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Laryngorhinootologie 2008; 87: S54-S71
DOI: 10.1055/s-2007-995558
Früherkennung

© Georg Thieme Verlag KG Stuttgart · New York

Früherkennung schlafbezogener Atmungsstörungen

J.  T.  Maurer1
  • 1Schlafmedizinisches Zentrum, Universitäts-Hals-Nasen-Ohrenklinik Mannheim (Direktor: Prof. Dr. med. Karl Hörmann), Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg
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Publication History

Publication Date:
28 March 2008 (online)

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Zusammenfassung

Die obstruktive Schlafapnoe als häufigste schlafbezogene Atmungsstörung führt zu nicht-erholsamem Schlaf, zu einer erhöhten kardiovaskulären Morbidität und Mortalität und zu einer erhöhten Unfallneigung. In Deutschland muss von mindestens zwei Millionen Betroffenen ausgegangen werden. Durch die frühzeitige Erkennung der obstruktiven Schlafapnoe kann die Erholsamkeit des Schlafes wiederhergestellt, die Leistungsfähigkeit am Tage gesteigert, die Unfallgefahr reduziert und das kardiovaskuläre Risiko gesenkt werden. In diesem Referat werden Anamneseparameter, Fragebögen, klinische Parameter, Untersuchungsbefunde und unüberwachte Messungen während des Schlafes auf ihre diagnostische Genauigkeit in der Erkennung einer OSA untersucht. Es gibt eine Vielzahl von Verfahren mit ungenügenden Ergebnissen oder einer unzureichenden Datenlage, sodass sie nicht als Früherkennungsuntersuchung empfohlen werden können. Chancen bieten neuronale Netzwerke zur Beurteilung einer großen Zahl von Parametern und nicht-lineare Auswerteverfahren der Oximetrie alleine oder in Kombination mit der Herzfrequenzanalyse. Die nasale Staudruckmessung kann auch ohne schlafmedizinische Expertise für eine Risikobeurteilung herangezogen werden. Eine Verbreiterung der Datenlage ist erforderlich. Die Polygrafie in der Hand qualifizierter Ärzte ist der Goldstandard der Früherkennungsuntersuchungen der OSA. Ihre hohe Sensitivität und Spezifität wurde in mehreren Metaanalysen bestätigt.

Schlüsselwörter

Schlafbezogene Atmungsstörungen - obstruktive Schlafapnoe - Diagnostik - Früherkennung - Fragebögen - Polygrafie

