Quellen medizinischer Inhalte

1. Leitlinien

1.1 S3-Leitlinien:

1.1.1 Schnarchen

1. Stuck BA, Braumann Bert, Heiser Clemens, Herzog Michael, Maurer Joachim T., Plößl Sebastian, Steffen Armin, Sommer J. Ulrich, Verse Thomas, Hofauer Benedikt (Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V. DGHNO-KHC). S3-Leitlinie (Langfassung) Diagnostik und Therapie des Schnarchens des Erwachsenen. AWMF-Register-Nr. 017/068, PDF Extern;

1.1.2 Schlafapnoe

1. Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). S3 Leitlinie Nicht erholsamer Schlaf/Schlafstörung Kapitel „Schlafbezogene Atmungsstörungen bei Erwachsenen“. AWMF-Register Nr. 063/001, PDF Extern;
2. Stuck BA, Arzt M., Fietze I. et al. Teil-Aktualisierung S3-Leitlinie Schlafbezogene Atmungsstörungen bei Erwachsenen. Somnologie 24, 176–208 (2020), PDF Extern;

1.2 S2-Leitlinien:

1. Verse T, Dreher A, Heiser C, Herzog M, Maurer JT, Pirsig W, et al. S2e-Leitlinie: „HNO-spezifische Therapie der obstruktiven Schlafapnoe bei Erwachsenen“. AWMF-Register Nr. 017/069. Klasse: S2e. Stand 09/2015, PDF Extern;

2. Fachliteratur

1. Baenkler HW, Bals R, Goldschmidt H, Hahn JM, Hinterseer M, Knez A, et al. Kurzlehrbuch Innere Medizin. 4. Auflage. Stuttgart: Thieme, 2021;
2. Crönlein T, Galetke W, Young P. Schlafmedizin 1×1: Praxisorientiertes Basiswissen. 2. Aufl. Berlin: Springer, 2020;
3. Lambert S. Atmung, Schnarchen und Schlafapnoe: Behandlung der Atemwege in der modernen Präventivmedizin und -zahnmedizin. 1. Auflage. Berlin: Quintessenz; 2024;
4. Lehnert H, Märker-Hermann E, Marx N, Meyhöfer SM. DGIM Innere Medizin. Berlin: Springer, 2020, https://link.springer.com/referencework/10.1007/978-3-642-54676-1;
5. Peter H, Penzel T, Peter JH, Peter JG. Enzyklopädie der Schlafmedizin. 2. Aufl. Berlin: Springer, 2024;
6. Pollmächer T, Wetter TC, BAssetti CLA, Högl B, Randerath W, Wiater A. Handbuch Schlafmedizin. 1. Auflage. München: Urban & Fischer, 2020;
7. Schäfer JW. Schnarchen und Schlaf-Apnoe: Pathophysiologie, Diagnostik und Therapie schlafbezogener Atemstörungen. 1. Aufl. Stuttgart: Thieme, 1996;
8. Stuck BA. Schnarchen des Erwachsenen. 1. Aufl. Berlin: Springer; 2019;
9. Stuck BA, Maurer JT, Schlarb A, Schredl M, Weeß HG. Praxis der Schlafmedizin: Diagnostik, Differenzialdiagnostik und Therapie bei Erwachsenen und Kindern. 3. Aufl. Berlin: Springer, 2017.

3. Studien

• Aman, J., Elangovan, N., Yeh, I. L., & Konczak, J. (2015). The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in Human Neuroscience, 8, 1075.Frontiers | The effectiveness of proprioceptive training for improving motor function: a systematic review
• Andhare, N., Yeole, U., & Deshpande, S. (2018). Effect of Oropharyngeal Exercise on Obstructive Sleep Apnea. International Journal of Allied Medical Sciences and Clinical Research, 6(4), 887–893. Online verfügbar unter: https://www.researchgate.net/publication/329433602
• Antonaglia, C., & Passuti, G. (2022). Obstructive sleep apnea syndrome in non-obese patients. Sleep & Breathing, 26(2), 513–518. https://doi.org/10.1007/s11325-021-02412-1
• Bisogni, V., Pengo, M. F., De Vito, A., Maiolino, G., Rossi, G. P., Mortimore, I. B., & Steier, J. (2017). Electrical stimulation for the treatment of obstructive sleep apnoea: a review of the evidence. Expert Review of Respiratory Medicine, 11(9), 711–720. https://doi.org/10.1080/17476348.2017.1358619
• Bloch, K. E. (1999). German Version of the Epworth Sleepiness Scale. Respiration, 66(5), 440–447. German Version of the Epworth Sleepiness Scale
• Büttner, A., Feier, C. H., Galetke, W., & Rühle, K. H. (2008). Fragebogen zur Erfassung funktioneller Auswirkungen von Tagesschläfrigkeit auf die Lebensqualität bei obstruktivem Schlafapnoe-Syndrom. Functional Outcomes of Sleep Questionnaire (FOSQ). Pneumologie, 62(9), 548–552.  https://doi.org/10.1055/s-2008-1038172
• Camacho, M., Certal, V., Abdullatif, J., Zaghi, S., Ruoff, C. M., Capasso, R., & Kushida, C. A. (2015). Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep, 38(5), 669–675. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
• Carrasco-Llatas, M., O’Connor-Reina, C., & Calvo-Henríquez, C. (2021). The Role of Myofunctional Therapy in Treating Sleep-Disordered Breathing: A State-of-the-Art Review. International Journal of Environmental Research and Public Health, 18(14), 7291.The Role of Myofunctional Therapy in Treating Sleep-Disordered Breathing: A State-of-the-Art Review
