On any given night, due to a blockage, people with obstructive sleep apnea (OSA) can stop breathing from a few seconds to minutes, and at a rate of 5 to over 30 times per hour. Unfortunately, many of these individuals go about their daily lives not even realizing that they have this condition. Currently, it is estimated that this statistic might be at the 80 percent mark. If an unwitting sufferer needs surgery, screening for sleep apnea is extremely important. If not properly diagnosed, sleep apnea can place the individual at a higher risk for a variety of complications prior, during and post-surgery.
The concern is with merit as surgical complications for sleep apnea sufferers have been on the rise over the last several years. As a result, the Joint Commission (organization that accredits health care organizations in the United States) has recommended that the reduction of surgical complications among sleep apnea patients be added as a National Patient Safety Goal.
Anesthesia used during surgery can decrease respiration, and when sleep apnea is present, the effects are more significant. In addition, patients with diagnosed, but more so, undiagnosed sleep apnea present a special risk when it comes to pain control upon discharge. Pain medication, such as narcotics, can also lead to a decrease in respiration and might even trigger, though rare, sudden cardiac arrest. Another factor that should not be ignored is that undiagnosed and untreated sleep apnea places the individual at a higher risk for life-threatening illnesses such as high blood pressure, heart disease, type 2 diabetes and stroke. These conditions also place them as a high risk for surgery.
The proper management of surgical patients with sleep apnea is important to American Society of Anesthesiologists (ASA) and American Academy of Sleep Medicine (AASM). It prompted the organizations to develop clinical best practices and guidelines in order to decrease the incidence of complications, which include cautious use of medications and monitoring of upper airway obstruction.
“Screening for sleep apnea prior to surgery is important so that potential complications post operatively and in the home recovery period can be eliminated,” said Jeffrey L. Silveira, MD, Founder and Chief Executive Officer of Sleep Apnea Treatment Centers of America (SATCOA).
Screening for Sleep Apnea: How and When
Screening for sleep apnea before surgery can be accomplished in a physician’s office with a diagnostic tool known as STOP-Bang questionnaire. The STOP stands for the following:
- S: Snoring
- T: Tiredness during the daytime
- O: Observed apnea, i.e. pauses in breathing
- P: Pressure (high blood pressure)
- B: Body mass index (BMI)
- A: Age
- N: Neck circumference
- G: Gender
If the patient positively responds to three or more questions, sleep apnea is present at a high probability and would need further testing for an accurate diagnosis. Nevertheless, this questionnaire can easily be added into routine pre-screening protocol for physicians and surgeons in their offices.
If you have trouble sleeping or think you have sleep apnea, please contact one of our medical concierges today at 1-855-863-4537 to schedule a free consultation.
