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Abstract:
Sleep-related breathing disorders often lead to cardio-pulmonary and cardiovascular complications as well as to cardiac failure. It is thus necessary to carry out a detailed medical diagnostic work-up to assess the cardiac risk before initiating therapy. Basic requirements for successful therapy are preventive measures. Weight reduction for the usually overweight patients, avoidance of alcohol, sedatives and tranquilizers, and adequate sleep hygiene. Before a vacation at high altitudes, individual advice is needed. Medical treatment includes the prescription of respiration stimulants in certain cases as also--after careful estimation of the risks--prescription of tricyclic antidepressants. Today, the application of calcium-channel blockers and theophylline seems to be most successful. In an examination of our own involving 20 patients we found a significant reduction in the apnoea index due to treatment with euphyllong. In cases of pronounced findings and corresponding symptoms the use of mechanical measures, especially of nasal CPAP therapy can be recommended in more than 80% of patients. Those who cannot be adequately treated by the methods mentioned above, must be provided with a tracheostomy. This drastic form of therapy should only be considered after a thorough diagnostic evaluation and exhaustive use of all other methods. At present, oxygen therapy is still under discussion in the literature and can be recommended only in cases of an "overlap" syndrome.