• Corrêa, C. de C., & Berretin-Felix, G. (2015). Myofunctional therapy applied to upper airway resistance syndrome: a case report. CoDAS, 27(6), 604–609. https://doi.org/10.1590/2317-1782/20152014228
• 10.       Crook, S., Sievi, N. A., Bloch, K. E., et al. (2019). Minimum important difference of the Epworth Sleepiness Scale in obstructive sleep apnoea: estimation from three randomised controlled trials. Thorax, 74(2), 178–184. https://doi.org/10.1136/thoraxjnl-2018-211959
• 11.       De Felício, C. M., da Silva Dias, F. V., & Trawitzki, L. V. V. (2018). Obstructive sleep apnea: focus on myofunctional therapy. Nature and Science of Sleep, 10, 271–286. Obstructive sleep apnea: focus on myofunctional therapy | NSS | Dove Medical Press
• 12.       Diaféria, G., Santos-Silva, R., Truksinas, E., Haddad, F. L. M., Santos, R., Bommarito, S., et al. (2017). Myofunctional therapy improves adherence to continuous positive airway pressure treatment. Sleep & Breathing, 21(2), 387–395. https://doi.org/10.1007/s11325-016-1429-6
• 13.       Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). (2020). Pressetext krankhaftes Schnarchen. [Online: DGSM ]
• 14.       Peter, J. H., Penzel, T., & Cassel, W. (Hrsg.). (2020). Enzyklopädie der Schlafmedizin. Springer. https://doi.org/10.1007/978-3-642-54672-3
• 15.       Erturk, N., Calik-Kutukcu, E., Arikan, H., Savci, S., Inal-Ince, D., Caliskan, H., et al. (2020). The effectiveness of oropharyngeal exercises compared to inspiratory muscle training in obstructive sleep apnea: A randomized controlled trial. Heart & Lung, 49(6), 940–948.The effectiveness of oropharyngeal exercises compared to inspiratory muscle training in obstructive sleep apnea: A randomized controlled trial
• 16.       Ewers, M., Grewe, A., Helmbold, A., & Klewer, J. (2012). Forschung in den Gesundheitsfachberufen – Potenziale für eine bedarfsgerechte Gesundheitsversorgung in Deutschland. Deutsche Medizinische Wochenschrift, 137(S 02), S37–S73. https://doi.org/10.1055/s-0032-1304724
• 17.       Franklin, K. A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the population—a review on the epidemiology of sleep apnea. Journal of Thoracic Disease, 7(8), 1311–1322.Obstructive sleep apnea is a common disorder in the population—a review on the epidemiology of sleep apnea
• 18.       Gerlach, M., & Sanner, B. (2017a). Leitlinien in der Praxis: Die neue S3-Leitlinie „Nicht erholsamer Schlaf/Schlafstörungen – Schlafbezogene Atmungsstörungen“. Pneumologie, 71(8), 508–513. https://doi.org/10.1055/s-0043-113543
• 19.       Gerlach, M., & Sanner, B. (2017b). Leitlinien in der Praxis: Die neue S3-Leitlinie „Nicht erholsamer Schlaf/Schlafstörungen – Schlafbezogene Atmungsstörungen“. Laryngo-Rhino-Otologie, 96(10), 685–690. https://doi.org/10.1055/s-0043-111099
• 20.       Goswami, U., Black, A., Krohn, B., Meyers, W., & Iber, C. (2019). Smartphone-based delivery of oropharyngeal exercises for treatment of snoring: a randomized controlled trial. Sleep & Breathing, 23(1), 243–250. https://doi.org/10.1007/s11325-018-1690-y
• 21.       Grevendonk, L., Connell, N. J., McCrum, C., Fealy, C. E., Bilet, L., Schrauwen-Hinderling, V. B., … & Hoeks, J. (2021). Impact of aging and exercise on skeletal muscle mitochondrial capacity, energy metabolism, and physical function. Nature Communications, 12, 4773.https://doi.org/10.1038/s41467-021-24956-2
• 22.       Guimarães, K. C., Drager, L. F., Genta, P. R., Marcondes, B. F., & Lorenzi-Filho, G. (2009). Effects of oropharyngeal exercises on patients with moderate obstructive sleep apnea syndrome. American Journal of Respiratory and Critical Care Medicine, 179(10), 962–966.Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome
• 23.       Heiser, C., Maurer, J. T., Hofauer, B., Sommer, J. U., Seitz, A., & Steffen, A. (2017). Selective upper airway stimulation for obstructive sleep apnea: a single center clinical experience. European Archives of Oto-Rhino-Laryngology, 274(3), 1727–1734. Outcomes of Upper Airway Stimulation for Obstructive Sleep Apnea in a Multicenter German Postmarket Study
• 24.       Hsu, B., Mowdsley, C., Gao, X., & Reid, K. J. (2020). Effects of respiratory muscle therapy on obstructive sleep apnea: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine, 16(5), 785–801. https://doi.org/10.5664/jcsm.8318
