Empfehlungen zur ambulanten Diagnostik der Schlafapnoe*

Recent data of prevalence suggest a total of more than 400000 patients presenting with a severe obstructive sleep apnoea syndrome in the Federal Republic. Their ambulant diagnosis has been made possible trough two new items in the GOA, published in the Deutsche Arzteblatt 1991. According to this and a first paper on "Recommendations for diagnostics, therapy and long term management of patients with sleep apnoea (Medizinische Klinik 86: 46- 50, 1991) the Azbeitsgemeinschaft Klinischer Schlafzentren (German Sleep Centre Work Team) has elaborated recommendations for the ambulant diagnostics of sleep apnoea. Indications to such diagnosis are loud and irregular snoring, overweight, hypertonia and day-time sleepiness. The following stepwise concept of diagnostics is recommended: 1. questionnaire, 2. medical investigation including a sleep-wakehistory, 3. ambulant investigation using a system which allows the continuous registration of breathing, arterial O2-saturation, heart rate and other variables. In case of pathological results patients at risk have to be referred to a sleep laboratory, others can remain under ambulant care including information about overweight and alcohol as well as therapy of additional diseases. 4. cases which remain unsolved have to be examined in the sleep laboratory. Nasal CPAP-therapy and other forms of apparative ventilation have to be started in the sleep lab, routine controls may be done under ambulant conditions. The technical conditions of recording and evaluation as well as the available systems are presented, the topics of the seminars which are postulated by the KBV for ambulant apnoea diagnostics are formulated.