Sleep Care

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Surgery and Sleep Apnea

Have you or someone you’ve known undergone surgery successfully, only to experience respiratory or cardiovascular complications during recovery? In recent years, research has shown evidence that a number of serious post-operative complications can be linked to an undiagnosed sleep-related breathing disorder (SRBD), such as Obstructive Sleep Apnea (OSA). An unfortunate example comes from Barnes-Jewish Hospital, which became one of the first hospitals to screen surgery patients for OSA after a healthy woman successfully underwent a minor surgery, but later stopped breathing, went into a vegetative state, and eventually died. The hospital’s investigation of the incident indicated her death was likely due to undiagnosed sleep apnea. Back to the basics… What is sleep apnea? Sleep apnea is a common respiratory problem where sufferers stop breathing periodically during their sleep. Lapses in breathing can last anywhere from ten seconds to a minute or more, and the frequency of these events can span from dozens to hundreds of times in a single night. In severe cases, the person may feel even more tired upon awakening because their body is constantly struggling to arouse in an attempt to get enough oxygen. Apnea is nothing to take lightly – mounting evidence shows that the constant state of duress during sleep experienced by apneics can cause heart attacks, strokes, high blood pressure, and diabetes. Causes of the syndrome vary – obesity, airway abnormalities, and neurological disorders are a few common sources. Sleep Apnea & Surgery Anesthesia and pain medication used during, and after surgery, make up a dangerous cocktail for patients with an undiagnosed SRBD.

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Two common side effects of sedatives and medications that intensify the symptoms of sleep apnea are: Impaired muscle activity and drive to breathe; causing breathing to become slower, lighter and more erratic. Reduced ability to arouse from sleep, which is the body’s typical defense mechanism to the falling oxygen levels associated with apnea events and other sleep related breathing disorders. Individuals with apnea already have compromised or narrowed airways, so impaired muscle activity and respiratory drive brought on by sedatives makes apnea events longer and more frequent. Then to make matters worse, these people cannot awaken to re-establish muscle tension and combat falling oxygen levels. Why should you care? The real problem lies in the large portion of the US population with undiagnosed sleep apnea. If you have undiagnosed sleep apnea, it increases the risk of surgical complications as well as the likelihood

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that you may have to be re-admitted to the hospital or transferred to intensive care. The Good News Health care professionals are trained in preventative measures for patients undergoing surgery with known apnea – this in itself significantly reduces the risk of apnea related complications. In fact, a number of hospitals are beginning to acknowledge the seriousness of the matter and have begun taking a preventative approach by implementing pre-surgical OSA screening programs. What Can You Do? Considering surgery and suspect that you have sleep apnea? –Voice your concern to your doctor and notify healthcare staff during your pre-surgical consultation. Make arrangements with someone to check on you frequently the first few days post-surgery until sedatives and medications have had time to wear off. Small steps in prevention can be the deciding factor for a safe and speedy recovery.

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