• 25.       Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540–545.A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
• 26.       Kayamori, F., Mandelbaum, E., & Bianchini, G. (2017). Effects of orofacial myofunctional therapy on the symptoms and physiological parameters of sleep breathing disorders in adults: a systematic review. Revista CEFAC, 19(6), 868–878. https://doi.org/10.1590/1982-0216201719613317
• 27.       Kim, J., Oh, E. G., Choi, M., Choi, S. J., Joo, E. Y., Lee, H., & Kim, H. Y. (2020). Development and evaluation of myofunctional therapy support program (MTSP) based on self-efficacy theory for patients with obstructive sleep apnea. Sleep & Breathing, 24(3), 1051–1058. https://doi.org/10.1007/s11325-019-01957-6
• 28.       Koka, V., De Vito, A., Roisman, G., Neuzillet, Y., Petitjean, M., Triantafyllou, A., … & Cammaroto, G. (2021). Orofacial myofunctional therapy in obstructive sleep apnea syndrome: A pathophysiological perspective. Medicina, 57(4), 323.Orofacial Myofunctional Therapy in Obstructive Sleep Apnea Syndrome: A Pathophysiological Perspective
• 29.       Lally, P., van Jaarsveld, C. H., Potts, H. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998–1009.How are habits formed: Modelling habit formation in the real world
• 30.       Lee, J. J., & Sundar, K. M. (2021). Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome. Lung, 199(2), 87–101. https://doi.org/10.1007/s00408-021-00426-w
• 31.       Lorenzi-Filho, G., Almeida, F. R., & Strollo, P. J. (2017). Treating OSA: Current and emerging therapies beyond CPAP. Respirology, 22(8), 1500–1507.<em>Respirology</em> | APSR Respiratory Medicine Journal | Wiley Online Library
• 32.       McNicholas, W. T. (2017). Obstructive sleep apnoea of mild severity: should it be treated? Current Opinion in Pulmonary Medicine, 23(6), 506–511. https://doi.org/10.1097/MCP.0000000000000420
• 33.       Neruntarat, C., Khuancharee, K., & Shoowit, P. (2020). Er:YAG laser for snoring: a systemic review and meta-analysis. Lasers in Medical Science, 35(6), 1231–1238. https://doi.org/10.1007/s10103-020-02987-3
• 34.       O’Connor-Reina, C., Ignacio Garcia, J. M., Rodriguez Ruiz, E., Morillo Dominguez, M. D. C., Ignacio Barrios, V., Baptista Jardin, P., et al. (2020). Myofunctional Therapy App for Severe Apnea-Hypopnea Sleep Obstructive Syndrome: Pilot Randomized Controlled Trial. JMIR mHealth and uHealth, 8(11), e23123.Myofunctional Therapy App for Severe Apnea–Hypopnea Sleep Obstructive Syndrome: Pilot Randomized Controlled Trial
• 35.       O’Connor-Reina, C., Ignacio Garcia, J. M., Rodriguez Alcala, L., Rodríguez Ruiz, E., Garcia Iriarte, M. T., Casado Morente, J. C., et al. (2021). Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing. Journal of Clinical Medicine, 10(24), 6043. Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing
• 36.       O’Halloran, K. D., Lewis, P., & McDonald, F. (2017). Sex, stress and sleep apnoea: Decreased susceptibility to upper airway muscle dysfunction following intermittent hypoxia in females. Respiratory Physiology & Neurobiology, 245, 76–82. https://doi.org/10.1016/j.resp.2016.11.009
• 37.       Penzel, T., et al. (2005). Themenheft 27 „Schlafstörungen“. Gesundheitsberichterstattung des Bundes.https://www.rki.de/DE/Content/Gesundheitsmonitoring/Gesundheitsberichterstattung/GBEDownloadsT/schlaf.pdf 
• 38.       Rodríguez-Alcalá, L., Martínez, J. M., Baptista, P., Ríos Fernández, R., Javier Gómez, F., Parejo Santaella, J., et al. (2021). Sensorimotor tongue evaluation and rehabilitation in patients with sleep-disordered breathing: a novel approach. Journal of Oral Rehabilitation, 48(12), 1363–1372. https://doi.org/10.1111/joor.13247
• 39.       Rueda, J.-R., Mugueta-Aguinaga, I., Vilaró, J., & Rueda-Etxebarria, M. (2020). Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea. Cochrane Database of Systematic Reviews, Issue 11. https://doi.org/10.1002/14651858.CD013449.pub2
• 40.       Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde. (2015). S2e-Leitlinie: Obstruktive Schlafapnoe bei Erwachsenen: HNO-spezifische Therapie (Registernummer 017-069).https://lungen-aerzte.de/wp-content/uploads/2020/04/017-069k_S2e_Obstruktive_Schlafapnoe_Erwachsene_2015-12.pdf
• 41.       Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde. (2019). S3-Leitlinie: Diagnostik und Therapie des Schnarchens des Erwachsenen (Registernummer 017-068).AWMF Leitlinienregister
