Fahrsimulatoruntersuchung bei Patienten mit obstruktivem Schlafapnoe-Syndrom: Konsequenzen für die Beurteilung der Fahrtüchtigkeit?

Orth, M.; Herting, A.; Duchna, Hans‐Werner; Walther, Jörg; Zeeuw, Justus de; Bauer, Torsten T.; Schultze‐Werninghaus, G.; Kotterba, Sylvia

doi:10.1055/s-2005-918602

Cited by 15 publications

(8 citation statements)

References 17 publications

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“…It took three months for the OSA subjects to reach the same ESS scores as comparisons and while their FOSQ scores steadily improved over the study period, they never achieved the same level as the comparison group. Studies in which objective measures of sleepiness are repeatedly assessed have reported improvements within the first few days following initiation of PAP, which plateau within two to six-weeks [9, 10]. Less is known about the time-course of change in subjective measures over an extended period as most previous studies have only compared two endpoints –before and one to three-months after starting PAP.…”

Section: Discussionmentioning

confidence: 99%

“…Timing of sleep assessment is another potential factor. Sleepiness has been shown to improve within two weeks using MSLT [9] and driving simulator outcomes [10], while subjective improvement occurs more slowly [11, 12]. Finally, the nature of the residual symptoms may depend on how it is perceived by the patient; many complain of persistent fatigue, inattention or lack of a sense of well-being rather than “sleepiness” per se [13].…”

Section: Introductionmentioning

confidence: 99%

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Sleep remains disturbed in patients with obstructive sleep apnea treated with positive airway pressure: a three-month cohort study using continuous actigraphy

et al. 2016

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Objective Some patients with obstructive sleep apnea (OSA) remain sleepy despite positive airway pressure (PAP) therapy. The mechanisms by which this occurs are unclear but could include persistently disturbed sleep. The goal of this study was to explore the relationships between subjective sleepiness and actigraphic measures of sleep during the first three months of PAP treatment. Methods We enrolled 80 patients with OSA and 50 comparison subjects prior to treatment and observed them through three months of PAP therapy. PAP adherence and presence of residual respiratory events were determined from PAP machine downloads. Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and actigraphic data were collected before and at monthly intervals after starting PAP. Results OSA subjects were sleepier and showed a greater degree of sleep disruption by actigraphy at baseline. After three months of PAP, only ESS and number of awakenings normalized, while wake after sleep onset (WASO) and sleep efficiency (SE) remained worse in OSA subjects. For OSA subjects, FOSQ improved but never reached the same level as comparison subjects. ESS and FOSQ improved slowly over the study period. Conclusions As a group, OSA patients show actigraphic evidence of persistently disturbed sleep and sleepiness related impairments in day-to-day function after three months of PAP therapy. Improvements in sleepiness evolve over months with more severely affected patients responding quicker. Persistent sleep disruption may partially explain residual sleepiness in some PAP adherent OSA patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep remains disturbed in patients with obstructive sleep apnea treated with positive airway pressure: a three-month cohort study using continuous actigraphy

et al. 2016

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“…Insbesondere für die OSA wurde auch mit unterschiedlichen Fahrsimulatoren eine signifikant höhere Unfallrate in der simulierten Fahrsituation gegenüber Gesunden sowie eine deutliche Absenkung der Unfallhäufigkeit unter CPAP-Therapie nachgewiesen [18,20,21].…”

Section: Unfallhäufigkeit Bei Osa Unter Therapieunclassified

Gesundheitliche Auswirkungen der obstruktiven Schlafapnoe

Orth

Kotterba

2012

HNO

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Daytime sleepiness for any reason leads to impairment of daytime performance and an increased accident rate. The consequences are an increase of illness- and accident-related costs for the health system. Obstructive sleep apnea (OSA) is one of the major reasons for increased daytime sleepiness, especially in professional drivers. The accident frequency in OSA can be significantly reduced by adequate continuous positive airway pressure (CPAP) therapy. Up till now there are no uniform legal regulations about the handling of OSAS patients or patients with daytime sleepiness due to other diseases as far as driving ability is concerned.

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“…Es sollte nach Ablauf dieser Frist zur Überprüfung der Therapiecompliance und neuropsychologischer Testergebnisse eine Nachuntersuchung erfolgen (Rühle et al 1998). Neuere Studienergebnisse (Orth et al 2005b) belegen, dass der Therapieerfolg schon nach kürze-rer Frist (14 Tage) nachgewiesen werden kann, was unter wirtschaftlichen Aspekten wichtig ist (sechswöchige Krankschreibung fast nicht möglich). Bei privaten Kraftfahrern sollten die Aufmerksamkeitsfunktionen alle zwölf Monate, bei Berufskraftfahrern alle sechs Monate kontrolliert werden (Rühle et al 1998).…”

Section: Fahrtauglichkeitunclassified

Sozialmedizinische Begutachtung bei Schlafstörungen

Kotterba¹,

Orth²

2009

PiD - Psychotherapie im Dialog

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Fahrsimulatoruntersuchung bei Patienten mit obstruktivem Schlafapnoe-Syndrom: Konsequenzen für die Beurteilung der Fahrtüchtigkeit?

Cited by 15 publications

References 17 publications

Sleep remains disturbed in patients with obstructive sleep apnea treated with positive airway pressure: a three-month cohort study using continuous actigraphy

Sleep remains disturbed in patients with obstructive sleep apnea treated with positive airway pressure: a three-month cohort study using continuous actigraphy

Gesundheitliche Auswirkungen der obstruktiven Schlafapnoe

Sozialmedizinische Begutachtung bei Schlafstörungen

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