Zusammenfassung
Arousals spielen in verschiedenen Lebensbereichen eine wichtige Rolle. Auch in der Schlafmedizin haben sie als EEG-Arousal seit der Publikation der American Sleep Disorders Association (ASDA) im Jahr 1992 eine Standardisierung erhalten und werden als Kurzzeit-Arousal von mindestens 3, höchstens 30 s Dauer ermittelt. Die kriterien wurden innerhalb kürzester Zeit in automatische Analyseverfahren umgesetzt und erlauben derzeit eine schnelle Erkennung und Quantifizierung. Sie werden als Kennzeichen von Schlaffragmentierung, Ermüdung und verminderter Leistungsfähigkeit herangezogen. Es werden Untersuchungen mit automatischer Arousal-Analyse an 30 Schlaf-Apnoe-Patienten vorgestellt. Die Ergebnisse zeigen, daß sich der Therapieerfolg anhand von automatisch bestimmten EEG-Arousals ablesen läßt. Es folgen 246 ambulante Monitor-Untersuchungen an Patienten mit chronischen kardialen und pneumologischen Primärerkrankungen, bei denen eine schnarchassoziierte Herzfrequenzanalyse durchgeführt wurde. Diese Untersuchungen und die Original-Registrierung eines vital bedrohlichen Asthmaanfalls im Schlaf zeigen weiterhin, daß vegetativen und endokrinen Arousals zur Sicherung von Vitalfunktionen eine entscheidende Bedeutung zukommt. Ihre Funktion besteht vor allem darin, im Schlaf das Überleben zu sichern. Als Schlußfolgerung ergibt sich, daß EEG-Arousals durch neu zu definierende vegetative, motorische und möglicherweise auch endokrine Arousals ergänzt werden sollten.
Summary
Arousals play an important role in a variety of different life situations. In sleep medicine, the short time EEG-arousal was defined and standardized in the 1992 publication of the American Sleep Disorders Association (ASDA) as being at least 3 s, but not more than 30 s long. These criteria were quickly integrated in an automated analysis, enabling fast recognition and quantification. They are indicators of sleep fragmentation, drowsiness, and impaired physical and mental efficiency. This investigation presents the automatic arousal analysis of 30 patients with sleep apnea syndrome. The results demonstrate that an automated arousal analysis is indicative of a successful therapy. Additionally, 246 ambulatory monitoring investigations, including snore associated heart rate analysis, were carried out on patients with chronic cardiac and primary pulmonary diseases. These investigations, and the registration of a life threatening asthma attack during sleep, also demonstrate that autonomic and endocrine arousals play an important role in controlling vital functions. Above all, their primary function during sleep is to secure survival. In conclusion, the criteria for arousal analysis should include not only EEG-arousals, but also autonomic, motoric, and even endocrine arousals, which should be evaluated in standardised form.
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Raschke, F., Fischer, J. “Arousal” in der Schlafmedizin. Somnologie 1, 59–64 (1997). https://doi.org/10.1007/s11818-997-0012-6
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DOI: https://doi.org/10.1007/s11818-997-0012-6