• 42.       Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). (2016). S3-Leitlinie: Nicht erholsamer Schlaf/Schlafstörungen – Schlafbezogene Atmungsstörungen (Registernummer 063-001).https://register.awmf.org/assets/guidelines/063-001l_S3_SBAS_2023-01_verlaengert_und_Hinweis_Teil-Aktualisierung.pdf  
• 43.       Sil, A., & Barr, G. (2012). Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea. Journal of Laryngology & Otology, 126(4), 372–379. Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea | The Journal of Laryngology &amp; Otology | Cambridge Core  
• 44.       Sperger, T., Araujo, A. C. F., & Soares, C. F. P. (2022). Effect of myofunctional therapy on snoring in obese patients: a randomized trial. Sleep Science, 15(4), 421–428. Effect of myofunctional therapy on snoring in obese patients: a randomized trial
• 45.       Stoohs, R. (2007). Widerstandssyndrom der oberen Atemwege. Deutsches Ärzteblatt, 104(12), 784–788. PDF – Psychiatrische Versorgung: Eingeschränkte Therapieoptionen – Deutsches Ärzteblatt
• 46.       Stuck, B. A., Arzt, M., Fietze, I., et al. (2020). S3-Leitlinie „Diagnostik und Therapie des Schnarchens des Erwachsenen“. Somnologie, 23(3), 178–208. https://register.awmf.org/assets/guidelines/017-068l_S3_Diagnostik_Therapie_Schnarchen_Erwachsene_2019-8-abgelaufen.pdf
• 47.       Stuck, B. A., et al. (2013). S2k-Leitlinie „Diagnostik und Therapie des Schnarchens des Erwachsenen“. HNO, 61(11), 944–957. https://doi.org/10.1007/s00106-013-2770-1
• 48.       Stuck, B. A., et al. (2002). Diagnostik und Therapie des primären Schnarchens. Deutsches Ärzteblatt, 99(11), 710–716 https://www.aerzteblatt.de/pdf.asp?id=30650
• 49.       Suzuki, H., Yoshimiura, M., Iwata, Y., Oguchi, S., Kawara, M., & Chow, C. M. (2017). Lip muscle training improves obstructive sleep apnea and objective sleep: a case report. Sleep Science, 10(3), 128–131. https://doi.org/10.5935/1984-0063.20170022
• 50.       Valko, P. O., Bassetti, C. L., Bloch, K. E., Held, U., & Baumann, C. R. (2008). Validation of the Fatigue Severity Scale in a Swiss Cohort. Sleep, 31(11), 1601–1607.Validation of the Fatigue Severity Scale in a Swiss Cohort
• 51.       Verbraecken, J., Dieltjens, M., Op de Beeck, S., Vroegop, A., Braem, M., Vanderveken, O., et al. (2022). Non-CPAP therapy for obstructive sleep apnoea. Breathe, 18(3), 220164. https://doi.org/10.1183/20734735.0164-2022
• 52.       Wang, W., Di, C., Mona, S., Wang, L., & Hans, M. (2018). Tongue Function: An Underrecognized Component in the Treatment of Obstructive Sleep Apnea. Canadian Respiratory Journal, 2157974.https://doi.org/10.1155/2018/2157974
• 53.       Zhang, F., Tian, Z., Shu, Y., Zou, B., Yao, H., Li, S., et al. (2022). Efficiency of oro-facial myofunctional therapy in treating obstructive sleep apnoea. Journal of Oral Rehabilitation, 49(7), 734–745. Efficiency of oro‐facial myofunctional therapy in treating obstructive sleep apnoea: A meta‐analysis of observational studies
• 54.       De Godoy, L. B. M., Luz, G. P., Palombini, L. O., et al. (2016). Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality. PLoS One, 11(5), e0156235.Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea
• 55.       R Core Team. (o. D.). R: A language and environment for statistical computing. https://www.R-project.org/
• 56.       Wang, L., et al. (2022). Time Under 90% Oxygen Saturation and Systemic Hypertension. Nature and Science of Sleep, 14, 2123–2132. Time Under 90% Oxygen Saturation and Systemic Hypertension in Patients | NSS | Dove Medical Press
• 57.       Gabryelska, A., et al. (2021). Nocturnal Oxygen Saturation Parameters as Independent Risk Factors for Type 2 Diabetes Mellitus. Journal of Clinical Medicine, 10(24), 3770.Nocturnal Oxygen Saturation Parameters as Independent Risk Factors for Type 2 Diabetes Mellitus among Obstructive Sleep Apnea Patients
• 58.       Jullian-Desayes, I., et al. (2016). Impact of obstructive sleep apnea on diabetic retinopathy. British Journal of Clinical Pharmacology, 82(1), 133–140. https://doi.org/10.1111/bcp.12920
• 59.       DIMDI. (2020). Amtliche ATC-Klassifikation mit DDD für 2020 veröffentlicht. 
• 60.       Stuck, B. A., & Maurer, J. T. (2017). Praxis der Schlafmedizin.https://doi.org/10.1007/978-3-662-54400-6  
• 61.       American Academy of Sleep Medicine. (2014a). International Classification of Sleep Disorders (3.Aufl.)
