Skip to main content
SpringerLink
Log in

Differenzialdiagnose schlafbezogener Atmungsstörungen

The differential diagnosis of sleep-related breathing disorders

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Die Differenzialdiagnose schlafbezogener Atmungsstörungen (SBAS) erfolgt in Anlehnung an die durch die im Jahr 2005 von der American Academy of Sleep Medicine (AASM) neu aufgelegte Internationale Klassifikation von Schlafstörungen (ICSD-2). Die ICSD-2 teilt die derzeit bekannten Schlaf- und Aufwachstörungen in 8 Kategorien ein, die SBAS werden in Kategorie II aufgeführt. Die ICSD-2 ist kompatibel zu den international gebräuchlichen Systemen der Klassifikation von Krankheiten (ICD-9, ICD-10). Grundlage aller differenzialdiagnostischen Erwägungen stellt neben der ausführlichen Anamnese die Polysomnographie dar, ggf. ergänzt durch weiterführende internistische, neurologische, pädiatrische, Hals-Nasen-Ohren-ärztliche, Mund-Kiefer-Gesichts-chirurgische sowie neuropsychologische und neurophysiologische Untersuchungen.

Abstract

The differential diagnosis of sleep-related breathing disorders (SRBD) is made according to the revised International Classification of Sleep Disorders (ICSD-2) published by the American Academy of Sleep Medicine in 2005. This classifies the currently recognized sleep and arousal disorders into eight categories with SRBD being presented in category II. ICSD-2 is compatible with the internationally used system for disease classification (ICD-9, ICD-10). In addition to a detailed anamnesis, the basis for all differential diagnostic considerations involves polysomnography, if necessary supplemented with internal medical, neurological, pediatric, ear nose and throat, oral and maxillofacial surgery, as well as neuropsychological and neurophysiological examinations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. American Academy of Pediatrics, Committee on fetus and newborn (2003) Apnea, sudden infant death syndrome, and home monitoring. Pediatrics 111: 914–917

    Article  PubMed  Google Scholar 

  2. American Academy of Sleep Medicine (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 22: 667–689

    PubMed  Google Scholar 

  3. American Academy of Sleep Medicine (2005) ICSD-2 – International classification of sleep disorders, 2nd edn: Diagnostic and coding manual. Westchester, Illinois, USA

  4. American Thoracic Society (1996) Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 153: 866–878

    PubMed  Google Scholar 

  5. American Thoracic Society (1999) Idiopathic congenital central hypoventilation syndrome: diagnosis and management. Am J Respir Crit Care Med 160: 368–373

    PubMed  Google Scholar 

  6. Bye PT, Issa F, Berthon-Jones M, Sullivan CE (1984) Studies of oxygenation during sleep in patients with interstitial lung disease. Am Rev Respir Dis 129: 27–32

    PubMed  Google Scholar 

  7. Bye PT, Ellis ER, Issa FG et al. (1990) Respiratory failure and sleep in neuromuscular disease. Thorax 45: 241–247

    Google Scholar 

  8. Caples SM, Wolk R, Somers VK (2005) Influence of cardiac function and failure on sleep-disordered breathing: evidence for a causative role. J Appl Physiol 99: 2433–2439

    Article  PubMed  Google Scholar 

  9. Chaouat A, Weitzenblum E, Kessler R et al. (1997) Sleep-related O2 desaturation and daytime pulmonary haemodynamics in COPD patients with mild hypoxaemia. Eur Respir J 10: 1730–1735

    Article  PubMed  Google Scholar 

  10. Chobanian AV, Bakris GL, Black HR et al. (2003) The seventh report of th joint national committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure: The JNC 7 report. JAMA 289: 2560–2571

    PubMed  Google Scholar 

  11. Cormican LJ, Williams A (2005) Sleep disordered breathing and its treatment in congestive heart failure. Heart 91: 1265–1270

    Article  PubMed  Google Scholar 

  12. Duchna H-W, Grote L, Andreas S et al. (2003) State of the art article: Sleep-disordered breathing and cardio- and cerebrovascular diseases: update 2003 of clinical significance and future perspectives. Somnologie 7: 101–121

    Article  Google Scholar 

  13. Farney RJ, Walker JM, Cloward TV, Rhondeau S (2003) Sleep-disordered breathing associated with long-term opioid therapy. Chest 123: 632–639

    Article  Google Scholar 

  14. Flemons WW (2002) Clinical practice. Obstructive sleep apnea. N Engl J Med 347: 498–504

    Article  Google Scholar 

  15. Fletcher EC, Donner CF, Midgren B et al. (1992) Survival in COPD patients with a daytime PaO2 greater than 60 mmHg with and without nocturnal oxyhemoglobin desaturation. Chest 101: 649–655

    PubMed  Google Scholar 

  16. Guilleminault C, Robinson A (1996) Central sleep apnea. Neurol Clin 14: 611–628

    Article  PubMed  Google Scholar 

  17. Hall M, Xie A, Rutherford R et al. (1996) Cycle length of periodic breathing in patients with and without heart failure. Am J Respir Care Med 154: 376–381

