Früherkennung schlafbezogener Atmungsstörungen

Zusammenfassung

Die obstruktive Schlafapnoe als häufigste schlafbezogene Atmungsstörung führt zu nicht-erholsamem Schlaf, zu einer erhöhten kardiovaskulären Morbidität und Mortalität und zu einer erhöhten Unfallneigung. In Deutschland muss von mindestens zwei Millionen Betroffenen ausgegangen werden. Durch die frühzeitige Erkennung der obstruktiven Schlafapnoe kann die Erholsamkeit des Schlafes wiederhergestellt, die Leistungsfähigkeit am Tage gesteigert, die Unfallgefahr reduziert und das kardiovaskuläre Risiko gesenkt werden. In diesem Referat werden Anamneseparameter, Fragebögen, klinische Parameter, Untersuchungsbefunde und unüberwachte Messungen während des Schlafes auf ihre diagnostische Genauigkeit in der Erkennung einer OSA untersucht. Es gibt eine Vielzahl von Verfahren mit ungenügenden Ergebnissen oder einer unzureichenden Datenlage, sodass sie nicht als Früherkennungsuntersuchung empfohlen werden können. Chancen bieten neuronale Netzwerke zur Beurteilung einer großen Zahl von Parametern und nicht-lineare Auswerteverfahren der Oximetrie alleine oder in Kombination mit der Herzfrequenzanalyse. Die nasale Staudruckmessung kann auch ohne schlafmedizinische Expertise für eine Risikobeurteilung herangezogen werden. Eine Verbreiterung der Datenlage ist erforderlich. Die Polygrafie in der Hand qualifizierter Ärzte ist der Goldstandard der Früherkennungsuntersuchungen der OSA. Ihre hohe Sensitivität und Spezifität wurde in mehreren Metaanalysen bestätigt.

Schlüsselwörter

Schlafbezogene Atmungsstörungen - obstruktive Schlafapnoe - Diagnostik - Früherkennung - Fragebögen - Polygrafie

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