Literatur

  • 1 Primäre Prävention. In: Wikipedia, Die freie Enzyklopädie: Bearbeitungsstand: 18. Januar 2008, 18:42 UTC http://de.wikipedia.org/w/index.php?title=Prim%C3 %A4re_Pr%C3 %A4vention&oldid=41 352 543
  • 2 Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults.  N Engl J Med. 1993;  328 1230-1235
    CrossrefPubMedGoogle Scholar
  • 3 Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women.  Sleep. 1997;  20 705-706
    PubMedGoogle Scholar
  • 4 American Academy of Sleep Medicine .International classification of sleep disorders, 2nd ed. Diagnostic and coding manual. Westchester, Illinois; 2005
    Google Scholar
  • 5 Elmasry A, Lindberg E, Hedner J, Janson C, Boman G. Obstructive sleep apnoea and urine catecholamines in hypertensive males: a population-based study.  Eur Respir J. 2002;  19 511-517
    CrossrefPubMedGoogle Scholar
  • 6 Davies C W, Crosby J H, Mullins R L, Barbour C, Davies R J, Stradling J R. Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnoea and normal matched control subjects.  Thorax. 2000;  55 736-740
    CrossrefPubMedGoogle Scholar
  • 7 Loredo J S, Ziegler M G, Ancoli-Israel S, Clausen J L, Dimsdale J E. Relationship of arousals from sleep to sympathetic nervous system activity and BP in obstructive sleep apnea.  Chest. 1999;  116 655-659
    CrossrefPubMedGoogle Scholar
  • 8 Loredo J S, Ancoli-Israel S, Dimsdale J E. Sleep quality and blood pressure dipping in obstructive sleep apnea.  Am J Hypertens. 2001;  14 887-892
    CrossrefPubMedGoogle Scholar
  • 9 Sharabi Y, Dagan Y, Grossman E. Sleep apnea as a risk factor for hypertension.  Curr Opin Nephrol Hypertens. 2004;  13 359-364
    PubMedGoogle Scholar
  • 10 Peppard P E, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension.  N Engl J Med. 2000;  342 1378-1384
    CrossrefPubMedGoogle Scholar
  • 11 Coccagna G, Pollini A, Provini F. Cardiovascular disorders and obstructive sleep apnea syndrome.  Clin Exp Hypertens. 2006;  28 217-224
    CrossrefPubMedGoogle Scholar
  • 12 Marin J M, Carrizo S J, Vicente E, Agusti A G. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study.  Lancet. 2005;  365 1046-1053
    CrossrefPubMedGoogle Scholar
  • 13 Guilleminault C, Eldridge F L, Dement W C. Insomnia with sleep apnea: a new syndrome.  Science. 1973;  181 856-858
    PubMedGoogle Scholar
  • 14 Guilleminault C, Rosekind M. The arousal threshold: sleep deprivation, sleep fragmentation, and obstructive sleep apnea syndrome.  Bull Eur Physiopathol Respir. 1981;  17 341-319
    PubMedGoogle Scholar
  • 15 Guilleminault C, Tilkian A, Dement W C. The sleep apnea syndromes.  Annu Rev Med. 1976;  27 465-484
    CrossrefPubMedGoogle Scholar
  • 16 Orth M, Kotterba S, Duchna H W, de Zeeuw J, Schultze-Werninghaus G, Rasche K. Obstruktives Schlafapnoe-Hypopnoe-Syndrom - geschlechtsspezifische Unterschiede.  Somnologie. 2000;  4 3-6
    CrossrefPubMedGoogle Scholar
  • 17 Peter J H, Becker H, Blanke J, Clarenbach P, Mayer G, Raschke F, Rühle K H, Rüther E, Schläfke M, Schönbrunn E. et al . Empfehlungen zur Diagnostik, Therapie und Langzeitbetreuung von Patienten mit Schlafapnoe.  Med Klin (München). 1991;  86 46-50
    PubMedGoogle Scholar
  • 18 Gemeinsamer Bundesausschuss der Ärzte und Krankenkassen . Beschluss über eine Änderung der Richtlinien zur Bewertung medizinischer Untersuchungs- und Behandlungsmethoden gemäß § 135 Abs. 1 des Fünften Buches Sozialgesetzbuch (BUB-Richtlinien) in Anlage A „Anerkannte Untersuchungs- und Behandlungsmethoden” vom 15. Juni 2004/21. September 2004.  Dtsch Arztebl. 2004;  101 A-3370/B-2854/C-2702
    PubMedGoogle Scholar
  • 19 Fischer J, Mayer G, Peter J H, Riemann D, Sitter H. Nicht-erholsamer Schlaf. Leitlinie „S2” der Deutschen Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). Berlin, Wien; Blackwell Wissenschafts-Verlag 2002
    Google Scholar
  • 20 Gyulay S, Olson L G, Hensley M J, King M T, Allen K M, Saunders N A. A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea.  Am Rev Respir Dis. 1993;  147 50-53
    PubMedGoogle Scholar
  • 21 Herer B, Roche N, Carton M, Roig C, Poujol V, Huchon G. Value of clinical, functional, and oximetric data for the prediction of obstructive sleep apnea in obese patients.  Chest. 1999;  116 1537-1544
    CrossrefPubMedGoogle Scholar
