Sleep Apnea and Surgery: What You Need to Know - By: Patricia Woloch

Do you wake up in the morning feeling as if you haven't slept at all? Are you cranky, irritable, or depressed? Do you find yourself dozing off during movies or while performing routine tasks, including driving? Are you suddenly having difficulty with short-term memory or complex cognitive tasks?

If any of these are the case, you may have sleep apnea, and if even minor surgery is in your future, you need to determine whether you have sleep apnea or you could be putting your life at risk.

What Is Sleep Apnea?

Sleep apnea is a common condition in which breathing stops during sleep. As your body realizes it is suffocating, it wakens partially, which restores airflow, but disrupts sleep. Both parts of sleep apnea are harmful--reduced oxygen supply can lead to high blood pressure and increased risk of heart failure as the heart tries to compensate for low oxygen saturation. Sleep disruption decreases the amount of rest a person receives, reducing the level of rest a person receives during sleep.

Sleep Apnea Surgical Risks

According to studies, surgical patients with sleep apnea face highly increased risks. These risks are described as being periopoerative, meaning that they occur not only during surgery, but also following surgery and throughout recovery.

Surgical Risks include
• Difficulty in mask ventilation tracheal intubation, or laryngoscopic view
• Adverse response to anesthesia including apneic events where the waking response is inhibited, which can lead to dangerously low oxygen levels

Immediate Postsurgical Risks include
• Low blood oxygen levels
• High or low blood pressure
• Irregular heartbeat
• Pneumonia
• Collapsed lung
• Mental confusion
• Wound breakdown
• Oxygen starvation of the heart
• Stroke
• Death
• Brain damage

Recovery Period Risks include
• Shortness of breath
• Chest pain
• Abnormal post-surgical chest x-ray
• Transfer to ICU
• Necessity of mechanical ventilation
• Cardiac arrest
• Congestive heart failure
• Coma
• Death

In all, people with untreated sleep apnea have double the risk of perioperative complications and triple the risk of serious complications. And patients with untreated sleep apnea have, on average, 33 % longer hospital stays than other patients.

Get Tested

Although the rate for sleep apnea in the general population is only 2-4 %, studies found that as many as 19 % of the adult surgical population suffer from sleep apnea. The increase is due to the serious health complications resulting from sleep apnea, making sufferers disproportionately represented in the surgical population. Although many hospitals now pre-screen all surgical patients for sleep apnea, the screening tools are cursory and may not catch you. If you suffer from any of the symptoms of sleep apnea, such as daytime sleepiness, wake feeling poorly rested, experience excessive moodiness, or have difficulty with memory or cognitive tasks, you should consider being screened for sleep apnea before any surgery.

About the Author

For a comprehensive consultation on sleep apnea and its risks, contact Dr. Ira L. Shapira at the Chicago-area Snoring and Sleep Apnea Treatment Center.

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