• 62.       American Academy of Sleep Medicine. (2014b). International Classification of Sleep Disorders, ICSD-3..International Classification of Sleep Disorders | ICSD | AASM
• 63.       Thieme via medici. (2024). Schnarchen und Tagesschäfrigkeit.via medici: leichter lernen – mehr verstehen  
• 64.       Baenkler, H.-W., et al. (2015). Kurzlehrbuch Innere Medizin. Thieme. Kurzlehrbuch Innere Medizin: jetzt bestellen im Thieme Webshop | 9783132200005
• 65.       HNO-Ärzte im Netz. (o. D.). Schnarchen & Schlafapnoe – Entstehung und Einteilung. Entstehung und Einteilung » Schnarchen & Schlafapnoe » Krankheiten » HNO-Ärzte-im-Netz »
• 66.       Mayer, G., Arzt, M., Braumann, B., et al. (2017). German S3 Guideline Nonrestorative Sleep/Sleep Disorders. Somnologie, 21(4), 290–301. https://doi.org/10.1007/s11818-017-0136-2
• 67.       McNicholas, W. T. (2017). Obstructive sleep apnoea of mild severity: should it be treated? Current Opinion in Pulmonary Medicine, 23(6), 506–511. . https://doi.org/10.1007/978-3-031-06413-5_3 
• 68.       Lehnert, H., Märker-Hermann, E., Marx, N., & Meyhöfer, S. M. (2020). DGIM Innere Medizin. Springer.https://doi.org/10.1007/978-3-642-54676-1
• 69.       Sleep Diagnostics. (2021). Berlin Questionnaire. https://www.med.upenn.edu/cbti/assets/user-content/documents/Berlin%20Questionnaire.pdf
• 70.       Epworth Sleepiness Scale. (2021). About the ESS About the ESS
• 71.       Chung, F., et al. (2008). STOP Questionnaire. Anesthesiology, 108(5), 812–821. https://doi.org/10.5664/jcsm.9820
• 72.       STOP-BANG. (o. D.). STOP-BANG Questionnaire Website The Official STOP-Bang Questionnaire Website
• 73.       Luo, J. (2014). STOP-Bang questionnaire is superior to Epworth sleepiness scales. Chinese Medical Journal, 127(17), 3065–3070. https://doi.org/10.3760/cma.j.issn.0366-6999.20140417
• 74.       IQVIA. (2017). Impact of digital health grows. IQVIA Institute for Human Data Science Study: Impact of Digital Health Grows as Innovation, Evidence and Adoption of Mobile Health Apps Accelerate  
• 75.       Bundesamt für Sicherheit in der Informationstechnik (BSI). (2021). Gesundheits-Apps. https://www.bsi.bund.de/SharedDocs/Downloads/DE/BSI/Publikationen/DVS-Berichte/gesundheitsapps.pdf?__blob=publicationFile&v=2 
• 76.       Baptista, P. M., et al. (2022). A systematic review of smartphone applications and devices for obstructive sleep apnea. Brazilian Journal of Otorhinolaryngology. https://doi.org/10.1016/j.bjorl.2022.01.004
• 77.       Xu, Z. F., et al. (2019). Quality analysis of smart phone sleep apps in China. BMC Medical Informatics and Decision Making, 19(1). https://doi.org/10.1186/s12911-019-0916-7
• 78.       Zaremba, S., et al. (2023). Amendment S3-Leitlinie Schlafbezogene Atmungsstörungen des Erwachsenen. DGSM. https://register.awmf.org/assets/guidelines/063_D_Ges_fuer_Schlafforschung_und_Schlafmedizin/063-001am_S3_SBAS_Amendment_2023-01.pdf  
• 79.       Goldstein, C., & Zee, P. C. (2010). Obstructive sleep apnea-hypopnea and incident stroke. AJRCCM, 182(10), 1332. https://doi.org/10.1164/ajrccm.182.10.1332
• 80.       Sawilowsky, S. S. (2009). New Effect Size Rules of Thumb. Journal of Modern Applied Statistical Methods, 8(2).New Effect Size Rules of Thumb
• 81.       Cistulli, P. A., & Sutherland, K. (2019). Phenotyping obstructive sleep apnoea—Bringing precision to oral appliance therapy. Journal of Oral Rehabilitation, 46(12), 1185–1191. https://doi.org/10.1111/joor.12857
• 82.       Heiser, C., et al. (2017). Selective upper airway stimulation for obstructive sleep apnea. European Archives of Oto-Rhino-Laryngology, 274(3), 1727–1734. https://doi.org/10.1007/s00405-016-4297-6
• 83.       Centers for Medicare & Medicaid Services. (2008). Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA). NCA – Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (CAG-00093R2) – Decision Memo  
• 84.       Rosenberg, R., et al. (2022). Test-retest reliability of the Epworth Sleepiness Scale in clinical trial settings. Journal of Sleep Research, 31(2), e13476. https://doi.org/10.1111/jsr.13476
• 85.       Patel, S., et al. (2018). The Epworth Sleepiness Scale: Minimum Clinically Important Difference in Obstructive Sleep Apnea. AJRCCM, 197(7), 961–963. The Epworth Sleepiness Scale: Minimum Clinically Important Difference in Obstructive Sleep Apnea
• 86.       Grewe, F. A., et al. (2020). Low repeatability of Epworth Sleepiness Scale after short intervals. Journal of Clinical Sleep Medicine, 16(5), 757–764. https://doi.org/10.5664/jcsm.8350
• 87.       Hinz, A., et al. (2017). Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index. Sleep Medicine, 30, 57–63. https://doi.org/10.1016/j.sleep.2016.03.008
