Background: The obstructive sleep apnea syndrome (OSAS) is the most prevalent sleep-related breathing disorder. In Switzerland, the Swiss Respiratory Society together with the Swiss and the Cantonal Lung Associations have formed a Task Force to survey the current diagnostic and therapeutic state of the art. The present practice guidelines summarize the conclusions and recommendations based on scientific evidence and on the specific setting of the Swiss health care system. Methods: Review of the scientific literature, health care policy and practice, and expert panel discussions. Results: OSAS is diagnosed by typical symptoms together with findings during polysomnography. Pulse oximetry or limited respiratory polygraphy are not appropriate to exclude OSAS. Nasal continuous positive airway pressure (CPAP) is the most effective treatment for OSAS. In Switzerland, OSAS is diagnosed by pulmonary physicians in private practice and in sleep disorder centers. The pulmonologists work closely together with the local lung associations which play an essential role in the long-term care of OSAS patients on CPAP therapy. In particular, the associations provide counseling services, home care and technical support. With this approach, a high compliance with CPAP therapy has been achieved. The costs for CPAP therapy are reimbursed by the health insurance. Weight reduction in obese patients, sleep positional training and avoidance of alcohol and sedatives are adjunctive measures. In habitual snorers and in patients with OSAS unable to tolerate CPAP, removable oral appliances have provided favorable results. Conclusions: OSAS is suggested by a typical history and evaluated by a sleep study as a basis for treatment by nocturnal CPAP. Close cooperation of pulmonary physicians and lung associations provides excellent results in the long-term care of OSAS patients on CPAP.

Keywords:
Obstructive sleep apnea, Polysomnography, Continuous positive airway pressure, Oral appliances
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© 2002 S. Karger AG, Basel
2002
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