Skip to main content
Erschienen in: Der Pneumologe 4/2016

11.02.2016 | Schlafapnoe | CME

Schlafbezogene Atmungsstörungen

verfasst von: Prof. Dr. med. R. Schulz, MHBA

Erschienen in: Zeitschrift für Pneumologie | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Schlafbezogene Atmungsstörungen (SBAS) stellen ein klinisch und wissenschaftlich sehr wichtiges Feld der Pneumologie dar, welches zudem durch eine hohe Interdisziplinarität gekennzeichnet ist. Das pathophysiologische Verständnis der SBAS ist differenzierter geworden und erklärt, warum auch früher als „atypisch“ angesehene Patienten betroffen sind. Die SBAS-Prävalenz ist hoch und insbesondere diejenige der obstruktiven Schlafapnoe (OSA) nimmt weiter zu. Wahrscheinlich sind nur wenige SBAS-Patienten im Sinne von Tagesmüdigkeit bzw. -schläfrigkeit klinisch symptomatisch. Zunehmend wird die Bedeutung der OSA für kardiometabolische und evtl. sogar maligne Erkrankungen evident. Goldstandard in der SBAS-Diagnostik ist weiterhin die Polysomnographie, jedoch mit aktualisierten Auswerteregeln. Standardtherapie bleibt die nichtinvasive Maskenbeatmung. Trotzdem ist angesichts der oft nicht ausreichenden Adhärenz die Entwicklung alternativer und individualisierter Therapien wichtig. Ob und wie die Cheyne-Stokes-Atmung bei Herzinsuffizienz zu behandeln ist, bleibt offen.
Literatur
1.
Zurück zum Zitat Schulz R (2012) Schlafbezogene Atmungsstörungen. Pneumologe 9:147–158CrossRef Schulz R (2012) Schlafbezogene Atmungsstörungen. Pneumologe 9:147–158CrossRef
2.
Zurück zum Zitat De Backer W, Simonds A, Horn V et al (2011) Sleep HERMES: a European Core Syllabus in respiratory disorders during sleep. Breathe 8:61–68CrossRef De Backer W, Simonds A, Horn V et al (2011) Sleep HERMES: a European Core Syllabus in respiratory disorders during sleep. Breathe 8:61–68CrossRef
3.
Zurück zum Zitat White LH, Bradley TD (2013) Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea. J Physiol 591:1179–1193CrossRefPubMed White LH, Bradley TD (2013) Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea. J Physiol 591:1179–1193CrossRefPubMed
4.
Zurück zum Zitat Heinzer R, Vat S, Marques-Vidal P (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318CrossRefPubMedPubMedCentral Heinzer R, Vat S, Marques-Vidal P (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat American Academy of Sleep Medicine (2014) Diagnostic and coding manual, 3. Aufl. International classification of sleep disorders. American Academy of Sleep Medicine, Westchester American Academy of Sleep Medicine (2014) Diagnostic and coding manual, 3. Aufl. International classification of sleep disorders. American Academy of Sleep Medicine, Westchester
6.
Zurück zum Zitat Berry RB, Brooks R, Gamaldo CE, American Academy of Sleep Medicine (2012) The AASM manual for scoring of sleep and associated events: rules, terminology, and technical specifications. Version 2.0. www.aasmnet.org. Zugegriffen: 20. Januar 2016 Berry RB, Brooks R, Gamaldo CE, American Academy of Sleep Medicine (2012) The AASM manual for scoring of sleep and associated events: rules, terminology, and technical specifications. Version 2.0. www.​aasmnet.​org. Zugegriffen: 20. Januar 2016
7.
Zurück zum Zitat Campos-Rodriguez F, Martinez-Garcia MA, de la Cruz-Moron I, Almeida-Gonzalez C, Catalan-Serra P, Montserrat JM (2012) Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study. Ann Intern Med 156:115–122CrossRefPubMed Campos-Rodriguez F, Martinez-Garcia MA, de la Cruz-Moron I, Almeida-Gonzalez C, Catalan-Serra P, Montserrat JM (2012) Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: a cohort study. Ann Intern Med 156:115–122CrossRefPubMed
