Partial update of the German S3 Guideline Sleep-Related Breathing Disorders in Adults

1 AbstractA review of the recommendations in the currently applicable version of the chapter "Sleep-related breathing disorders in adults" in the guideline "Non-restorative sleep/sleep disorders" conducted by the guideline steering group identified a number of recommendations and chapters requiring revision or updating in the light of new scientific or clinical evidence. These included selected chapters on diagnosis (clinical examination, polysomnography, respiratory polygraphy, and diagnosis with reduced and alternative systems) and treatment (positional therapy, surgical procedures) of sleep-related breathing disorders, as well as the chapters on obstructive sleep apnea (OSA) and dementia and on sleep-related hypoventilation/sleep-related hypoxemia. These chapters were updated according to the methodology of an S3 guideline. The remaining recommendations and chapters, on the other hand, retain their validity for the time being.With regard to the diagnosis of sleep apnea, a number of recommendations on clinical examinations, as well as on respiratory polygraphy and polysomnography, have been specified more precisely and modified. A chapter on diagnosis has been supplemented with alternative systems: tonometry-based diagnostics has been included as an alternative for the diagnosis of sleep apnea. Positional therapy for positional OSA and tonsillectomy with uvulopalatopharyngoplasty are given a higher level of recommendation based on new randomized trials. Recommendations on OSA and dementia can no longer be made due to a lack of evidence; the recommendations on sleep-related hypoventilation/sleep-related hypoxemia have been specified with greater precision.