Proportion of surgical patients with undiagnosed obstructive sleep apnoea

Abstract

We found that anaesthetists and surgeons failed to identify a significant number of patients with pre-existing OSA and symptomatic undiagnosed OSA, before operation. This study may provide an impetus for more diligent case finding of OSA before operation.

Implementing an educational program to increase preoperative screening for obstructive sleep apnea using the stop-bang questionnaire

“…OSA is defined by a pause in breathing that lasts at least 10 seconds and a decrease in oxygen saturation by 4% from the patient's baseline oxygen saturation (Henrichs & Walsh, 2012;Mehta et al, 2014;Singh et al, 2013). The obstructive breathing pattern characteristic of OSA occurs when the muscles that typically support an open airway during sleep, relax in tone causing the airway to collapse and airflow to decrease or cease altogether (Henrichs & Walsh, 2012).…”

“…The obstructive breathing pattern characteristic of OSA occurs when the muscles that typically support an open airway during sleep, relax in tone causing the airway to collapse and airflow to decrease or cease altogether (Henrichs & Walsh, 2012). OSA is a potentially fatal disease process and has been independently associated with higher rates of morbidity and mortality as well as increased perioperative complications, including a higher incidence of difficult intubation, obstructive breathing, postoperative complications, and increased length of hospital stays (Mehta et al, 2014; Singh et al, 2013). A recent meta-analysis found that OSA was associated with a higher risk of postoperative cardiac events, respiratory failure, and intensive care unit (ICU) admission (Kaw et al, 2012).…”

“…Additionally, rapid eye movement (REM) sleep is greatly diminished if not completely absent the first night following surgery and then rebounds in the following 48 hours, subjecting the patient to increased hypoxemic obstructive episodes during this period (Vasu et al, 2010). Patients with moderate-to-severe OSA experience an adjusted hazard ratio for all-cause mortality that is three to six times higher than those without OSA (Singh et al, 2013). OSA prevalence ranges from 9% to 24% in the general population based on numerous epidemiological studies (Singh et al, 2013).…”

“…Patients with moderate-to-severe OSA experience an adjusted hazard ratio for all-cause mortality that is three to six times higher than those without OSA (Singh et al, 2013). OSA prevalence ranges from 9% to 24% in the general population based on numerous epidemiological studies (Singh et al, 2013). It is estimated that more than 18 million Americans suffer from OSA.…”

“…It is estimated that more than 18 million Americans suffer from OSA. More than 92% of women and 82% of men who suffer from moderate to severe sleep apnea are undiagnosed (Henrichs & Walsh, 2012;Mehta et al, 2014;Singh et al, 2013). The prevalence of OSA in surgical candidates is higher than the general population, and varies by surgery type, with the highest prevalence in patients presenting for bariatric surgery Singh et al, 2013).…”