  • 22 Johns M W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale.  Sleep. 1991;  14 540-545
    Google Scholar
  • 23 Bloch K E, Schoch O D, Zhang J N, Russi E W. German version of the Epworth Sleepiness Scale.  Respiration. 1999;  66 440-447
    CrossrefPubMedGoogle Scholar
  • 24 Pouliot Z, Peters M, Neufeld H, Kryger M H. Using self-reported questionnaire data to prioritize OSA patients for polysomnography.  Sleep. 1997;  20 232-236
    PubMedGoogle Scholar
  • 25 Osman E Z, Osborne J, Hill P D, Lee B W. The Epworth Sleepiness Scale: can it be used for sleep apnoea screening among snorers?.  Clin Otolaryngol Allied Sci. 1999;  24 239-241
    CrossrefPubMedGoogle Scholar
  • 26 Netzer N C, Stoohs R A, Netzer C M, Clark K, Strohl K P. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome.  Ann Intern Med. 1999;  131 485-491
    PubMedGoogle Scholar
  • 27 Sharma S K, Vasudev C, Sinha S, Banga A, Pandey R M, Handa K K. Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome.  Indian J Med Res. 2006;  124 281-290
    PubMedGoogle Scholar
  • 28 Weinreich G, Plein K, Teschler T, Resler J, Teschler H. Ist der Berlin-Fragebogen ein geeignetes Instrument der schlafmedizinischen Diagnostik in der pneumologischen Rehabilitation?.  Pneumologie. 2006;  60 737-742
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Ahmadi N, Chung S A, Gibbs A, Shapiro C M. The Berlin questionnaire for sleep apnea in a sleep clinic population: relationship to polysomnographic measurement of respiratory disturbance.  Sleep Breath. 2007;  epub ahead of print
    PubMedGoogle Scholar
  • 30 Netzer N C, Hoegel J J, Loube D, Netzer C M, Hay B, Alvarez-Sala R, Strohl K P.. Sleepin Primary Care International Study Group . Prevalence of symptoms and risk of sleep apnea in primary care.  Chest. 2003;  124 1406-1414
    CrossrefPubMedGoogle Scholar
  • 31 Hiestand D M, Britz P, Goldman M, Phillips B. Prevalence of symptoms and risk of sleep apnea in the US population: Results from the national sleep foundation sleep in America 2005 poll.  Chest. 2006;  130 780-786
    CrossrefPubMedGoogle Scholar
  • 32 Moreno C R, Carvalho F A, Lorenzi C, Matuzaki L S, Prezotti S, Bighetti P, Louzada F M, Lorenzi-Filho G. High risk for obstructive sleep apnea in truck drivers estimated by the Berlin questionnaire: prevalence and associated factors.  Chronobiol Int. 2004;  21 871-879
    CrossrefPubMedGoogle Scholar
  • 33 Mustafa M, Erokwu N, Ebose I, Strohl K. Sleep problems and the risk for sleep disorders in an outpatient veteran population.  Sleep Breath. 2005;  9 57-63
    CrossrefPubMedGoogle Scholar
  • 34 Ocasio-Tascón M E, Alicea-Colón E, Torres-Palacios A, Rodríguez-Cintrón W. The veteran population: one at high risk for sleep-disordered breathing.  Sleep Breath. 2006;  10 70-75
    CrossrefPubMedGoogle Scholar
  • 35 Chung F, Ward B, Ho J, Yuan H, Kayumov L, Shapiro C. Preoperative identification of sleep apnea risk in elective surgical patients, using the Berlin questionnaire.  J Clin Anesth. 2007;  19 130-134
    CrossrefPubMedGoogle Scholar
  • 36 Auckley D, Moallem M, Shaman Z, Mustafa M. Findings of a Berlin Questionnaire survey: Comparison between patients seen in an asthma clinic versus internal medicine clinic.  Sleep Med. 2007;  epub ahead of print
    PubMedGoogle Scholar
  • 37 Viner S, Szalai J P, Hoffstein V. Are history and physical examination a good screening test for sleep apnea?.  Ann Intern Med. 1991;  115 356-359
    CrossrefPubMedGoogle Scholar
  • 38 Hoffstein V, Szalai J P. Predictive value of clinical features in diagnosing obstructive sleep apnea.  Sleep. 1993;  16 118-122
    PubMedGoogle Scholar
  • 39 Dreher A, de la Chaux R, Klemens C, Werner R, Baker F, Barthlen G, Rasp G. Correlation between otorhinolaryngologic evaluation and severity of obstructive sleep apnea syndrome in snorers.  Arch Otolaryngol Head Neck Surg. 2005;  131 95-98
    CrossrefPubMedGoogle Scholar
  • 40 Tsai W H, Remmers J E, Brant R, Flemons W W, Davies J, Macarthur C. A decision rule for diagnostic testing in obstructive sleep apnea.  Am J Respir Crit Care Med. 2003;  167 1427-1432
    CrossrefPubMedGoogle Scholar
  • 41 Nuckton T J, Glidden D V, Browner W S, Claman D M. Physical examination: Mallampati score as an independent predictor of obstructive sleep apnea.  Sleep. 2006;  29 903-908
