Die neue „International Classification of Sleep Disorders“: Eine kritische Würdigung der diagnostischen Kriterien für schlafbezogene Atmungsstörungen

Abstract

The third issue of the International Classification of Sleep Disorders (ICSD-3) was published in 2014. This article describes the differences compared to the second issue on sleep disordered breathing in a more detailed fashion and discusses their significance for clinical practice. For obstructive sleep apnea (OSA) in adults, the clinical conditions that lead to the diagnosis in combination with respiratory events have been expanded with cardiovascular and mental comorbidities. OSA may now be diagnosed more frequently. In children, obstructive hypoventilation is now included in the diagnostic criteria. For the diagnosis of OSA in adults, out-of-center testing is mentioned as an alternative to polysomnography (PSG). This will intensify the current discussion regarding the role of PSG and outpatient recordings in the management of the disease. Sleep-related hypoventilation syndromes and sleep-related hypoxemia are now separate identities and oxygen saturation is no longer a diagnostic criterion for sleep-related hypoventilation. Treatment-emergent central sleep apnea as well as obesity hypoventilation are now included in the ICSD-3, the latter requiring daytime hypoventilation.