    Google Scholar 

  18. Hein H, Rasche K, Wiebel M et al. (2006) Empfehlungen zur Heim- und Langzeitbeatmung. Med Klin 101: 148–152

    Article  Google Scholar 

  19. Hill NS, Eveloff SE, Carlisle CC, Goff SG (1992) Efficacy of nocturnal nasal ventilation in patients with restrictive thoracic disease. Am Rev Respir Dis 145: 365–371

    PubMed  Google Scholar 

  20. Hukins CA, Hillman DR (2000) Daytime predictors of sleep hypoventilation in Duchenne muscular dystrophy. Am J Respir Crit Care Med 161: 166–170

    PubMed  Google Scholar 

  21. Javaheri S (2005) Central sleep apnea in congestive heart failure: prevalence, mechanisms, impact, and therapeutic options. Semin Respir Crit Care Med 26: 44–55

    Article  PubMed  Google Scholar 

  22. Kahn A, Groswasser J, Franco P (2000) Breathing during sleep in infancy. In: Loughlin G, Carroll J, Marcus C (eds) Sleep and breathing in children. Marcel Dekker, Inc., New York, 147: 405–422

  23. Labanowski M, Schmidt-Nowara W, Guilleminault C (1996) Sleep and neuromuscular disease: frequency of sleep-disordered breathing in a neuromuscular disease clinic population. Neurology 47: 1173–1180

    PubMed  Google Scholar 

  24. Lanfranchi P, Braghiroli A, Bosimini E et al. (1999) Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure. Circulation 99: 1435–1440

    PubMed  Google Scholar 

  25. Lopata M, Onal E (1982) Mass loading, sleep apnea, and the pathogenesis of obesity hypoventilation. Am Rev Respir Dis 126: 640–645

    PubMed  Google Scholar 

  26. Malhotra A, White DP (2002) Pathogenesis of obstructive sleep apnea hypopnea syndrome. In: McNicholas WT, Phillipson EA (eds) Breathing disorders during sleep. WB Saunders, London, pp 44–63

  27. Marcus C, Jansen M, Poulsen M et al. (1991) Medical and psychosocial outcome of children with congenital central hypoventilation syndrome. J Pediatr 119: 888–895

    Article  PubMed  Google Scholar 

  28. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365: 1046–1053

    PubMed  Google Scholar 

  29. Masa JF, Corral J, Martin MJ et al. (2003) Assessment of thoracoabdominal bands to detect respiratory effort-related arousal. Eur Respir J 22: 661–667

    PubMed  Google Scholar 

  30. Mellies U, Dohna-Schwake C, Voit T (2005) respiratory function assessment and intervention in neuromuscular disorders. Curr Opin Neurol 18: 543–547

    Article  PubMed  Google Scholar 

  31. Naughton M, Benard D, Tam A et al. (1993) The role of hyperventilation in the pathogenesis of central sleep apnea in patients with congestive heart failure. Am Rev Respir Dis 148: 330–338

    PubMed  Google Scholar 

  32. Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342: 1378–1384

    Article  PubMed  Google Scholar 

  33. Pepin JL, Chouri-Pontarollo N, Tasimier R, Levy P (2006) Cheyne-Stokes respiration with central sleep apnea in chronic heart failure: proposals for a diagnostic and therapeutic strategy. Sleep Med Rev 10: 33–47

    Article  PubMed  Google Scholar 

  34. Poulain M, Doucet M, Major GC et al. (2006) Te effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. CMAJ 174: 1293–1299

    PubMed  Google Scholar 

  35. Rafanan A, Golish J, Dinner D et al. (2001) Nocturnal hypoxemia is common in primary pulmonary hypertension. Chest 120: 894–899

    Article  PubMed  Google Scholar 

  36. Redline S, Tishler PV, Schluchter M et al. (1999) Risk factors for sleep-disordered breathing in children. Association with obesity, race, and respiratory problems. Am J Respir Crit Care Med 159: 1527–1532

    PubMed  Google Scholar 

  37. Sanders MH, Newman AB, Haggerty CL et al. (2003) Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med 167: 7–14

    Article  PubMed  Google Scholar 

  38. Schoene R (1982) Control of ventilation in climbers to extreme altitude. J Appl Physiol 53: 886–890

    Article  PubMed  Google Scholar 

  39. Sin D, Fitzgerald F, Parker J et al. (1999) Risk factors for central and obstructive sleep apnea in 450 men and women with and without congestive heart failure. Am J Respir Crit Care Med 160: 1101–1106

    Google Scholar 

  40. Young T, Palta M, Dempsey J et al. (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328: 1230–1235

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Berufgenossenschaftliche Kliniken Bergmannsheil, Klinikum der Ruhr-Universität-Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland

    H.-W. Duchna, G. Schultze-Werninghaus & M. Orth

Authors
  1. H.-W. Duchna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Schultze-Werninghaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Orth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H.-W. Duchna.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duchna, HW., Schultze-Werninghaus, G. & Orth, M. Differenzialdiagnose schlafbezogener Atmungsstörungen. Pneumologe 4, 76–84 (2007). https://doi.org/10.1007/s10405-006-0136-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10405-006-0136-6

Schlüsselwörter

Keywords

Search

Navigation