Versorgung von Patienten mit obstruktiver Schlafapnoe in kardiologischen Praxen und Kliniken

BACKGROUND AND OBJECTIVES: In the generalpopulation there is a high prevalence of sleep-related disordersof breathing (sleep apnea). In addition to being leading symptomof excessive day-time sleepiness they are also important predictorsare cardiovascular disease such as arterial hypertension, heartfailure, cardiac arrhythmias and stroke. Are the cardiologists thespecialists who recognize such patients and refer them to diagnostic proceduresand treatment? METHODS: We sent out a questionnairesto cardiologists in private practice, to hospitals with cardiologydepartments and to cardiology rehabilitation units in Germany inorder to assess the knowledge about sleep apnea and of the currentdiagnostic and therapeutic procedures in patients with suspectedsleep apnea. All cardiology rehabilitation units and every otherpractice and cardiology department listed in the reference book ’Medfuhrer’ wereapproached. RESULTS: 98 % of 388cardiologists with private practice were found to know about thedisorder sleep apnea. 94.3 % routinely asked theirpatients about any sleep disorder and specifically about excessiveday-time sleepiness. More than half of the cardiologists (59.3 %)questioned patients about possible sleep apnea as part of theirinterview, but only 32.7 % carried out tests witha portable sleep apnea monitor. Most patients were referred to asleep center. In 60 % of the cardiology departmentsa portable sleep apnea monitor was used. Further diagnostic investigationfollowed in collaborating sleep centers (66.4 %),because only 22.4 % of the departments had a sleeplaboratories. The main focus was on the diagnosis of abnormal sleppdue to central or obstructive disorders of breathing. More thantwo thirds of the cardiology departments initiate nocturnal ventilationtreatment. CONCLUSION: Cardiologists in privatepractice and cardiologists in hospital departments know about sleep-relatedabnormal breathing. The use of portable sleep apnea monitors andof polysomnography in special as parts of sleep centers within cardiologydepartments should be improved.