    PubMedGoogle Scholar
  • 42 Sanders M H, Martin R J, Pennock B E, Rogers R M. The detection of sleep apnea in the awake patient. The ‘saw-tooth’ sign.  JAMA. 1981;  245 2414-2418
    CrossrefPubMedGoogle Scholar
  • 43 Shore E T, Millman R P. Abnormalities in the flow-volume loop in obstructive sleep apnoea sitting and supine.  Thorax. 1984;  39 775-779
    PubMedGoogle Scholar
  • 44 Krieger J, Weitzenblum E, Vandevenne A, Stierle J L, Kurtz D. Flow-volume curve abnormalities and obstructive sleep apnea syndrome.  Chest. 1985;  87 163-167
    CrossrefPubMedGoogle Scholar
  • 45 Hoffstein V, Wright S, Zamel N. Flow-volume curves in snoring patients with and without obstructive sleep apnea.  Am Rev Respir Dis. 1989;  139 957-960
    PubMedGoogle Scholar
  • 46 Rauscher H, Popp W, Zwick H. Flow-volume curves in obstructive sleep apnea and snoring.  Lung. 1990;  168 209-214
    PubMedGoogle Scholar
  • 47 Amado V M, Costa A C, Guiot M, Viegas C A, Tavares P. Inspiratory flow-volume curve in snoring patients with and without obstructive sleep apnea.  Braz J Med Biol Res. 1999;  32 407-411
    PubMedGoogle Scholar
  • 48 Hoffstein V, Oliver Z. Pulmonary function and sleep apnea.  Sleep Breath. 2003;  7 159-165
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Zerah-Lancner F, Lofaso F, Coste A, Ricolfi F, Goldenberg F, Harf A. Pulmonary function in obese snorers with or without sleep apnea syndrome.  Am J Respir Crit Care Med. 1997;  156 522-527
    PubMedGoogle Scholar
  • 50 Zerah-Lancner F, Lofaso F, d’Ortho M P, Delclaux C, Goldenberg F, Coste A, Housset B, Harf A. Predictive value of pulmonary function parameters for sleep apnea syndrome.  Am J Respir Crit Care Med. 2000;  162 2208-2212
    PubMedGoogle Scholar
  • 51 Davies R J, Stradling J R. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome.  Eur Respir J. 1990;  3 509-514
    PubMedGoogle Scholar
  • 52 Lowe A A, Fleetham J A, Adachi S, Ryan C F. Cephalometric and computed tomographic predictors of obstructive sleep apnea severity.  Am J Orthod Dentofacial Orthop. 1995;  107 589-595
    CrossrefPubMedGoogle Scholar
  • 53 Will M J, Ester M S, Ramirez S G, Tiner B D, McAnear J T, Epstein L. Comparison of cephalometric analysis with ethnicity in obstructive sleep apnea syndrome.  Sleep. 1995;  18 873-875
    PubMedGoogle Scholar
  • 54 Pracharktam N, Nelson S, Hans M G, Broadbent B H, Redline S, Rosenberg C, Strohl K P. Cephalometric assessment in obstructive sleep apnea.  Am J Orthod Dentofacial Orthop. 1996;  109 410-419
    CrossrefPubMedGoogle Scholar
  • 55 Shinohara E, Kihara S, Yamashita S, Yamane M, Nishida M, Arai T, Kotani K, Nakamura T, Takemura K, Matsuzawa Y. Visceral fat accumulation as an important risk factor for obstructive sleep apnoea syndrome in obese subjects.  J Intern Med. 1997;  241 11-18
    CrossrefPubMedGoogle Scholar
  • 56 Bates C J, McDonald J P. The relationship between severity of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) and lateral cephalometric radiograph values: a clinical diagnostic tool.  Surgeon. 2005;  3 338-346
    CrossrefPubMedGoogle Scholar
  • 57 Julià-Serdà G, Pérez-Peñate G, Saavedra-Santana P, Ponce-González M, Valencia-Gallardo J M, Rodríguez-Delgado R, Cabrera-Navarro P. Usefulness of cephalometry in sparing polysomnography of patients with suspected obstructive sleep apnea.  Sleep Breath. 2006;  10 181-187
    CrossrefPubMedGoogle Scholar
  • 58 Rodenstein D O, Dooms G, Thomas Y, Liistro G, Stanescu D C, Culee C, Aubert-Tulkens G. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea.  Thorax. 1990;  45 722-727
    PubMedGoogle Scholar
  • 59 Salisbury J I, Sun Y. Rapid screening test for sleep apnea using a nonlinear and nonstationary signal processing technique.  Med Eng Phys. 2007;  29 336-343
    CrossrefPubMedGoogle Scholar
  • 60 Senn O, Brack T, Russi E W, Bloch K E. A continuous positive airway pressure trial as a novel approach to the diagnosis of the obstructive sleep apnea syndrome.  Chest. 2006;  129 67-75
    CrossrefPubMedGoogle Scholar
  • 61 Rodsutti J, Hensley M, Thakkinstian A, D’Este C, Attia J. A clinical decision rule to prioritize polysomnography in patients with suspected sleep apnea.  Sleep. 2004;  27 694-699
