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Der Klinikarzt 2006; 35(4): 153-159
DOI: 10.1055/s-2006-942077
In diesem Monat

© Georg Thieme Verlag Stuttgart · New York

Stufendiagnostik führt zum Ziel - Diagnostik und Therapie der Schlafapnoesyndrome

Diagnosis in a Stepwise Approach Hits the Target - Diagnosis and Treatment of Sleep Apnoea SyndromesK.-H. Rühle1 , G. Nilius1
  • 1Klinik für Pneumologie, Allergologie und Schlafmedizin, Klinik Ambrock Hagen, Universität Witten-Herdecke (Chefarzt: Prof. Dr. K.-H. Rühle)
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Publication History

Publication Date:
10 May 2006 (online)

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Zusammenfassung

Schlafapnoesyndrome lassen sich in zwei Gruppen klassifizieren: Schlafapnoesyndrome mit und ohne Obstruktion. Ein typisches Symptom der obstruktiven Form (OSAS) ist die Schläfrigkeit, die mithilfe subjektiver Messskalen bewertet werden kann. Schwere und Häufigkeit der Symptome wie zum Beispiel das Schnarchen, Schläfrigkeit und Bluthochdruck können zusammen mit anthropometrischen Daten wie dem Body-Mass-Index mit hoher Sensitivität die Wahrscheinlichkeit bestimmen, ob der Apnoe-Hypopnoe-Index ansteigt. Die Diagnose sollte schrittweise erfolgen und ein ambulantes Monitoring sowie eine nächtliche Polysomnografie beinhalten. Eine kontinuierliche Überdruckbeatmung (CPAP-Therapie; „continuous positive airway pressure”) kann der Obstruktion der oberen Atemwege entgegenwirken und so die Symptome, angefangen von der Tagesschläfrigkeit bis hin zur Lebensqualität, reduzieren bzw. verbessern. Bei Patienten mit obstruktiven Schlafapnoesyndromen ist sie die Therapie der Wahl. In den letzten Jahren wurden auch Geräte entwickelt, die den Beatmungsdruck an den Atemfluss anpassen, sodass der Beatmungsdruck deutlich reduziert werden kann.

Summary

Sleep related breathing disorders can be classified in those with and without obstruction. Sleepiness is a typical symptom of obstructive sleep apnoea syndrome (OSAS) and can be chararacterized by subjective ratings. Severity and frequency of symptoms as snoring, observed chocking, sleepiness and hypertension together with anthropometric data as body mass index predict with high sensitivity the probability of an increased apnoea/hypopnoea index. Diagnosis should be performed by a stepwise approach including ambulatory monitoring and overnight polysomnography. Treatment with continuous positive airway pressure (CPAP) reverses the obstruction of the upper airways and improves daytime symptoms. CPAP is the treatment of choice for the obstructive sleep apnoea syndrome. In the last years automatic devices changing the treatment pressure based on the measurement of upper airway impedance or airflow were developed.

Key Words

sleep apnoea - sleepiness - continuous positive airway pressure - mandibular advancement - quality of life

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1 Bewertung ärztlicher Untersuchungs- und Behandlungsmethoden

2 Joint National Committee

Anschrift für die Verfasser

Prof. Karl-Heinz Rühle

Klinik für Pneumologie, Allergologie und Schlafmedizin, Klinik Ambrock

Ambrockerweg 60

58091 Hagen