SURGERY

Patients are encouraged to bring their CPAP from home for use during and after procedures involving sedation.

Breathe Easy

Surgical patients screened for obstructive sleep apnea

issue 18 | spring/summer 2013

Undiagnosed obstructive sleep apnea can be a major risk factor for airway collapse and related respiratory complications after surgery and procedures requiring sedation, according to U-M sleep neurologists and anesthesiologists.

Physicians should consider a patient's apnea risk when referring them for elective surgery or even procedures such as colonoscopy. A simple questionnaire, known as STOP BANG, can help assess risk and determine whether patients should have a more formal obstructive sleep apnea evaluation before surgery.

U-M screens elective surgery patients for obstructive sleep apnea. Patients who snore, are sleepy, have hypertension or have a large neck circumference may be at increased risk. Patients found to have a high risk of apnea are referred to U-M's Sleep Disorders Center for further assessment and treatment, including fitting with CPAP (continuous positive airway pressure) equipment for use before, during and after surgery.

Patients who use CPAP at home should be encouraged to bring the equipment with them to the hospital or procedure unit, because anesthesia can compromise breathing. Patients with apnea require special monitoring during operations and sedated procedures, and during the post-anesthesia period. U-M sleep neurologist Shelley Hershner, M.D., notes that undiagnosed patients' risk continues after discharge, especially if opioid analgesics have been prescribed for post-procedure pain.