    PubMedGoogle Scholar
  • 62 Crocker B D, Olson L G, Saunders N A, Hensley M J, McKeon J L, Allen K M, Gyulay S G. Estimation of the probability of disturbed breathing during sleep before a sleep study.  Am Rev Respir Dis. 1990;  142 14-18
    PubMedGoogle Scholar
  • 63 Flemons W W, Whitelaw W A, Brant R, Remmers J E. Likelihood ratios for a sleep apnea clinical prediction rule.  Am J Respir Crit Care Med. 1994;  150 1279-1285
    Google Scholar
  • 64 Maislin G, Pack A I, Kribbs N B, Smith P L, Schwartz A R, Kline L R, Schwab R J, Dinges D F. A survey screen for prediction of apnea.  Sleep. 1995;  18 158-166
    PubMedGoogle Scholar
  • 65 Rowley J A, Aboussouan L S, Badr M S. The use of clinical prediction formulas in the evaluation of obstructive sleep apnea.  Sleep. 2000;  23 929-938
    PubMedGoogle Scholar
  • 66 Gurubhagavatula I, Maislin G, Pack A I. An algorithm to stratify sleep apnea risk in a sleep disorders clinic population.  Am J Respir Crit Care Med. 2001;  164 1904-1909
    PubMedGoogle Scholar
  • 67 Roche N, Herer B, Roig C, Huchon G. Prospective testing of two models based on clinical and oximetric variables for prediction of obstructive sleep apnea.  Chest. 2002;  121 747-752
    CrossrefPubMedGoogle Scholar
  • 68 Kirby S D, Eng P, Danter W, George C F, Francovic T, Ruby R R, Ferguson K A. Neural network prediction of obstructive sleep apnea from clinical criteria.  Chest. 1999;  116 409-415
    CrossrefPubMedGoogle Scholar
  • 69 el-Solh A A, Mador M J, Ten-Brock E, Shucard D W, Abul-Khoudoud M, Grant B J. Validity of neural network in sleep apnea.  Sleep. 1999;  22 105-111
    PubMedGoogle Scholar
  • 70 Pillar G, Peled N, Katz N, Lavie P. Predictive value of specific risk factors, symptoms and signs, in diagnosing obstructive sleep apnoea and its severity.  J Sleep Res. 1994;  3 241-244
    PubMedGoogle Scholar
  • 71 Olson L G, Ambrogetti A, Gyulay S G. Prediction of sleep-disordered breathing by unattended overnight oximetry.  J Sleep Res. 1999;  8 51-55
    CrossrefPubMedGoogle Scholar
  • 72 Svanborg E, Larsson H, Carlsson-Nordlander B, Pirskanen R. A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed.  Chest. 1990;  98 1341-1345
    PubMedGoogle Scholar
  • 73 Douglas N J, Thomas S, Jan M A. Clinical value of polysomnography.  Lancet. 1992;  339 347-350
    CrossrefPubMedGoogle Scholar
  • 74 Sériès F, Marc I, Cormier Y, LaForge J. Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome.  Ann Intern Med. 1993;  119 449-453
    PubMedGoogle Scholar
  • 75 Duchna H W, Rasche K, Orth M, Schultze-Werninghaus G. Sensitivität und Spezifität der Pulsoximetrie in der Diagnostik schlafbezogener Atmungsstörungen.  Pneumologie. 1995;  49 (Suppl 1) 113-115
    PubMedGoogle Scholar
  • 76 Lévy P, Pépin J L, Deschaux-Blanc C, Paramelle B, Brambilla C. Accuracy of oximetry for detection of respiratory disturbances in sleep apnea syndrome.  Chest. 1996;  109 395-399
    CrossrefPubMedGoogle Scholar
  • 77 Rodríguez González-Moro J M, de Lucas Ramos P, Sánchez Juanes M J, Izquierdo Alonso J L, Peraíta Adrados R, Cubillo Marcos J M. [Usefulness of the visual analysis of night oximetry as a screening method in patients with suspected clinical obstructive sleep apnea syndrome].  Arch Bronconeumol. 1996;  32 437-441
    PubMedGoogle Scholar
  • 78 Chiner E, Signes-Costa J, Arriero J M, Marco J, Fuentes I, Sergado A. Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies?.  Thorax. 1999;  54 968-971
    CrossrefPubMedGoogle Scholar
  • 79 Vázquez J C, Tsai W H, Flemons W W, Masuda A, Brant R, Hajduk E, Whitelaw W A, Remmers J E. Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea.  Thorax. 2000;  55 302-307
    CrossrefPubMedGoogle Scholar
  • 80 Zamarrón C, Romero P V, Rodriguez J R, Gude F. Oximetry spectral analysis in the diagnosis of obstructive sleep apnoea.  Clin Sci (Lond). 1999;  97 467-473
    PubMedGoogle Scholar
  • 81 Zamarrón C, Gude F, Barcala J, Rodriguez J R, Romero P V. Utility of oxygen saturation and heart rate spectral analysis obtained from pulse oximetric recordings in the diagnosis of sleep apnea syndrome.  Chest. 2003;  123 1567-1576
    CrossrefPubMedGoogle Scholar