• 88.       Bertolazi, A. N., et al. (2011). Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Medicine, 12(1), 70–75. https://doi.org/10.1016/j.sleep.2010.04.020
• 89.       Longo, U. G., et al. (2021). Minimal Clinically Important Difference and Patient Acceptable Symptom State for the PSQI. IJERPH, 18(16), 8666. https://doi.org/10.3390/ijerph18168666
• 90.       Hughes, C. M., et al. (2009). Acupuncture and reflexology for insomnia: a feasibility study. Acupuncture in Medicine, 27(4), 163–168. https://doi.org/10.1136/aim.2009.000760
• 91.       Saba, E. S., Kim, H., Huynh, P., & Jiang, N. (2024). Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Systematic Review. Laryngoscope, 134(1), 480–495. https://doi.org/10.1002/lary.30974
• 92.       Fietze, I., et al. (2021). Diagnostik und Therapie der residualen Tagesschläfrigkeit bei Patienten mit therapierter obstruktiver Schlafapnoe. Somnologie, 25, 99–109. https://doi.org/10.1007/s11818-021-00305-9
• 93.       Schlafzentrum Ruhrgebiet. (2024). Epworth-Test zur Tagesschläfrigkeit. Epworth-Test zur Tagesschläfrigkeit (Epworth Sleepiness Scale) – Schlafzentrum Ruhrgebiet  
• 94.       Carpenter, J. R., et al. (2013). Analysis of Longitudinal Trials with Protocol Deviation. Journal of Biopharmaceutical Statistics.Analysis of Longitudinal Trials with Protocol Deviation: A Framework for Relevant, Accessible Assumptions, and Inference via Multiple Imputation
• 95.       Schafer, J. L. (1997). Analysis of incomplete multivariate data. Chapman & Hall. Analysis of Incomplete Multivariate Data  
• 96.       Launois, S. H., et al. (2013). On treatment but still sleepy: cause and management of residual sleepiness. Current Opinion in Pulmonary Medicine, 19(6), 601–608. https://doi.org/10.1097/MCP.0b013e328365ab4a
• 97.       Millar, M., & Dillman, D. A. (2012). Encouraging survey response via smartphones. Survey Practice, 5(3). Encouraging Survey Response via Smartphones | Published in Survey Practice
• 98.       Brueton, V. C., et al. (2014). Strategies to improve retention in randomised trials: a Cochrane systematic review. BMJ Open, 4(2), e003821. https://doi.org/10.1136/bmjopen-2013-003821
• 99.       Dietrich, U., et al. (2010). Memorandum III „Methods for Health Services Research“. Medizinische Klinik, 105, 924–929. 
• 100.     Deutsche Forschungsgemeinschaft (DFG). (2013). Sicherung guter wissenschaftlicher Praxis. [ISBN: 978-3-527-33703-3]
• 101.     Hoffmann, W., et al. (2010). Jahresbericht der Deutschen Gesellschaft für Epidemiologie. https://www.dgepi.de/assets/Jahresberichte/Bericht2010bis2011.pdf
• 102.     Randerath, W., et al. (2018). Challenges and perspectives in obstructive sleep apnoea. European Respiratory Journal, 52(3). Challenges and perspectives in obstructive sleep apnoea: Report by an ad hoc working group of the Sleep Disordered Breathing Group of the European Respiratory Society and the European Sleep Research Society
• 103.     Abu Alheija, A., et al. (2025). Effects of orolingual myofunctional therapy on snoring – a randomized controlled trial. Acta Oto-Laryngologica, 145(9), 857–865.Effects of orolingual myofunctional therapy on snoring–a randomized controlled trial
• 104.     Baglioni, C., et al. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation. Journal of Affective Disorders, 135(1–3), 10–19. https://doi.org/10.1016/j.jad.2011.01.011
• 105.     Kroenke, K., et al. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
• 106.     Marzouqah, R., et al. (2023). Strengthening oropharyngeal muscles for post-stroke OSA: A feasibility RCT. Journal of Sleep Research, e14086.https://doi.org/10.1111/jsr.14086
• 107.     Sawyer, A. M., et al. (2011). A systematic review of CPAP adherence across age groups. Sleep Medicine Reviews, 15(6), 343–356. https://doi.org/10.1016/j.smrv.2011.01.003
• 108.     Siripajana, P., et al. (2024). Efficacy of oropharyngeal exercises as an adjuvant therapy for OSA. Journal of Prosthodontic Research. Efficacy of oropharyngeal exercises as an adjuvant therapy for obstructive sleep apnea: A randomized controlled trial
• 109.     Xu, Y., Yang, R., Yu, M., & Gao, X. (2025). Efficacy of myofunctional therapy for OSA: Network meta-analysis. The Journal of Evidence-Based Dental Practice, 25(1). https://doi.org/10.1016/j.jebdp.2025.102137
• 110.     Zhang, D., et al. (2021). Excessive daytime sleepiness in depression and OSA. Frontiers in Psychiatry, 12, 710435.Frontiers | Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom
• 111.     American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.).
