Schlaf 2018; 07(04): 183-186
DOI: 10.1055/s-0038-1677330
Review/Original
Georg Thieme Verlag KG Stuttgart · New York

Telemonitoring bei schlafbezogenen Atmungsstörungen

Alexander Blau
,
Christian Veauthier
Further Information

Publication History

Publication Date:
07 January 2019 (online)

Telemonitoring kann bei Patienten ohne wesentliche Begleiterkrankungen zur Diagnostik einer obstruktiven Schlafapnoe eingesetzt werden sowie zur Einleitung einer CPAP-Therapie und zur CPAP-Kontrolle. Der Vorteil des Telemonitoring im Vergleich zur konventionellen Behandlung im Schlaflabor besteht in der raschen Verfügbarkeit, da die Untersuchung zu Hause erfolgt, sowie im geringeren Ressourcen-Verbrauch. Darüber hinaus kann Telemonitoring zu einer Steigerung der nächtlichen Nutzungsdauer und besseren CPAP-Adhärenz führen. Patienten mit nicht eindeutiger Symptomatik, nicht eindeutigen Befunden oder weiteren Erkrankungen sowie mit V.a. Hypoventilations-Syndromen bedürfen einer Untersuchung und ggf. Behandlung im Schlaflabor.

 
  • Literatur

  • 1 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; Apr 29 328 (17) 1230-5.
  • 2 Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; May 1; 165 (09) 1217-39.
  • 3 Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; May 1; 177 (09) 1006-14.
  • 4 Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep 1997; Aug; 20 (08) 608-13.
  • 5 Lavie P, Herer P, Peled R, Berger I, Yoffe N, Zomer J. et al. Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 1995; Apr; 18 (03) 149-57.
  • 6 Pataka A, Riha RL. Continuous positive airway pressure and cardiovascular events in patients with obstructive sleep apnea. Curr Cardiol Rep 2013; Aug; 15 (08) 385.
  • 7 Newman AB, Nieto FJ, Guidry U, Lind BK, Redline S, Pickering TG. et al. Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study. Am J Epidemiol 2001; Jul 1; 154 (01) 50-9.
  • 8 Richtlinie des Gemeinsamen Bundesausschusses zu Untersuchungs- und Behandlungsmethoden der vertragsärztlichen Versorgung. Bundesanzeiger; 2016
  • 9 Mayer G, Arzt M, Braumann B, Ficker JH, Fietze I, Frohnhofen H. et al. German S3 Guideline Nonrestorative Sleep/ Sleep Disorders, chapter “Sleep-Related Breathing Disorders in Adults,” short version: German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin, DGSM). Somnologie 2017; Dec; 21 (04) 290-301.
  • 10 Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D. et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006; Mar; 29 (03) 375-80.
  • 11 Ayas NT, FitzGerald JM, Fleetham JA, White DP, Schulzer M, Ryan CF. et al. Cost-effectiveness of continuous positive airway pressure therapy for moderate to severe obstructive sleep apnea/hypopnea. Arch Intern Med 2006; May 8; 166 (09) 977-84.
  • 12 Alkhalil M, Schulman ES, Getsy J. Obstructive sleep apnea syndrome and asthma: the role of continuous positive airway pressure treatment. Ann Allergy Asthma Immunol 2008; Oct; 101 (04) 350-7.
  • 13 Iftikhar IH, Bittencourt L, Youngstedt SD, Ayas N, Cistulli P, Schwab R. et al. Comparative efficacy of CPAP, MADs, exercise-training, and dietary weight loss for sleep apnea: a network meta-analysis. Sleep Med 2017; Feb; 30: 7-14.
  • 14 Stanchina ML, Welicky LM, Donat W, Lee D, Corrao W, Malhotra A. Impact of CPAP use and age on mortality in patients with combined COPD and obstructive sleep apnea: the overlap syndrome. J Clin Sleep Med 2013; Aug 15; 9 (08) 767-72.
  • 15 Ge X, Han F, Huang Y, Zhang Y, Yang T, Bai C. et al. Is obstructive sleep apnea associated with cardiovascular and all-cause mortality?. PLoS ONE 2013; 8 (07) e69432.
  • 16 Martínez-García M-A, Campos-Rodríguez F, Catalán-Serra P, Soler-Cataluña J-J, Almeida-Gonzalez C, De la Cruz Morón I. et al. Cardiovascular mortality in obstructive sleep apnea in the elderly: role of long-term continuous positive airway pressure treatment: a prospective observational study. Am J Respir Crit Care Med 2012; Nov 1; 186 (09) 909-16.
  • 17 de Abreu-Silva EO, Beltrami-Moreira M. Sleep apnea: an underestimated cause of resistant hypertension. Curr Hypertens Rev 2014; 10 (01) 2-7.
  • 18 Shafazand S, Patel SR. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hyper-tension. J Clin Sleep Med 2014; Mar 15; 10 (03) 341-3.
  • 19 Hu X, Fan J, Chen S, Yin Y, Zrenner B. The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens (Greenwich) 2015; Mar; 17 (03) 215-22.
  • 20 Qureshi WT, Nasir UB, Alqalyoobi S, O’Neal WT, Mawri S, Sabbagh S. et al. Meta-Analysis of Continuous Positive Airway Pressure as a Therapy of Atrial Fibrillation in Obstructive Sleep Apnea. Am J Cardiol 2015; Dec 1; 116 (11) 1767-73.
  • 21 Morgenstern M, Wang J, Beatty N, Batemarco T, Sica AL, Greenberg H. Obstructive sleep apnea: an unexpected cause of insulin resistance and diabetes. Endocrinol Metab Clin North Am 2014; Mar; 43 (01) 187-204.
  • 22 McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X. et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 08; 375 (10) 919-31.
  • 23 McEvoy RD, Neal B, Anderson CS. CPAP in Obstructive Sleep Apnea. N Engl J Med 2016; 08; 375 (23) 2302-3.
  • 24 Pépin JL, Krieger J, Rodenstein D, Cornette A, Sforza E, Delguste P. et al. Effective compliance during the first 3 months of continuous positive airway pressure. A European prospective study of 121 patients. Am J Respir Crit Care Med 1999; Oct; 160 (04) 1124-9.
  • 25 Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martínez-Alonso M, Carmona C, Barceló A. et al. Effect of continuous positive airway pressure on the incidence of hyper-tension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 2012; May 23; 307 (20) 2161-8.
  • 26 Crawford MR, Espie CA, Bartlett DJ, Grunstein RR. Integrating psychology and medicine in CPAP adherence--new concepts?. Sleep Med Rev 2014; Apr; 18 (02) 123-39.
  • 27 Hwang D, Chang JW, Benjafield AV, Crocker ME, Kelly C, Becker KA. et al. Effect of Telemedicine Education and Telemonitoring on Continuous Positive Airway Pressure Adherence. The Tele-OSA Randomized Trial. Am J Respir Crit Care Med 2018; Jan 1; 197 (01) 117-26.
  • 28 Weaver TE. Don’t start celebrating--CPAP adherence remains a problem. J Clin Sleep Med 2013; Jun 15; 9 (06) 551-2.
  • 29 Weaver TE, Sawyer AM. Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Indian J Med Res 2010; Feb; 131: 245-58.