How to Tell Before Surgery If You Have Sleep Apnea
For people with obstructive sleep apnea—a condition in which people stop breathing briefly while asleep—surgery can be risky. Those with apnea have a greater chance of problems such as postoperative complications, difficult intubation, admission to the intensive care unit, and a longer hospital stay. But a new tool called STOP, which consists of a series of yes-or-no questions, may help people figure out if they're at risk—and encourage them to seek treatment before going under the knife.
Between 2 and 26 percent of the population has sleep apnea, according to widely disparate estimates. About 80 percent of men and 93 percent of women with moderate-to-severe conditions don't know they have the disorder, says a study published this week, which appears in the May issue of Anesthesiology. Diagnosing sleep apnea typically involves undergoing an overnight sleep study in a laboratory, although a home test for sleep apnea may be on the horizon.
Because so many people are unaware they have sleep apnea, the new list of questions may prove valuable, says Frances Chung, a professor at the University of Toronto's University Health Network and lead author of the study that recommends the STOP questionnaire. (Chung also answered a few questions about why apnea increases surgical risk and what you can do about it.)
The STOP questionnaire consists of the following questions; if people answer yes to two or more of them, a medical evaluation for obstructive sleep apnea may be warranted prior to surgery, Chung says.
S: Do you snore loudly?
T: Do you often feel tired, fatigued, or sleepy during the daytime?
O: Has anyone observed you stop breathing during sleep?
P: Do you have or are you being treated for high blood pressure?
While having sleep apnea may prove risky when having surgery for other reasons, a surgical procedure, ironically, is sometimes used to treat the condition. The treatment procedure used in children with sleep apnea, however, only works for some kids.
Reader Comments
surgery
Septoplasty and turbinate reduction to straighten the nasal septum and reduce the turbinates does eliminate one of 4 areas that can lead to upper airway obstruction and obstructive sleep apnea. It probably won't eliminate your sleep apnea alone, and it's hard to say if it will change your voice. I have not had a patient after this surgery that had a significant voice change.
Two great sleep solutions.
I have been a snorer for a long time. As I got older, my snoring has gotten more frequent and louder. I also noticed I was tired a lot and liked to take naps during the day. People complained about my snoring and I could not sleep in the same room with other people for fear of keeping them awake.
Finally, I asked my doctor about the problem. He sent me home with a machine to check my breating and pulse while I slept. The results really shocked me! The doc said my airway was closing off up to 70 times each hour, and that I stopped breathing for as long as one full minute at a time! I had severe apnea. He strongly recommended I start using the CPAP machine, since I was risking damage to my heart due to lack of oxygen.
I had read about CPAP machines before and always thought I would never be able to sleep with one, since I am somewhat claustrophobic. Surprisingly, it only took me a few minutes to get used to, and I was able to sleep comfortably from the very beginning with no problem.
The mask portion is just a small apparatus that fits on the nostrils to blow in air that keeps the throat inflated, thus preventing any snoring. Straps over the head are a little annoying, but they are necessary to keep the nose piece in place. If one changes sleeping positions at night, it’s possible for these straps to move, causing the nose piece to slip off.
I have been using a Dreamhelmet, a combination sleep mask sound-muffling pillow for years now, for sleeping at night and for napping during the day. I always find it hard to sleep without the Dreamhelmet, and I was afraid I would not be able to use it with the CPAP mask, but I was wrong about that too.
After I slept with the CPAP machine and mask for a short while, I tried wearing the Dreamhelmet over the CPAP, covering up the straps – voila, it worked like a charm! I found that the Dreamhelmet actually helps keep the straps in place when I change positions, so now I can sleep all night in comfort, not being bothered by sound, light, or changing positions. The CPAP and the Dreamhelmet are the perfect sleeping combination for me.
I now wake up rested, and I have energy that lasts all day long. I don’t feel so run down all the time or feel like I need an afternoon nap, but I still carry an extra Dreamhelmet in the car with me just in case I do need a nap.
SURGERY
Will the nasal part of the surgery help with obstructed airways and change a very nasal sounding voice?
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