Category Archives: Sleep Apnea

Unrecognized Sleep Apnea in the Surgical Patient: Conclusion

Should be avoided altogether in the postoperative setting for these patients due to their effects on the CNS and upper airway musculature. Likewise, the use of narcotics should be limited, and the use of alternative forms of analgesia, such as … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: Does the Diagnosis of OSA Influence the Decision Regarding the Appropriate Setting of Surgery?

These data all suggest that there may be some benefit to the use of CPAP in the perioperative setting for patients with suspected OSAS, although this remains to be proven. In patients with known OSAS, nasal CPAP therapy has been … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: How Beneficial Is Perioperative CPAP?

In general, surgery need not be delayed to allow for improvements in cognition and hemodynamics that accompany the long-term use of CPAP. This late effect may, however, be beneficial in certain settings, such as before major elective intraabdominal, intrathoracic, or … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: What Is the Best Perioperative Intervention for Suspected Cases of OSAS?

Of interest, RDI determined with the patient in the supine position was found to be high in patients with OSAS who were undergoing joint replacement even though they had a low preoperative RDI. This study suggests that the supine RDI … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: OSAS

Clinical suspicion for sleep apnea may also first be recognized intraoperatively if the patient has problems with the maintenance of the airway, proves difficult to intubate, or is observed postoperatively to be snoring and/or having obstructions. An airway obstruction that … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: What Is the Most Reliable Tool To Assess OSAS in the Perioperative Setting?

In contrasting literature, Ghamande and col-leagues performed a retrospective study of patients undergoing cardiopulmonary bypass grafting and did not show any correlation between polysomnography variables such as the AHI, the lowest absolute oxygen saturation and the percentage sleep time spent … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: Is OSAS an Independent Risk Factor for Perioperative Complications?

The problem in addressing the relative impact of OSAS on perioperative outcomes is further hindered by the difficulty in diagnosing OSAS. The diagnosis can be elusive as the symptomatology of sleep apnea may be difficult to distinguish from normal variations … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: Study

The effect of sleep deprivation on upper airway muscle function is of equal concern. A lower threshold for upper airway collapse, presumably due to reduced genioglossus muscle activity, has been reported following complete sleep deprivation for 1 night. In addition, … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: How Can OSAS Affect Perioperative Outcomes?

REM rebound has been suggested to contribute to hemodynamic instability, myocardial ischemia and infarction, stroke, mental confusion, and wound breakdown. In REM sleep, the neural drive to the pharyngeal muscles is at a minimum, and the atonia of antigravity muscles … Continue reading

Unrecognized Sleep Apnea in the Surgical Patient: Methods

In most patients, REM sleep subsequently reappears with increased density and duration, and REM-associated hypoxemic episodes increase about threefold on the second and third postoperative nights compared with the night before surgery.” Sleep studies” performed in patients undergoing major abdominal … Continue reading