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Erschienen in: Somnologie 2/2017

29.11.2016 | Schlafapnoe | S3-Leitlinie Schlafbezogene Atmungsstörungen Zur Zeit gratis

S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen – Kapitel „Schlafbezogene Atmungsstörungen“

Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM)

Erschienen in: Somnologie | Sonderheft 2/2017

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1.
Zusammenfassung
 
1.1
Was gibt es Neues?
 
1.2
Neue Empfehlungen gegenüber der Leitlinie „Nicht erholsamer Schlaf“, Kapitel „Schlafbezogene Atmungsstörungen“ von 2009
 
1.2.1
Perioperatives Management
 
1.2.2
Obstruktive Schlafapnoe
 
1.2.3
Zentrale Schlafapnoe
 
1.2.4
Schlafbezogene Hypoventilation/Hypoxämie
 
2.
Einleitung
 
3.
Diagnostik
 
3.1
Allgemein
 
3.2
Nicht-apparative Diagnostik
 
3.2.1
Fragebögen und Leistungs- und Vigilanztests
 
3.2.2
Klinische Untersuchung
 
3.2.3
Apparative Diagnostik
 
3.2.4
Polysomnographie
 
3.2.5
Polygraphie für schlafbezogen Atmungsstörungen
 
3.2.6
Monitoring für schlafbezogene Atmungsstörungen mit reduziertem System
 
4.
Grundlagen der Indikationsstellung zur Therapie schlafbezogener Atmungsstörung
 
5.
Obstruktive Schlafapnoesyndrome
 
5.1
Obstruktive Schlafapnoe
 
5.2
Klinische Symptomatik
 
5.3
Epidemiologie
 
5.4
Prädisponierende Faktoren
 
5.5
Familienanamnese, Genetik
 
5.6
Beginn, Verlauf, Komplikationen
 
5.7
Tagesschläfrigkeit
 
5.8
Kardiovaskuläres Risiko
 
5.9
Arterielle Hypertonie
 
5.10
Schlaganfall
 
5.11
Herzinsuffizienz
 
5.12
Diabetes mellitus
 
5.13
Maligne Erkrankungen
 
5.14
Perioperative Komplikationen
 
5.15
PAP-Therapie-Verfahren
 
5.15.1
Nächtliche Überdruckatmung
 
5.15.2
Modifizierte Positivdruckverfahren
 
5.15.3
Compliance
 
5.16
Telemonitoring
 
5.17
OSA in der Schwangerschaft
 
5.18
OSA beim älteren Menschen
 
5.19
Obstruktive Schlafapnoe und Demenz
 
5.19.1
Therapie der obstruktiven Schlafapnoe bei Menschen mit Demenz
 
5.20
Nicht-CPAP-Verfahren bei obstruktiver Schlafapnoe
 
5.20.1
Gewichtsreduktion
 
5.20.2
Nicht-operative Gewichtsreduktion
 
5.20.3
Operative Gewichtsreduktion
 
5.20.4
Unterkieferprotrusionsschienen
 
5.20.5
Medikamentöse Therapie
 
5.20.6
Medikamentöse Therapie bei residualer Tageschläfrigkeit unter CPAP-Therapie
 
5.20.7
Verfahren zur Erhöhung des Muskeltonus
 
5.20.8
Therapie mit Sauerstoff
 
5.20.9
Lagetherapie
 
5.20.10
Chirurgische Therapieverfahren
 
6.
Zentrale Schlafapnoesyndrome
 
6.1
Zentrale Schlafapnoe mit Cheyne-Stokes-Atmung
 
6.1.1
Hauptbefunde
 
6.1.2
Epidemiologie
 
6.1.3
Diagnostik
 
6.1.4
Therapie
 
6.1.5
Respiratorische Stimulanzien und CO2
 
6.1.6
Unilaterale Stimulation des Nervus Phrenicuus
 
6.1.7
Sauerstoff
 
6.1.8
Continuous Positive Airway Pressure
 
6.1.9
Bilevel Positive Airway Pressure
 
6.1.10
Adaptive Servoventilation
 
6.2
Zentrale Schlafapnoe ohne Cheyne-Stokes-Atmung
 
6.2.1
Hauptbefunde
 
6.2.2
Diagnostik
 
6.2.3
Therapie
 
6.3
Zentrale Schlafapnoe bei höhenbedingter periodischer Atmung
 
6.3.1
Hauptbefunde
 
6.3.2
Therapie
 
6.4
Zentrale Schlafapnoe durch Medikamente, Drogen oder Substanzen
 
6.4.1
Hauptbefunde
 
6.4.2
Therapie
 
6.5
Primäre zentrale Schlafapnoe
 
6.5.1
Hauptbefunde
 
6.5.2
Epidemiologie
 
6.5.3
Therapie
 
6.6
Zentrale Schlafapnoe als Therapiefolge
 
6.6.1
Hauptbefunde
 
6.6.2
Epidemiologie
 
6.6.3
Diagnostik
 
6.6.4
Therapie
 
7.
Schlafbezogene Hypoventilation/Schlafbezogene Hypoxämie
 
7.1
Obesitas-Hypoventilationssyndrome (OHS)
 
7.1.1
Hauptbefunde
 
7.1.2
Diagnostik
 
7.1.3
Therapie
 
7.2
Schlafbezogene Hypoventilation durch eine körperliche Erkrankung
 
7.2.1
Hauptbefunde
 
7.2.2
Beginn, Verlauf, Komplikationen
 
7.2.3
Diagnostik
 
7.2.4
Therapie
 
8.
Rechtliche Konsequenzen
 
9.
Glossar
 
10.
Anhänge
 
10.1
Anhang A: Leitlinienreport
 
10.2
Anhang B: Tabellen
 
10.3
Anhang C: Algorithmen
 
10.4
Anhang D: Addendum
 
11.
Literatur
 
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Hinweise: Aus personellen Gründen konnte die Fachgesellschaft nicht an den Konsensuskonferenzen teilnehmen, sodass nur Kommentierungen im laufenden Schriftverkehr stattfanden.
 
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Metadaten
Titel
S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen – Kapitel „Schlafbezogene Atmungsstörungen“
Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM)
Publikationsdatum
29.11.2016
Verlag
Springer Medizin
Erschienen in
Somnologie / Ausgabe Sonderheft 2/2017
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI
https://doi.org/10.1007/s11818-016-0093-1

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