Sleep Apnea Screening is Necessary Before Surgery

For patients undergoing surgery, unidentified Obstructive Sleep Apnea is associated with increased risk of complications. Untreated sleep apnea patients are at greater risk of cardiovascular disease, type II diabetes, and premature death. During October 16-20, 2010 the annual meeting of the American Society of Anesthesiologists two similar studies were presented regarding screening presurgical patients for sleep apnea. The patients who screened positive for sleep apnea could be definitively diagnosed and treated and/or monitored more carefully during their time in surgical care.

One study used a comprehensive home sleep study or a full in-laboratory study. 819 patients were enrolled and a stunning 536 patients, 2/3 of the total (65.4%) tested positive for sleep apnea. Of these 85.5% of the patients with severe sleep apnea were not identified by the surgeons and 47% of the severe sleep apnea patients were not identified by the anesthesiologists based on clinical assessment alone.

In a second study a questionnaire followed by an overnight oxygen recorder screened for possible sleep apnea. Although this protocol did not diagnose sleep apnea, it identified patients at greater risk for sleep apnea and therefore at greater risk for surgical complications. 367 patients patients completed the study. It was concluded that simply performing the questionnaire followed by the overnight oxygen overnight screening test identified greater than 90% of the cases of sleep apnea.

The doctors could send the patients for full diagnostic sleep testing to reduce the surgical risks.

In our practice we routinely evaluate and treat patients before surgery. Since surgery often requires a specific time frame, we work closely with the surgical team, cardiology team, or other procedural team to integrate with their surgical schedules. As a result our services are often requested to assist patients in pre-operative evaluation. We use comprehensive questionnaires, home screening tests when appropriate, and state of the art full diagnostic sleep testing to assess patients

When speaking with your surgeon, cardiologist, or other physician prior to a surgery or significant procedure, ask for a referral to  Sleep Medicine for a pre-operative assessment for Obstructive sleep apnea.

Darius Zoroufy