D, Franz CK. Phrenic Nerve Involvement in Neuralgic Amyotrophy (Parsonage-Turner Syndrome). Sleep Med Clin 2020; 15: 539-543
  • 75 Schilero GJ, Bauman WA, Radulovic M. Traumatic Spinal Cord Injury: Pulmonary Physiologic Principles and Management. Clin Chest Med 2018; 39: 411-425
  • 76 Nardone R, Zuccoli G, Brigo F. et al Seronegative neuromyelitis optica presenting with life-threatening respiratory failure. J Spinal Cord Med 2016; 39: 734-736
  • 77 Howard RS, Thorpe J, Barker R. et al Respiratory insufficiency due to high anterior cervical cord infarction. J Neurol Neurosurg Psychiatry 1998; 64: 358-361
  • 78 Vitacca M, Montini A, Lunetta C. et al Impact of an early respiratory care program with NIV adaptation in patients with ALS. Eur J Neurol 2017
  • 79 Ishikawa Y, Miura T, Ishikawa Y. et al Duchenne muscular dystrophy: survival by cardio-respiratory interventions. Neuromuscul Disord 2011; 21: 47-51
  • 80 Onders RP, Elmo M, Kaplan C. et al Long-term experience with diaphragm pacing for traumatic spinal cord injury: Early implantation should be considered. Surgery 2018; 164: 705-711
  • 81 McDermott CJ, Bradburn MJ, Maguire C. et al DiPALS: Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis – a randomised controlled trial. Health Technol Assess 2016; 20: 1-186
  • 82 Gonzalez-Bermejo J, Morelot-Panzini C, Tanguy ML. et al Early diaphragm pacing in patients with amyotrophic lateral sclerosis (RespiStimALS): a randomised controlled triple-blind trial. Lancet Neurol 2016; 15: 1217-1227
  • 83 Kaminska M, Kimoff RJ, Benedetti A. et al Obstructive sleep apnea is associated with fatigue in multiple sclerosis. Mult Scler Houndmills Basingstoke Engl 2012; 18: 1159-1169
  • 84 Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 2014; 10: 155-162
  • 85 Levit E, Bouley A, Baber U. et al Brainstem lesions are associated with sleep apnea in multiple sclerosis. Mult Scler J – Exp Transl Clin 2020; 6: 2055217320967955
  • 86 Morelli C, Aeby A, Scaillet S. et al Central Sleep Apnea Syndrome Can Complicate Neuromyelitis Optica Spectrum Disorder: A Case Report. Front Pediatr 2020; 8: 547474
  • 87 Osorio RS, Gumb T, Pirraglia E. et al Sleep-disordered breathing advances cognitive decline in the elderly. Neurology 2015; 84: 1964-1971
  • 88 Gaeta AM, Benítez ID, Jorge C. et al Prevalence of obstructive sleep apnea in Alzheimer’s disease patients. J Neurol 2020; 267: 1012-1022
  • 89 Liguori C, Mercuri NB, Izzi F. et al Obstructive Sleep Apnea is Associated With Early but Possibly Modifiable Alzheimer’s Disease Biomarkers Changes. Sleep 2017: 40
  • 90 Przybylska-Kuć S, Zakrzewski M, Dybała A. et al Obstructive sleep apnea may increase the risk of Alzheimer’s disease. PloS One 2019; 14: e0221255
  • 91 Tsai M-S, Li H-Y, Huang C-G. et al Risk of Alzheimer’s Disease in Obstructive Sleep Apnea Patients With or Without Treatment: Real-World Evidence. The Laryngoscope 2020; 130: 2292-2298
  • 92 Lutsey PL, Misialek JR, Mosley TH. et al Sleep characteristics and risk of dementia and Alzheimer’s disease: The Atherosclerosis Risk in Communities Study. Alzheimers Dement J Alzheimers Assoc 2018; 14: 157-166
  • 93 Yaffe K, Laffan AM, Harrison SL. et al Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 2011; 306: 613-619
  • 94 Mullins AE, Kam K, Parekh A. et al Obstructive Sleep Apnea and Its Treatment in Aging: Effects on Alzheimer’s disease Biomarkers, Cognition, Brain Structure and Neurophysiology. Neurobiol Dis 2020; 145: 105054
  • 95 Wang D, Teichtahl H. Opioids, sleep architecture and sleep-disordered breathing. Sleep Med Rev 2007; 11: 35-46
  • 96 Walker JM, Farney RJ, Rhondeau SM. et al Chronic opioid use is a risk factor for the development of central sleep apnea and ataxic breathing. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 2007; 3: 455-461
  • 97 George CFP, Feldman N, Inhaber N. et al A safety trial of sodium oxybate in patients with obstructive sleep apnea: Acute effects on sleep-disordered breathing. Sleep Med 2010; 11: 38-42