According to the American Sleep Association, millions of Americans have sleep apnea. Sleep apnea increases your risk for more serious health conditions such as high blood pressure and heart problems.
A recent US News Health article has shed light on another adverse effect of sleep apnea–greater risk for surgery-related complications. The article reported the findings of a recent study that suggests screening and treatment of obstructive sleep apnea prior to surgery could reduce a patient’s risk of cardiovascular complications after surgery by more than half.
Researchers conducted a study to demonstrate the effectiveness of continuous positive airway pressure (CPAP) therapy on reducing the risk of post-surgical complications associated with sleep apnea. CPAP therapy keeps the airways open by delivering a steady stream of air through a face mask. The study involved more than 4,000 patients who were diagnosed with sleep apnea before or after surgery, as well as a group of patients without sleep apnea. The sleep apnea patients that were diagnosed before surgery received CPAP therapy.
The study found that the patients who were not treated before surgery had a greater risk for cardiovascular complications such as cardiac arrest or shock. The patients who received treatment prior to surgery had less than half the likelihood of developing the same complications. Researchers also found that the sleep apnea patients were more likely to experience surgery-related respiratory issues than the patients without sleep apnea, despite receiving CPAP therapy.
General anesthesia can also pose a problem for a surgical patient with sleep apnea, according to the American Sleep Apnea Association (ASAA). Sleep apnea occurs when the airways collapse or become obstructed during sleep. This collapse or obstruction occurs in the upper airways.
General anesthesia suppresses the upper airways, which can cause the airways to close entirely. This may increase the frequency of sleep apnea episodes and lower oxygen arterial oxygen levels. Anesthesia also prevents arousals that occur during normal sleep.
The ASAA recommends extensive monitoring of sleep apnea patients before, during and after surgery. Post-surgical patients with sleep apnea should be monitored much longer than post-op patients without sleep apnea to ensure their breathing will not be obstructed. Physicians should also exercise proper judgment when prescribing pre-operative sedatives because these medications also suppress upper airway muscles.
If you plan to have surgery and have been diagnosed with sleep apnea, or you think you may have sleep apnea, do not hesitate to tell your doctor. It is important to let your doctor know if you have sleep apnea or any other health condition so he can do what is necessary to make your surgery goes as smooth as possible.
By Ramie A Tritt, MD, President, Atlanta ENT
