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Pathophysiologie der obstruktiven Schlafapnoe

Pathophysiology of obstructive sleep apnea

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Zusammenfassung

Die Prävalenz der obstruktiven Schlafapnoe (OSA) wird in den westlichen Industrieländern als sehr hoch angenommen. Für die Behandlung des OSA gibt es konservative und operative Therapien. Die Pathophysiologie ist dennoch weitestgehend ungeklärt und lässt sich nicht allein durch anatomische Auffälligkeiten erklären. So konnte in den letzten Jahren eine Reihe nichtanatomischer Faktoren identifiziert werden, die die Entstehung einer OSA begünstigen. Hierunter fallen die respiratorische Erregungsschwelle (Arousals), der respiratorische Atemantrieb („loop gain“) sowie die Kontrolle und Funktion der oberen muskulären Atemwegsdilatatoren. Das Verständnis für die einzelnen pathophysiologischen Prozesse kann in der Zukunft hilfreich sein, um individuelle Therapieansätze für Patienten zu entwickeln.

Abstract

The prevalence of obstructive sleep apnea (OSA) is considered to be very high in western industrialized countries. There are conservative and surgical forms of treatment for OSA; however, the pathophysiology is largely unexplained and cannot be explained by anatomical abnormalities alone. In recent years, a number of non-anatomical factors have been found that favor the development of OSA. These include the respiratory excitation threshold (arousals), the respiratory drive (loop gain), as well as the control and function of the muscular upper airway dilators. The understanding of the individual pathophysiological processes may be helpful in the future to develop individual treatment approaches for patients.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    C. Heiser

  2. Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australien

    D. Eckert

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  1. C. Heiser
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Correspondence to C. Heiser.

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Interessenkonflikt

C. Heiser ist als Berater für Inspire Medical Systems tätig. Er erhielt Reisekostenzuschüsse von Löwenstein Medical, Sutter Medizintechnik, Neuwirth Medical Products. Weiterhin ist er im Advisory Board von Galvani Bioelectronics. D. Eckert hat ein Forschungsstipendium von Bayer und Apnimed erhalten. Er verfügt über ein CRC-P-Stipendium (Cooperative Research Center). Weiterhin erhielt er finanzielle Unterstützung von der australischen Regierung und Industriepartner Oventus Medical.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Bei dieser Arbeit handelt es sich um eine modifizierte Übersetzung der Originalarbeit von D. Eckert aus dem Jahre 2018 [8]. Der Abdruck erfolgt mit freundlicher Genehmigung des Elsevier-Verlages.

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Heiser, C., Eckert, D. Pathophysiologie der obstruktiven Schlafapnoe. HNO 67, 654–662 (2019). https://doi.org/10.1007/s00106-019-0720-9

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