Schlafmedizin – Was sollte der HNO-Arzt (über das Themengebiet) wissen?

Zusammenfassung

Die Schlafmedizin nimmt einen festen Stellenplatz in der medizinischen Versorgung des Hals-Nasen-Ohrenarztes ein. Die aktuelle S3 Leitlinie „Nicht erholsamer Schlaf/ Schlafstörungen“ legt dabei die Standards in der Diagnostik und Therapie fest. Unter den Schlafbezogenen Atmungsstörungen stellt das obstruktive Schlafapnoesyndrom (OSA) die häufigste Schlafatmungsstörung unter den 30- bis 60-Jährigen dar. Die Diagnose wird anhand einer Stufendiagnostik durch eine ambulante Polygrafie und eine anschließende stationäre Polysomnografie gestellt. Je nach Schweregrad des OSA und Klinik des Patienten stehen dem Hals-Nasen-Ohrenarzt heutzutage verschiedene operative und konservative Therapieoptionen zur Verfügung. Die überlegene Therapieform für alle Schweregrade des OSA ist weiterhin die nichtinvasive nächtliche Überdruckbeatmung (CPAP). Für die richtige Therapieentscheidung und zur Abgrenzung eines OSA von anderen schlafbezogenen Atmungsstörungen sind fundierte Kenntnisse der Schlafmedizin unabdingbar. Eine interdisziplinäre Zusammenarbeit mit Neurologen, Pädiatern, Internisten oder Pulmologen sollte in komplexeren Fällen erfolgen.

Abstract

The somnology occupies a firm place in medical care of the ENT physician. The S3 guideline “non-restorative sleep/sleep” defines the standards in diagnosis and therapy. Among the sleep-disordered breathing obstructive sleep apnea syndrome is the most common sleep breathing disorder among those aged 30–60 years. The diagnostics is based on a stepwise approach by ambulatory polygraphy and subsequent inpatient polysomnography. Depending on the focus degree of OSA and symptoms of the patient various treatment options surgical and conservative for the ENT specialist are available today. The superior form of therapy for all severities of OSA remains the non-invasive nocturnal airway pressure (CPAP). Detailed knowledge of sleep medicine is essential for differential diagnosis and the correct treatment decision. An interdisciplinary collaboration with a neurologist, pediatrician or pulmonologist should be included in more complex cases.

Schlüsselwörter

Schlafmedizin - Obstruktives Schlafapnoesyndrom (OSAS) - S3 Leitlinie - CPAP (continuous positive airway pressure) - Polysomnografie - ambulante Polygrafie

Key words

somnology - obstructive sleep apnoe syndrome - S3 guideline - CPAP (continuous positive airway pressure) - polysomnography - ambulatory polygraphy

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