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Dtsch Med Wochenschr 2017; 142(12): 912-923
DOI: 10.1055/s-0042-124260
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© Georg Thieme Verlag KG Stuttgart · New York

Update: Kardiovaskuläre Schlafmedizin

Update: Cardiovascular Sleep Medicine
Benedikt Linz
,
Michael Böhm
,
Dominik Linz
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Publication History

Publication Date:
21 June 2017 (online)

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Abstract

The prevalence of sleep-disordered breathing (SDB) is high in patients with cardiovascular diseases. Typical symptoms like daytime sleepiness can be absent and those patients may report unspecific, therapy-resistant symptoms related to their underlying disease. Particularly sleep-related symptoms like nocturia, nocturnal dyspnea and pectangina can be present. Based on the results of recently published studies, the treatment of central sleep apnea in patients with symptomatic, systolic heart failure by adaptive servo-ventilation is no longer recommended. Although the treatment of obstructive sleep apnea did not prevent cardiovascular events, it improved snoring, daytime sleepiness and health-related quality of life. Furthermore, studies imply that treatment of SDB should be considered as an adjunct treatment modality in patients with hypertension and atrial fibrillation. Due to the high prevalence, screening for SDB can help to identify patients at high cardiovascular risk.

Atemstörungen im Schlaf kommen bei Herzpatienten häufig vor – z. T. ohne die klassischen Symptome. Häufig weisen sie jedoch internistische Symptome auf, die bislang therapieresistent waren. Die Polygrafie hilft hier, Risikopatienten zu identifizieren. Neben Verhaltensregeln zählen Beatmungsmaßnahmen zu den Therapieoptionen, so z. B. CPAP bei OSA und Herzinsuffizienz. Bei ZSA und Herzinsuffizienz ist die adaptive Servoventilation nicht empfohlen.

Schlüsselwörter

Schlafbezogene Atmungsstörung - Pathophysiologie - obstruktive Schlafapnoe - zentrale Schlafapnoe - Herzinsuffizienz - Vorhofflimmern - Hypertonus

Key words

sleep-disordered breathing - pathophysiology - obstructive sleep apnea - central sleep apnea - heart failure - atrial fibrillation - hypertension
 

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