8.
Zurück zum Zitat Martinez-Garcia MA, Campos-Rodriguez F, Catalán-Serra P et al (2012) Cardiovascular mortality in obstructive sleep apnea in the elderly. Role of long-term CPAP treatment: a prospective observational trial. Am J Respir Crit Care Med 186:909–916CrossRefPubMed Martinez-Garcia MA, Campos-Rodriguez F, Catalán-Serra P et al (2012) Cardiovascular mortality in obstructive sleep apnea in the elderly. Role of long-term CPAP treatment: a prospective observational trial. Am J Respir Crit Care Med 186:909–916CrossRefPubMed
9.
Zurück zum Zitat Taylor CT, Kent BD, Crinion SJ, McNicholas WT, Ryan S (2014) Human adipocytes are highly sensitive to intermittent hypoxia induced NFκB activity and subsequent inflammatory gene expression. Biochem Biophys Res Commun 447:660–665CrossRefPubMed Taylor CT, Kent BD, Crinion SJ, McNicholas WT, Ryan S (2014) Human adipocytes are highly sensitive to intermittent hypoxia induced NFκB activity and subsequent inflammatory gene expression. Biochem Biophys Res Commun 447:660–665CrossRefPubMed
10.
Zurück zum Zitat Gharib SA, Hayes AL, Rosen MJ, Patel SR (2013) A pathway-based analysis on the effects of obstructive sleep apnea in modulating visceral fat transcriptome. Sleep 36:23–30PubMedPubMedCentral Gharib SA, Hayes AL, Rosen MJ, Patel SR (2013) A pathway-based analysis on the effects of obstructive sleep apnea in modulating visceral fat transcriptome. Sleep 36:23–30PubMedPubMedCentral
11.
Zurück zum Zitat Dumitrascu R, Heitmann J, Seeger W, Weissmann N, Schulz R (2013) Obstructive sleep apnea, oxidative stress and cardiovascular disease: lessons from animal studies. Oxid Med Cell Longev 2013:234631CrossRefPubMedPubMedCentral Dumitrascu R, Heitmann J, Seeger W, Weissmann N, Schulz R (2013) Obstructive sleep apnea, oxidative stress and cardiovascular disease: lessons from animal studies. Oxid Med Cell Longev 2013:234631CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Schulz R, Murzabekova G, Egemnazarov B et al (2014) Arterial hypertension in a murine model of sleep apnea – role of NADPH oxidase 2. J Hypertens 32:300–305CrossRefPubMed Schulz R, Murzabekova G, Egemnazarov B et al (2014) Arterial hypertension in a murine model of sleep apnea – role of NADPH oxidase 2. J Hypertens 32:300–305CrossRefPubMed
14.
Zurück zum Zitat Campos-Rodriguez F, Martinez-Garcia MA, Martinez M et al (2013) Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med 187:99–105CrossRefPubMed Campos-Rodriguez F, Martinez-Garcia MA, Martinez M et al (2013) Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med 187:99–105CrossRefPubMed
15.
Zurück zum Zitat Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farré R (2012) Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 186:190–194CrossRefPubMedPubMedCentral Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farré R (2012) Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med 186:190–194CrossRefPubMedPubMedCentral
16.
17.
Zurück zum Zitat Strollo PJ Jr, Soose RJ, Maurer JT et al (2014) STAR Trial Group. Upper-airway stimulation for obstructive sleep apnea. N Engl J Med 370:139–149CrossRefPubMed Strollo PJ Jr, Soose RJ, Maurer JT et al (2014) STAR Trial Group. Upper-airway stimulation for obstructive sleep apnea. N Engl J Med 370:139–149CrossRefPubMed
18.
