Persistent snoring under conscious sedation during colonoscopy is a predictor of obstructive sleep apnea

Sharara, Ala I.; Zahabi, Lara El; Maasri, Karim; Hashash, Jana G.; Mansour, Nabil; Skoury, Assaad; Kanafani, Zeina A.; Bou‐Khalil, Pierre; Husari, Ahmad

doi:10.1016/j.gie.2009.11.049

Cited by 19 publications

(19 citation statements)

References 47 publications

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“…In the study by Sharara et al[9] all the patients investigated who snored during conscious sedation for their colonoscopy were diagnosed with OSA, with 70% of these found to have moderate to severe OSA. In our study, patients with snoring > 10 s were more likely to have a positive Berlin questionnaire.…”

Section: Discussionmentioning

confidence: 99%

“…In one study, patients in the high risk group on the Berlin questionnaire predicted a respiratory disturbance index of greater than 5 with a sensitivity of 86% and a specificity of 77% with a positive predictive value of 89%[8]. One study showed that of patients who snored greater than 10 s during their screening colonoscopies, all were noted to have OSA[9]. We sought to determine the prevalence of patients at risk for OSA and the feasibility of screening patients for sleep apnea presenting for a routine colonoscopy to our outpatient endoscopy facility.…”

Section: Introductionmentioning

confidence: 99%

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Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea

Harvin¹,

Ali²,

Raina³

et al. 2016

WJGE

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AIMTo discover the prevalence and the feasibility of screening for obstructive sleep apnea (OSA) in patients presenting for routine colonoscopy.METHODSAdult patients having a colonoscopy for routine indications at our outpatient endoscopy center were eligible if they did not carry a diagnosis of OSA or had not had a prior sleep study. All patients were administered the Berlin questionnaire prior to the procedure. Mallampati, neck circumference, height, weight, and BMI were obtained for each patient. Patients were observed for any drops in oxygen saturation < 92% or the presence of snoring for > 10 s. Patients were determined to be high-risk if they met at least 2 of the 3 symptom categories for the Berlin questionnaire.RESULTSA total of 60 patients were enrolled and completed the study; mean age was 56 years (range 23-72 year). Twenty-six patients had a positive Berlin questionnaire (43.3%), 31 patients had a negative Berlin questionnaire (51.6%) and 3 patients had an equivocal result (5.0%). Patients with a positive Berlin questionnaire were more likely to be of increased weight (mean 210.5 lbs vs mean 169.8 lbs, P = 0.003), increased BMI (33.0 kg/m2 vs 26.8 kg/m2, P = 0.0016), and have an increased neck circumference (38.4 cm vs 35.5 cm, P = 0.012). Patients with a positive Berlin questionnaire were more likely to have a drop in oxygen saturation < 92% (76.9% vs 36.4%, P = 0.01). Patients with snoring were more likely to have a positive Berlin questionnaire (8/9 patients vs 1/31 patients with negative Berlin questionnaire; P = 0.0045).CONCLUSIONRisk for OSA is extremely common in a population presenting for a routine colonoscopy, and screening at the time of a colonoscopy offers an excellent opportunity to identify these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea

Harvin¹,

Ali²,

Raina³

et al. 2016

WJGE

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“…In this study, nasal oxygen was not administered at sedation induction, 10 whereas, in contrast to the Khiani et al 11 study, all patients were given 2 L of nasal oxygen at procedure onset. In the latter study, there was a 10% rate of hypoxia in the high-risk group as defined by desaturation less than 92% compared with 7% in the low-risk group.…”

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confidence: 88%

Obstructive sleep apnea: can we gauge risk?

Pambianco

2010

Gastrointestinal Endoscopy

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“…Thus, OSA patients who already collapse their airways during "normal" sleep would likely be at increased risk of heightened airway collapsibility when normal sleep interacts with sedation/narcosis. In the gastrointestinal endoscopy literature, OSA has been diagnosed in patients who have been noted to snore during their sedation for outpatient colonscopy [43,44]. Some have advocated for the application of CPAP during preoxygenation and as an adjunct to sedation during regional anesthesia [45].…”

Section: The Role For Cpap During Sedation Remains Poorly Definedmentioning

confidence: 99%

Perioperative Implementation of Continuous Positive Airway Pressure: A Review of the Considerations

Karan

Black²,

Mouton³

2011

TOATJ

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OSA patients present unique challenges in the peri-operative period. They routinely require more monitoring, oxygen therapy, unplanned ICU admissions, longer hospital stays, and have more adverse events than healthy counterparts. Some data suggest that perioperative CPAP use is associated with reduced morbidity and mortality of patients with OSA, and yet its application remains inconsistent. This review aims to summarize existing literature on the peri-operative use of CPAP, identify barriers to its implementation, and begin defining an algorithm for the practical application of peri-operative CPAP.

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Persistent snoring under conscious sedation during colonoscopy is a predictor of obstructive sleep apnea

Cited by 19 publications

References 47 publications

Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea

Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea

Obstructive sleep apnea: can we gauge risk?

Perioperative Implementation of Continuous Positive Airway Pressure: A Review of the Considerations

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