Konsensuspapier zur Diagnostik und Therapie schlafbezogener Atmungsstörungen bei Erwachsenen^[*]

 

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Zusammenfassung

Die Diagnostik und Therapie schlafbezogener Atmungsstörungen (SBAS) unterliegt wesentlichen Veränderungen sowohl in medizinisch-wissenschaftlicher Hinsicht als auch in Bezug auf die Versorgungssituation der Patienten und sozioökonomische Aspekte. Die Relevanz der SBAS für die Morbidität und Mortalität Betroffener ist neben der besseren Differenzierung und Phänotypisierung der Untertypen der SBAS Gegenstand intensiver Forschungsaktivitäten. Diese differenzierte Betrachtung verändert die Vorgehensweise beim Verdacht auf SBAS erheblich. Dem stehen Trends zur Simplifizierung des diagnostischen Prozederes und der Therapieeinleitung, der Verlagerung medizinischer Leistungen auf nicht-medizinisches Personal und Fragen der Kostenminimierung entgegen. In diesem Konsensuspapier werden daher vor dem Hintergrund der aktuellen Situation die Prinzipien der Diagnostik, Therapieeinleitung und Versorgung sowie die Rolle der verschiedenen Beteiligten am Gesundheitssystem und die Bewertung der Therapieangebote vorgestellt. Zu den Kernstücken gehören die Differenzierung der Diagnostik in Screening, Bestätigungsdiagnostik und Differenzialdiagnostik, der Zugang zum Patienten nach der Vortestwahrscheinlichkeit und ein therapeutischer Algorithmus.

Abstract

Diagnosis and treatment of sleep disordered breathing (SDB) undergo substantial changes, both in terms of increasing scientific knowledge and also in terms of patient provision and socio-economic aspects. Increasing evidence shows the relevance of SDB on morbidity and mortality of affected patients. The precise differentiation of different phenotypes of SDBs has improved substantially in recent years. These proceedings influence the approach to the patients suspected of suffering from SDB. The scientific advances on the one hand are facing intentions to simplify diagnostical processes and treatment initiation and intentions to translate duties of physicians to non-medical personnel on the other hand. This consensus paper presents the principals of diagnosis, treatment initiation and provision, including the role of different participants of the healthcare system, and compares different treatment options. Major aspects include the differentiation of the diagnostical process in screening, affirmation of diagnosis and differential diagnosis. In addition, it focusses on the relevance of the pretest probability and describes a therapeutical algorithm.

^* Dieses Konsensuspapier erscheint zeitgleich in den Fachzeitschriften „Pneumologie“ und „Somnologie“.

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