• 112.     Berlin Questionnaire. (2021). Screening for obstructive sleep apnea. Sleep Diagnostics.Take the Berlin Questionnaire — National Sleep Diagnostics
• 113.     Berry, R. B., Brooks, R., Gamaldo, C., Harding, S. M., Lloyd, R. M., Quan, S. F., … & Vaughn, B. V. (2017). The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications (Version 2.4). American Academy of Sleep Medicine.
• 114.     Bertolazi, A. N., Fagondes, S. C., Hoff, L. S., Dartora, E. G., Miozzo, I. C., de Barba, M. E., & Barreto, S. S. (2011). Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Medicine, 12(1), 70–75. https://doi.org/10.1016/j.sleep.2010.04.020
• 115.     Centers for Medicare & Medicaid Services. (2008). Continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) (CAG-00093R2).
• 116.     Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., … & Shapiro, C. M. (2008). STOP questionnaire: A tool to screen patients for obstructive sleep apnea. Anesthesiology, 108(5), 812–821.https://doi.org/10.1097/ALN.0b013e31816d83e4
• 117.     Cistulli, P. A., & Sutherland, K. (2019). Phenotyping obstructive sleep apnoea—Bringing precision to oral appliance therapy. Journal of Oral Rehabilitation, 46(12), 1185–1191. https://doi.org/10.1111/joor.12845
• 118.     Epworth Sleepiness Scale. (2021). About the ESS.About the ESS
• 119.     Fietze, I., Blum, H. C., Grüger, H., Käßner, F., Maurer, J. T., Nilius, G., … & Arzt, M. (2021). Diagnostik und Therapie der residualen Tagesschläfrigkeit bei Patienten mit therapierter obstruktiver Schlafapnoe. Somnologie, 25(2), 99–109.https://doi.org/10.1007/s11818-021-00305-9
• 120.     Gabryelska, A., Sochal, M., Wasik, B., Turkiewicz, S., Ditmer, M., Karuga, M. S., … & Bialasiewicz, P. (2021). Nocturnal oxygen saturation parameters as independent risk factors for type 2 diabetes mellitus among obstructive sleep apnea patients. Journal of Clinical Medicine, 10(24), 3770. https://doi.org/10.3390/jcm10243770
• 121.     Goldstein, C., & Zee, P. C. (2010). Obstructive sleep apnea-hypopnea and incident stroke: The sleep heart health study. American Journal of Respiratory and Critical Care Medicine, 182(10), 1332. https://doi.org/10.1164/ajrccm.182.10.1332a
• 122.     Grewe, F. A., Roeder, M., Bradicich, M., Schwarz, E. I., Held, U., Thiel, S., … & Kohler, M. (2020). Low repeatability of Epworth Sleepiness Scale after short intervals in a sleep clinic population. Journal of Clinical Sleep Medicine, 16(5), 757–764.https://doi.org/10.5664/jcsm.8350
• 123.     Heinzer, R., Vat, S., Marques-Vidal, P., Marti-Soler, H., Andries, D., Tobback, N., … & Haba-Rubio, J. (2009). Prevalence and characteristics of positional sleep apnea in the HypnoLaus study. Sleep Medicine, 10(10), 1059–1064. https://doi.org/10.1016/j.sleep.2008.05.013
• 124.     Hinz, A., Glaesmer, H., Brähler, E., Löffler, M., Engel, C., Enzenbach, C., … & Sander, C. (2017). Sleep quality in the general population: Psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people. Sleep Medicine, 30, 57–63. https://doi.org/10.1016/j.sleep.2016.03.008
• 125.     Longo, U. G., Berton, A., De Salvatore, S., Piergentili, I., Casciani, E., Faldetta, A., … & Denaro, V. (2021). Minimal clinically important difference and patient acceptable symptom state for the Pittsburgh Sleep Quality Index in patients who underwent rotator cuff tear repair. International Journal of Environmental Research and Public Health, 18(16), 8666. https://doi.org/10.3390/ijerph18168666
• 126.     Luo, J. (2014). STOP-Bang questionnaire is superior to Epworth sleepiness scales, Berlin questionnaire, and STOP questionnaire in screening obstructive sleep apnea hypopnea syndrome patients. Chinese Medical Journal, 127(17), 3065–3070. https://doi.org/10.3760/cma.j.issn.0366-6999.20141196
• 127.     Patel, S., Kon, S. S. C., Nolan, C. M., Barker, R. E., Simonds, A. K., Morrell, M. J., & Man, W. D. (2018). The Epworth Sleepiness Scale: Minimum clinically important difference in obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 197(7), 961–963.The Epworth Sleepiness Scale: Minimum Clinically Important Difference in Obstructive Sleep Apnea
• 128.     Peter, J. H., Penzel, T., & Cassel, W. (Hrsg.). (2020). Enzyklopädie der Schlafmedizin. Springer.
• 129.     Penzel, T., et al. (2005). Themenheft 27: Schlafstörungen. Gesundheitsberichterstattung des Bundes. Robert Koch-Institut.
