Why Apnea Is a Surgical Risk—and What to Do About It
U.S. News asked Frances Chung, a professor at the University of Toronto's University Health Network, about the surgery-associated risks tied to sleep apnea. Chung was the lead author of a new study that offers a tool to help diagnose sleep apnea. Excerpts:
What is it about sleep apnea that poses a problem during surgery?
There are two components to it. Obstructive sleep apnea in general is an issue for a lot of patients, and it is underdiagnosed. And these patients are more difficult to manage in terms of anesthesia. It may be the morphine afterwards for some of them. These patients are much more sensitive to pain medications.
Do doctors, clinics, and hospitals usually screen patients for sleep apnea prior to surgery?
It's not a routine. That's why what we are doing is important. That is why we actually came up with this STOP tool. People are aware that there is an issue and there is a need, and we've come up with a simple tool which anybody can use.
Do complications typically occur during or after surgery?
Complications are less likely during the surgery itself because the anesthesiologist is there, and we make sure the patient is breathing OK. Most of the risk for surgery is actually afterwards. During surgery, we are with the patient, so if anything happens, we are there to treat them. But afterwards patients are by themselves, with nurses and doctors checking on them but not there constantly.
What can be done to reduce the risk of complications?
If you know you have sleep apnea, most of the time you would've seen a sleep specialist, who would recommend treatment. If it's very mild sleep apnea, you probably don't need treatment. But those with more severe sleep apnea need CPAP [continuous positive airway pressure] treatment. These patients usually wear a CPAP machine while sleeping. It expands the airway so that when you sleep, your airway doesn't get obstructed.
So if you're coming for surgery and you have mild sleep apnea, you probably don't have anything to worry about. But if you have a CPAP machine, the anesthesiologist will usually put you back on the CPAP machine after surgery. And we take additional precautions after surgery.
Is it ever unsafe to have surgery if you have sleep apnea, perhaps if you're planning cosmetic surgery or another elective procedure?
I think the risk is really low. What we are saying is that we should screen for sleep apnea, and then we'll take the proper precautions.
Reader Comments
Sleep Apnea
I have Sleep Apnea plus sinus condition. I have a C-Pap machine and have trieds 1/2 a dozen masks, which not only wake me up but also my wife. I believe that I get as much sleep without tha mask as I do with it. I like to know about surgery procedures. I was told that the soft palate is what closes the airways, also the back part of the tongue as it rolls back during sleep. I went to a Ear, Nose Dr. that said there was a way of cautherizing the inside of the back of the tongue, which will prevent the tongue from rolling back, and also a partial removal of the offending soft palate. Unfortunately, I had to move before I could find more about this procedure. I would appreciate any medical information concerning those procedures. Thank you.
Sincerely,........Desperate!
apnea tips froma CPAP user
Tips from a long-time sleep apnea patient:
1-even if you are only able to sleep with the CPAP mask on 2 hours a night, that is better than zero hours and it affects your long-term health;
2- if the first, second and third masks tou try don't work, keep trying until you find the one that you can sleep in, and even that one may take many nights of on & off before you start making it all night with the mask intact.;
3- every couple of months, get online and look for new products like masks, etc., to make it easier to comply. On Ebay you can find a company who makes headgear covers to keep the mask marks off your face and make the mask a little more comfortable;
4-try using refrigersted water in your humidifier if you feel like the air is too thick to breathe. Most people use heat with their humidifiers but for me, refrigerating the water made a HUGE difference, and so did using nasal gel to keep my nose from drying out and burning.
5-Make your own creative adjustments if they help. For example, I am now on a nasal mask with an attached chinstrap. The chinstrap hurt until I put a thin piece of cotton cloth over it. I got smalll sores under each nostril until I found out that putting a piece of medical gauze under my nose was comfortable and prevented irritation. The smallest things make the biggest difference!!!!
sleep apnea
in my opinion its very good and informative article as i m not aware of this disease and today i came to know about it.
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