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.

bookmark

Three Types of Sleep Apnea

The three types of sleep apneas are central sleep apnea (CSA), obstructive sleep apnea (OSA), and mixed sleep apnea (a combination of the two).

During sleep, the brain instructs the muscles of breathing to take a breath. Central sleep apnea occurs when the brain does not send the signal to the muscle to take a breath, and there is no muscular effort to take a breath. Obstructive sleep apnea occurs when the brain sends the signal to the muscles and the muscles make an effort to take a breath but are unsuccessful because the airway becomes obstructed and prevents the flow of air. The third type of sleep apnea, mixed sleep apnea, occurs when there is both central and obstructive sleep apnea.

CSA and its Causes

CSA occurs when the brain does not send the signal to the muscles of breathing. This type of apnea usually occurs in infants or adults with heart disease, cerebrovascular disease, or congenital diseases, but CSA can also be caused by some medications and high altitudes.

CSA, when occurring in premature infants, is defined as apnea lasting more than 20 seconds, usually with a change in heart rate, a reduction in blood oxygen, or hypotonia (a general relaxation of the body’s muscles). CSA is not the same thing as sudden infant death syndrome (SIDS).

OSA

People with obstructive sleep apnea have an airway that is more narrow than normal, usually at the base of the tongue and palate. When lying flat, the palate is above the air passage. When the pharyngeal muscles relax, the palate can fall backwards obstructing the airway. Patients with OSA often do not report waking up during the night.OSA can cause the following medical problems (just to name a few):

· High blood pressure

· Heart problems

· Weight gain

· Constant tiredness

· Diabetes

· Slow metabolism

· Memory/concentration problems

· Depression

· Anxiety

· Sore throat

· Dry mouth

bookmark