  • 82 Perleth M, von der Leyen U, Schmitt H, Dintsios C M, Felder S, Schwartz F W, Teske (Hrsg) S. Das Schlaf-Apnoe-Syndrom - Systematische Übersichten zur Diagnostik, Therapie und Kosten-Effektivität. Schriftenreihe Health Technology Assessment, Band 25. St. Augustin; Asgard-Verlag 2003
    Google Scholar
  • 83 Magalang U J, Dmochowski J, Veeramachaneni S, Draw A, Mador M J, El-Solh A, Grant B J. Prediction of the apnea-hypopnea index from overnight pulse oximetry.  Chest. 2003;  124 1694-1701
    CrossrefPubMedGoogle Scholar
  • 84 Hornero R, Alvarez D, Abasolo D, Gomez C, Del Campo F, Zamarron C. Approximate entropy from overnight pulse oximetry for the obstructive sleep apnea syndrome.  Conf Proc IEEE Eng Med Biol Soc. 2005;  6 6157-6160
    PubMedGoogle Scholar
  • 85 del Campo F, Hornero R, Zamarrón C, Abasolo D E, Alvarez D. Oxygen saturation regularity analysis in the diagnosis of obstructive sleep apnea.  Artif Intell Med. 2006;  37 111-118
    PubMedGoogle Scholar
  • 86 Zamarrón C, Hornero R, del Campo F, Abásolo D, Alvarez D. Heart rate regularity analysis obtained from pulse oximetric recordings in the diagnosis of obstructive sleep apnea.  Sleep Breath. 2006;  10 83-89
    CrossrefPubMedGoogle Scholar
  • 87 Hornero R, Alvarez D, Abásolo D, del Campo F, Zamarrón C. Utility of approximate entropy from overnight pulse oximetry data in the diagnosis of the obstructive sleep apnea syndrome.  IEEE Trans Biomed Eng. 2007;  54 107-113
    CrossrefPubMedGoogle Scholar
  • 88 Alvarez D, Hornero R, Marcos J, del Campo F, Lopez M. Obstructive Sleep Apnea Detection Using Clustering Classification of Nonlinear Features from Nocturnal Oximetry.  Conf Proc IEEE Eng Med Biol Soc. 2007;  1 1937-1940
    PubMedGoogle Scholar
  • 89 Alvarez D, Hornero R, Abásolo D, del Campo F, Zamarrón C. Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection.  Physiol Meas. 2006;  27 399-412
    CrossrefPubMedGoogle Scholar
  • 90 Alvarez D, Hornero R, García M, del Campo F, Zamarrón C. Improving diagnostic ability of blood oxygen saturation from overnight pulse oximetry in obstructive sleep apnea detection by means of central tendency measure.  Artif Intell Med. 2007;  41 13-24
    PubMedGoogle Scholar
  • 91 Marcos J V, Hornero R, Alvarez D, del Campo F, López M, Zamarrón C. Radial basis function classifiers to help in the diagnosis of the obstructive sleep apnoea syndrome from nocturnal oximetry.  Med Biol Eng Comput. 2007;  epub ahead of print
    PubMedGoogle Scholar
  • 92 Zamarrón C, Romero P V, Gude F, Amaro A, Rodriguez J R. Screening of obstructive sleep apnoea: heart rate spectral analysis of nocturnal pulse oximetric recording.  Respir Med. 2001;  95 759-765
    PubMedGoogle Scholar
  • 93 Sériès F, Kimoff R J, Morrison D, Leblanc M H, Smilovitch M, Howlett J, Logan A G, Floras J S, Bradley T D. Prospective evaluation of nocturnal oximetry for detection of sleep-related breathing disturbances in patients with chronic heart failure.  Chest. 2005;  127 1507-1514
    CrossrefPubMedGoogle Scholar
  • 94 Epstein L J, Dorlac G R. Cost-effectiveness analysis of nocturnal oximetry as a method of screening for sleep apnea-hypopnea syndrome.  Chest. 1998;  113 97-103
    CrossrefPubMedGoogle Scholar
  • 95 Shochat T, Hadas N, Kerkhofs M, Herchuelz A, Penzel T, Peter J H, Lavie P. The SleepStrip: an apnoea screener for the early detection of sleep apnoea syndrome.  Eur Respir J. 2002;  19 121-126
    CrossrefPubMedGoogle Scholar
  • 96 Pang K P, Dillard T A, Blanchard A R, Gourin C G, Podolsky R, Terris D J. A comparison of polysomnography and the SleepStrip in the diagnosis of OSA.  Otolaryngol Head Neck Surg. 2006;  135 265-268
    CrossrefPubMedGoogle Scholar
  • 97 Hollingworth L, Tooby M, Roberts D, Hanning C D. Practicality of the Sleepstrip in postal screening for obstructive sleep apnoea.  J Sleep Res. 2003;  12 157-159
    CrossrefPubMedGoogle Scholar
  • 98 Baisch A, Afshar S, Hörmann K, Maurer J T. Der klinische Einsatz eines Schlafapnoescreeners in der Praxis.  HNO. 2007;  55 90-92
    CrossrefPubMedGoogle Scholar
  • 99 Thurnheer R, Xie X, Bloch K E. Accuracy of nasal cannula pressure recordings for assessment of ventilation during sleep.  Am J Respir Crit Care Med. 2001;  164 1914-1919
    PubMedGoogle Scholar
