Maurer Joachim T
Sleep Disorders Centre, University Dept. of Otorhinolaryngology, Head and Neck Surgery Mannheim, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2008;7:Doc03. Epub 2010 Oct 7.
Obstructive sleep apnea (OSA) being the most frequent sleep related breathing disorder results in non-restorative sleep, an increased cardiovascular morbidity and mortality as well as an elevated number of accidents. In Germany at least two million people have to be expected. If obstructive sleep apnea is diagnosed early enough then sleep may regain its restorative function, daytime performance may be improved and accident risk as well as cardiovascular risk may be normalised. This review critically evaluates anamnestic parameters, questionnaires, clinical findings and unattended recordings during sleep regarding their diagnostic accurracy in recognising OSA. There are numerous tools with insufficient results or too few data disqualifying them for screening for OSA. Promising preliminary results are published concerning neural network analysis of a high number of clinical parameters and non-linear analysis of oximetry itself or in combination with heart rate. Nasal pressure recordings can be used for risk estimation even without expertise in sleep medicine. More data is needed. Unattended portable monitoring used by qualified physicians is the gold standard procedure when screening methods for OSA are compared. It has a very high sensitivity and specificity well documented by several meta-analyses.
阻塞性睡眠呼吸暂停（OSA）是最常见的与睡眠相关的呼吸障碍，会导致睡眠无法恢复体力，心血管疾病的发病率和死亡率增加，以及事故数量增多。在德国，预计至少有200万人受此影响。如果阻塞性睡眠呼吸暂停能被足够早地诊断出来，那么睡眠可能会恢复其恢复体力的功能，白天的表现可能会得到改善，事故风险以及心血管风险也可能恢复正常。这篇综述批判性地评估了问诊参数、问卷、临床发现以及睡眠期间的无人值守记录在识别阻塞性睡眠呼吸暂停方面的诊断准确性。有许多工具的结果不充分或数据太少，使其不适合用于阻塞性睡眠呼吸暂停的筛查。关于大量临床参数的神经网络分析以及血氧饱和度测定本身或与心率相结合的非线性分析，已经发表了有前景的初步结果。即使没有睡眠医学专业知识，鼻压力记录也可用于风险评估。还需要更多数据。在比较阻塞性睡眠呼吸暂停的筛查方法时，由合格医生使用的无人值守便携式监测是金标准程序。它具有非常高的敏感性和特异性，多项荟萃分析对此有充分记录。
