Neurológia pre prax 1/2013

Guidelines for sleep related breathing disorders treatment using positive airways pressure in adults Czech Sleep Research and Sleep Medicine Society Report

Sleep related breathing disorders (SRBD), mainly sleep apnea (SA), strongly caused quality of sleep and subsequently quality of patient’s life. Patophysiologic consequences of SRBD influence course of cardiovascular disorders. Early and quality treatment of SRBD decreased cardiovascular morbidity and mortality and favorably affects their socioeconomic impact. Given mentioned facts the Czech Sleep Research and Sleep Medicine Society (CSRSMS) decided to create guidelines for SRBD treatment using positive airways pressure in adults. SRBD are diagnosed by polysomnography or polygraphy. Severity is assessed based on apnea-hypopnea index (AHI) – mild is defined by AHI <15, moderate by AHI 15–30 and severe by AHI>30. CPAP (continuous positive airway pressure) treatment is recommended for moderate and severe SA. BPAP (bi-level positive airways pressure) treatment is recommended for treatment of moderate and severe SA in case of insufficient CPAP efficacy. Residual AHI level (recorded by device from the last control) and sufficient usage (> 4 hours/day in average) are markers of treatment efficacy. The first control of compliance with treatment is set during the interval of 1–3 months from the beginning of treatment. The other controls follow in regular interval of 1 year. Sleep medicine centres accredited by CSRSMS have authorization for treatment indication, titration and prescription.

Keywords: sleep related breathing disorders (SRBD), sleep apnea (SA), CPAP (continuous positive airway pressure), BPAP (bi-level positive airways pressure), treatment compliance.