  • 100 Fleury B, Rakotonanahary D, Hausser-Hauw C, Lebeau B, Guilleminault C. A laboratory validation study of the diagnostic mode of the Autoset system for sleep-related respiratory disorders.  Sleep. 1996;  19 502-505
    PubMedGoogle Scholar
  • 101 Heitman S J, Atkar R S, Hajduk E A, Wanner R A, Flemons W W. Validation of nasal pressure for the identification of apneas/hypopneas during sleep.  Am J Respir Crit Care Med. 2002;  166 386-391
    CrossrefPubMedGoogle Scholar
  • 102 Hosselet J J, Norman R G, Ayappa I, Rapoport D M. Detection of flow limitation with a nasal cannula/pressure transducer system.  Am J Respir Crit Care Med. 1998;  157 1461-1467
    PubMedGoogle Scholar
  • 103 Epstein M D, Chicoine S A, Hanumara R C. Detection of upper airway resistance syndrome using a nasal cannula/pressure transducer.  Chest. 2000;  117 1073-1077
    CrossrefPubMedGoogle Scholar
  • 104 Wang Y, Teschler T, Weinreich G, Hess S, Wessendorf T E, Teschler H. Validierung von microMesam als Screeninggerät für schlafbezogene Atmungsstörungen.  Pneumologie. 2003;  57 734-740
    Article in Thieme ConnectPubMedGoogle Scholar
  • 105 Erman M K, Stewart D, Einhorn D, Gordon N, Casal E. Validation of the ApneaLink for the screening of sleep apnea: a novel and simple single-channel recording device.  J Clin Sleep Med. 2007;  3 387-392
    PubMedGoogle Scholar
  • 106 de Almeida F R, Ayas N T, Otsuka R, Ueda H, Hamilton P, Ryan F C, Lowe A A. Nasal pressure recordings to detect obstructive sleep apnea.  Sleep Breath. 2006;  10 62-69
    CrossrefPubMedGoogle Scholar
  • 107 Nakano H, Tanigawa T, Furukawa T, Nishima S. Automatic detection of sleep-disordered breathing from a single-channel airflow record.  Eur Respir J. 2007;  29 728-736
    CrossrefPubMedGoogle Scholar
  • 108 American Academy of Sleep Medicine . 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. 1999;  22 667-689
    PubMedGoogle Scholar
  • 109 Ayappa I, Norman R G, Suryadevara M, Rapoport D M. Comparison of limited monitoring using a nasal-cannula flow signal to full polysomnography in sleep-disordered breathing.  Sleep. 2004;  27 1171-1179
    PubMedGoogle Scholar
  • 110 Baltzan M A, Verschelden P, Al-Jahdali H, Olha A E, Kimoff R J. Accuracy of oximetry with thermistor (OxiFlow) for diagnosis of obstructive sleep apnea and hypopnea.  Sleep. 2000;  23 61-69
    PubMedGoogle Scholar
  • 111 Wittig R M, Romaker A, Zorick F J, Roehrs T A, Conway W A, Roth T. Night-to-night consistency of apneas during sleep.  Am Rev Respir Dis. 1984;  129 244-246
    PubMedGoogle Scholar
  • 112 Meyer T J, Eveloff S E, Kline L R, Millman R P. One negative polysomnogram does not exclude obstructive sleep apnea.  Chest. 1993;  103 756-760
    CrossrefPubMedGoogle Scholar
  • 113 Zamarrón C, Pichel F, Romero P V. Coherence between oxygen saturation and heart rate obtained from pulse oximetric recordings in obstructive sleep apnoea.  Physiol Meas. 2005;  26 799-810
    CrossrefPubMedGoogle Scholar
  • 114 Alvarez D, Hornero R, Garcia M, Campo F D, Zamarron C, Lopez M. Cross approximate entropy analysis of nocturnal oximetry signals in the diagnosis of the obstructive sleep apnea syndrome.  Conf Proc IEEE Eng Med Biol Soc. 2006;  1 6149-6152
    PubMedGoogle Scholar
  • 115 Ross S D, Sheinhait I A, Harrison K J, Kvasz M, Connelly J E, Shea S A, Allen I E. Systematic review and meta-analysis of the literature regarding the diagnosis of sleep apnea.  Sleep. 2000;  23 519-532
    PubMedGoogle Scholar
  • 116 Flemons W W, Littner M R, Rowley J A, Gay P, Anderson W M, Hudgel D W, McEvoy R D, Loube D I. Home diagnosis of sleep apnea: a systematic review of the literature. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society.  Chest. 2003;  124 1543-1579
    CrossrefPubMedGoogle Scholar
  • 117 Ballester E, Solans M, Vila X, Hernandez L, Quintó L, Bolivar I, Bardagi S, Montserrat J M. Evaluation of a portable respiratory recording device for detecting apnoeas and hypopnoeas in subjects from a general population.  Eur Respir J. 2000;  16 123-127
    CrossrefPubMedGoogle Scholar
  • 118 Yin M, Miyazaki S, Ishikawa K. Evaluation of type 3 portable monitoring in unattended home setting for suspected sleep apnea: factors that may affect its accuracy.  Otolaryngol Head Neck Surg. 2006;  134 204-209
    CrossrefPubMedGoogle Scholar