Zurück zum Zitat Strollo PJ Jr, Gillespie MB, Soose RJ et al (2015) Stimulation Therapy for Apnea Reduction (STAR) Trial Group. Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep 38:1593–1598CrossRefPubMedPubMedCentral Strollo PJ Jr, Gillespie MB, Soose RJ et al (2015) Stimulation Therapy for Apnea Reduction (STAR) Trial Group. Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep 38:1593–1598CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Van de Heyning PH, Badr MS, Baskin JZ et al (2012) Implanted upper airway stimulation device for obstructive sleep apnea. Laryngoscope 122:1626–1633CrossRefPubMed Van de Heyning PH, Badr MS, Baskin JZ et al (2012) Implanted upper airway stimulation device for obstructive sleep apnea. Laryngoscope 122:1626–1633CrossRefPubMed
20.
Zurück zum Zitat Abraham WT, Jagielski D, Oldenburg O et al (2015) remedē Pilot Study Investigators. Phrenic nerve stimulation for the treatment of central sleep apnea. JACC Heart Fail 3:360–369CrossRefPubMed Abraham WT, Jagielski D, Oldenburg O et al (2015) remedē Pilot Study Investigators. Phrenic nerve stimulation for the treatment of central sleep apnea. JACC Heart Fail 3:360–369CrossRefPubMed
21.
Zurück zum Zitat Cowie MR, Woehrle H, Wegscheider K et al (2015) Adaptive servo-ventilation for central sleep apnea in systolic heart failure. N Engl J Med 373:1095–1105CrossRefPubMedPubMedCentral Cowie MR, Woehrle H, Wegscheider K et al (2015) Adaptive servo-ventilation for central sleep apnea in systolic heart failure. N Engl J Med 373:1095–1105CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Köhnlein T, Windisch W, Köhler D et al (2014) Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med 2:698–705CrossRefPubMed Köhnlein T, Windisch W, Köhler D et al (2014) Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med 2:698–705CrossRefPubMed
23.
Zurück zum Zitat Ebben MR, Narizhnaya M, Segal AZ, Barone D, Krieger AC (2014) A randomised controlled trial on the effect of mask choice on residual respiratory events with continuous positive airway pressure treatment. Sleep Med 15:619–624CrossRefPubMed Ebben MR, Narizhnaya M, Segal AZ, Barone D, Krieger AC (2014) A randomised controlled trial on the effect of mask choice on residual respiratory events with continuous positive airway pressure treatment. Sleep Med 15:619–624CrossRefPubMed
24.
Zurück zum Zitat Morgenthaler TI, Kuzniar TJ, Wolfe LF, Willes L, McLain WC 3rd, Goldberg R (2014) The complexsleep apnea resolution study: a prospective randomized controlled trial of continuous positive airway pressure versus adaptive servoventilation therapy. Sleep 37:927–934PubMedPubMedCentral Morgenthaler TI, Kuzniar TJ, Wolfe LF, Willes L, McLain WC 3rd, Goldberg R (2014) The complexsleep apnea resolution study: a prospective randomized controlled trial of continuous positive airway pressure versus adaptive servoventilation therapy. Sleep 37:927–934PubMedPubMedCentral
25.
Zurück zum Zitat Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. N Engl J Med 340:847–851CrossRefPubMed Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. N Engl J Med 340:847–851CrossRefPubMed
26.
Zurück zum Zitat Alonderis A, Barbe F, Bonsignore M et al (2008) Medicolegal implications of sleep apnoea syndrome: driving licence regulations in Europe. Sleep Med 9:362–375CrossRefPubMed Alonderis A, Barbe F, Bonsignore M et al (2008) Medicolegal implications of sleep apnoea syndrome: driving licence regulations in Europe. Sleep Med 9:362–375CrossRefPubMed
Metadaten
Titel
Schlafbezogene Atmungsstörungen
verfasst von
Prof. Dr. med. R. Schulz, MHBA
Publikationsdatum
11.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Pneumologie / Ausgabe 4/2016
Print ISSN: 2731-7404
Elektronische ISSN: 2731-7412
DOI
https://doi.org/10.1007/s10405-015-0030-1

Weitere Artikel der Ausgabe 4/2016

Der Pneumologe 4/2016 Zur Ausgabe