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Obstruktive Schlafapnoe bei neurologischen Erkrankungen

Speziell als Risikofaktor für Schlaganfall

Obstructive sleep apnea in neurological diseases

Specially as a risk factor for stroke

Zusammenfassung

Patienten mit neurologischen Erkrankungen haben häufig schlafbezogene Atmungsstörungen als Begleiterkrankungen. Umgekehrt werden bei Patienten mit obstruktiver Schlafapnoe (OSA) gehäuft Erkrankungen des zerebro- und kardiovaskulären Systems gefunden. Epidemiologische Studien haben gezeigt, dass die unbehandelte OSA ein unabhängiger Risikofaktor für das Auftreten eines Schlaganfalls, einer arteriellen Hypertonie oder einer kardiovaskulären Erkrankung ist. Pathogenetisch bedeutsam sind apnoeassoziierte Faktoren wie die arterielle Hypertonie, das Auftreten von Vorhofflimmern, ein erhöhter Sympathikotonus, die intermittierende Hypoxie sowie eine vaskuläre Dysfunktion. Frühzeitige Diagnosestellung und Therapieeinleitung der schlafbezogenen Atmungsstörungen bei neurologischen Erkrankungen führen zu einem verbesserten Behandlungsergebnis der neurologischen Erkrankung und zu einer Reduktion zerebro- und kardiovaskulärer Folgeerkrankungen.

Summary

Neurological diseases are frequently associated with sleep-related breathing disorders. In contrast patients with obstructive sleep apnea (OSA) suffer more often from cerebrovascular and cardiovascular diseases. Epidemiological studies have shown that OSA is common among patients with stroke, arterial hypertension or cardiovascular disease. In particular apnea-associated arterial hypertension, atrial fibrillation, activation of the sympathetic nervous system, recurrent hypoxemia and vascular inflammatory response should be considered as risk factors for the vascular system. Early diagnosis and treatment of sleep-related breathing disorders in neurological diseases are required to reduce the risk of subsequent cerebrovascular and cardiovascular diseases.

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Abbreviations

AHI:

Apnoe-Hypopnoe-Index

ANF:

atrialer natriuretischer Faktor

CPAP:

continuous positive airway pressure

OSA:

obstruktive Schlafapnoe

RAAS:

Renin-Angiotensin-Aldosteron-System

SBAS:

schlafbezogene Atmungsstörung

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Einhaltung ethischer Richtlinien

Interessenkonflikt. U. Koehler, W. Cassel, O. Hildebrandt, K. Kesper, P. Kianinejad, C. Nell, G. Mayer und G. Ohl geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Koehler, U., Cassel, W., Hildebrandt, O. et al. Obstruktive Schlafapnoe bei neurologischen Erkrankungen. Nervenarzt 85, 35–42 (2014). https://doi.org/10.1007/s00115-013-3890-9

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  • DOI: https://doi.org/10.1007/s00115-013-3890-9

Schlüsselwörter

  • Schlafbezogene Atmungsstörungen
  • Autonome Dysfunktion
  • Vorhofflimmern
  • Schlaganfall
  • Kardiovaskuläres Risiko

Keywords

  • Sleep related breathing disorders
  • Autonomic dysfunction
  • Atrial fibrillation
  • Stroke
  • Cardiovascular risk