  • 119 Westbrook P R, Levendowski D J, Cvetinovic M, Zavora T, Velimirovic V, Henninger D, Nicholson D. Description and validation of the apnea risk evaluation system: a novel method to diagnose sleep apnea-hypopnea in the home.  Chest. 2005;  128 2166-2175
    CrossrefPubMedGoogle Scholar
  • 120 Thurnheer R, Bloch K E, Laube I, Gugger M, Heitz M. Swiss Respiratory Polygraphy Registry . Respiratory polygraphy in sleep apnoea diagnosis. Report of the Swiss respiratory polygraphy registry and systematic review of the literature.  Swiss Med Wkly. 2007;  137 97-102
    PubMedGoogle Scholar
  • 121 Quintana-Gallego E, Villa-Gil M, Carmona-Bernal C, Botebol-Benhamou G, Martínez-Martínez A, Sánchez-Armengol A, Polo-Padillo J, Capote F. Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure.  Eur Respir J. 2004;  24 443-448
    CrossrefPubMedGoogle Scholar
  • 122 Marrone O, Salvaggio A, Insalaco G, Bonsignore M R, Bonsignore G. Evaluation of the POLYMESAM system in the diagnosis of obstructive sleep apnea syndrome.  Monaldi Arch Chest Dis. 2001;  56 486-490
    PubMedGoogle Scholar
  • 123 Calleja J M, Esnaola S, Rubio R, Durán J. Comparison of a cardiorespiratory device versus polysomnography for diagnosis of sleep apnoea.  Eur Respir J. 2002;  20 1505-1510
    CrossrefPubMedGoogle Scholar
  • 124 Golpe R, Jiménez A, Carpizo R. Home sleep studies in the assessment of sleep apnea/hypopnea syndrome.  Chest. 2002;  122 1156-1561
    CrossrefPubMedGoogle Scholar
  • 125 Dingli K, Coleman E L, Vennelle M, Finch S P, Wraith P K, Mackay T W, Douglas N J. Evaluation of a portable device for diagnosing the sleep apnoea/hypopnoea syndrome.  Eur Respir J. 2003;  21 253-259
    CrossrefPubMedGoogle Scholar
  • 126 Reichert J A, Bloch D A, Cundiff E, Votteri B A. Comparison of the NovaSom QSG, a new sleep apnea home-diagnostic system, and polysomnography.  Sleep Med. 2003;  4 213-218
    PubMedGoogle Scholar
  • 127 Penzel T, Fricke R, Jerrentrup A, Peter J H, Vogelmeier C. Peripheral arterial tonometry for the diagnosis of obstructive sleep apnea.  Biomed Tech (Berl). 2002;  47 (Suppl 1 Pt 1) 315-317
    PubMedGoogle Scholar
  • 128 O’Donnell C P, Allan L, Atkinson P, Schwartz A R. The effect of upper airway obstruction and arousal on peripheral arterial tonometry in obstructive sleep apnea.  Am J Respir Crit Care Med. 2002;  166 965-971
    CrossrefPubMedGoogle Scholar
  • 129 Pillar G, Bar A, Betito M, Schnall R P, Dvir I, Sheffy J, Lavie P. An automatic ambulatory device for detection of AASM defined arousals from sleep: the WP100.  Sleep Med. 2003;  4 207-212
    PubMedGoogle Scholar
  • 130 Bar A, Pillar G, Dvir I, Sheffy J, Schnall R P, Lavie P. Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies.  Chest. 2003;  123 695-703
    CrossrefPubMedGoogle Scholar
  • 131 Penzel T, Kesper K, Pinnow I, Becker H F, Vogelmeier C. Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea.  Physiol Meas. 2004;  25 1025-1036
    CrossrefPubMedGoogle Scholar
  • 132 Penzel T, Kesper K, Ploch T, Becker H F, Vogelmeier C. Ambulatory recording of sleep apnea using peripheral arterial tonometry.  Conf Proc IEEE Eng Med Biol Soc. 2004;  5 3856-3859
    PubMedGoogle Scholar
  • 133 Pittman S D, Ayas N T, MacDonald M M, Malhotra A, Fogel R B, White D P. Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validation.  Sleep. 2004;  27 923-933
    PubMedGoogle Scholar
  • 134 Zou D, Grote L, Peker Y, Lindblad U, Hedner J. Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography.  Sleep. 2006;  29 367-374
    PubMedGoogle Scholar
  • 135 Ayas N T, Pittman S, MacDonald M, White D P. Assessment of a wrist-worn device in the detection of obstructive sleep apnea.  Sleep Med. 2003;  4 435-442
    CrossrefPubMedGoogle Scholar
  • 136 Fischer J, Raschke F. Kosten-Nutzen-Analyse bei Patienten mit schlafbezogenen Atmungsstörungen - Diagnostik und nCPAP-Therapie während der medizinischen Rehabilitation.  Biomed Tech (Berl). 2003;  48 245-251
    PubMedGoogle Scholar

Dr. Joachim T. Maurer

Schlafmedizinisches Zentrum
Universitäts-Hals-Nasen-Ohrenklinik Mannheim

Medizinische Fakultät Mannheim der Ruprecht-Karls-Universität Heidelberg
68135 MannheimTheodor-Kutzer-Ufer 1 - 3

Email: Joachim.Maurer@hno.ma.uni-heidelberg.de

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