• 130.     Rosenberg, R., Babson, K., Menno, D., Morris, S., Baladi, M., Hyman, D., & Black, J. (2022). Test-retest reliability of the Epworth Sleepiness Scale in clinical trial settings. Journal of Sleep Research, 31(2), e13476. https://doi.org/10.1111/jsr.13476
• 131.     Schlafzentrum Ruhrgebiet. (2024). Epworth-Test zur Tagesschläfrigkeit.Epworth-Test zur Tagesschläfrigkeit (Epworth Sleepiness Scale) – Schlafzentrum Ruhrgebiet
• 132.     Sil, A., & Barr, G. (2012). Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea. The Journal of Laryngology & Otology, 126(4), 372–379. https://doi.org/10.1017/S002221511100318X
• 133.     Stuck, B. A., & Maurer, J. T. (2017). Praxis der Schlafmedizin. Springer.
• 134.     Wang, L., He, S., Cheng, J., Liu, H., Xu, H., & Yi, H. (2022). Time under 90% oxygen saturation and systemic hypertension in patients with obstructive sleep apnea syndrome. Nature and Science of Sleep, 14, 2123–2132. https://doi.org/10.2147/NSS.S387707
• 135.     Buysse, Daniel J., Lan Yu, Douglas E. Moul, Anne Germain, Angela Stover, Nathan E. Dodds, Kelly L. Johnston, Melissa A. Shablesky-Cade, Paul A. Pilkonis, Development and Validation of Patient-Reported Outcome Measures for Sleep Disturbance and Sleep-Related Impairments, Sleep, Volume 33, Issue 6, June 2010, Pages 781–792, Development and Validation of Patient-Reported Outcome Measures for Sleep Disturbance and Sleep-Related Impairments
• 136.     Jutta Backhaus, Klaus Junghanns, Andreas Broocks, Dieter Riemann, Fritz Hohagen, Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia, Journal of Psychosomatic Research, Volume 53, Issue 3, 2002, Pages 737-740, ISSN 0022-3999, https://doi.org/10.1016/S0022-3999(02)00330-6.
• 137.     Bernd Löwe, Kurt Kroenke, Wolfgang Herzog, Kerstin Gräfe, Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9), Journal of Affective Disorders, Volume 81, Issue 1, 2004, Pages 61-66, ISSN 0165-0327, https://doi.org/10.1016/S0165-0327(03)00198-8.
• 138.     Miles, J., & Shevlin, M. (2001). Applying Regression and Correlation: A Guide for Students and Researchers. Sage Publications.
• 139.     Castellanos, M. F. I., da Costa, J. L., Oliveira, L. M., de Oliveira, J., Zanatta, F. B., & Callegaro, C. C. (2026). Comparative effectiveness of CPAP and isolated or combined non-invasive therapies for obstructive sleep apnea: A network meta-analysis. Sleep Medicine. https://doi.org/10.1016/j.sleep.2026.108795
• 140.     Yalamanchali, S., Farajian, V., Hamilton, C., Pott, T. R., Samuelson, C. G., & Friedman, M. (2013). Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: A meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 139(12), 1343–1350. Diagnosis of Obstructive Sleep Apnea
• 141.     Collop, N. A., Tracy, S. L., Kapur, V., Mehra, R., Kuhlmann, D., Fleishman, S. A., & Ojile, J. M. (2011). Obstructive sleep apnea devices for out-of-center (OOC) testing: Technology evaluation. Journal of Clinical Sleep Medicine, 7(5), 531–548. https://doi.org/10.5664/jcsm.1328
• 142.     Patel, A. K., Reddy, V., Shumway, K. R., & Araujo, J. F. (2024). Physiology, Sleep Stages. In StatPearls. StatPearls Publishing. PMID: 30252388.
• 143.     Chow, S.-C., & Chang, M. (2008). Adaptive design methods in clinical trials – a review. Orphanet Journal of Rare Diseases, 3, 11. https://doi.org/10.1186/1750-1172-3-11
• 144.     von Hippel, P. T., & Bartlett, J. W. (2021). Maximum Likelihood Multiple Imputation: Faster Imputations and Consistent Standard Errors Without Posterior Draws. Statistical Science, 36(3), 400–420. https://doi.org/10.1214/20-STS793
• 145.     Zhang, Z., Sowho, M., Otvos, T., Sperandio, L. S., East, J., Sgambati, F., Schwartz, A., & Schneider, H. (2020). A comparison of automated and manual sleep staging and respiratory event recognition in a portable sleep diagnostic device with in-lab sleep study. Journal of Clinical Sleep Medicine, 16(4), 563–573. https://doi.org/10.5664/jcsm.8278    von Hippel, P. T., & Bartlett, J. W. (2021). Maximum Likelihood Multiple Imputation: Faster Imputations and Consistent Standard Errors Without Posterior Draws. Statistical Science, 36(3), 400–420. https://doi.org/10.1214/20-STS793
• 146.     Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006–1014. Increased Prevalence of Sleep-Disordered Breathing in Adults     von Hippel, P. T., & Bartlett, J. W. (2021). Maximum Likelihood Multiple Imputation: Faster Imputations and Consistent Standard Errors Without Posterior Draws. Statistical Science, 36(3), 400–420. https://doi.org/10.1214/20-STS793

Stand 2026-06-06