Download Obstructive Sleep Apnea (OSA)

Obstructive Sleep Apnea (OSA)
and Surgery: What are the Risks?
PATIENT IDENTIFICATION
What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) is a common sleep
disorder. With OSA, breathing pauses during sleep
due to a blocked airway. The pause in breathing is
called ‘apnea’ or an ‘apneic spell’.
People with OSA often have apneic spells that last
more than 10 seconds. They may have as many as
20-60 events every hour. This causes them to lose
oxygen. Their brain awakens their body so they can
start breathing again.
Normal airway
What causes OSA?
There are several possible causes of OSA:
• Muscles of the throat and tongue relax during
sleep
• Born with a narrow airway, short lower jaw, or
large tongue
• Overweight: extra fat around the airway causes it
to close off
• Enlarged tonsils or adenoids
What are the signs of OSA?
• Snoring
• Apnea or gasping while sleeping (often noticed by
sleep partner)
• Waking up often during sleep
• Daytime sleepiness
Airway in a person with sleep apnea
Is OSA harmful to my health?
Who is at risk for OSA?
There are many health risks that may result from
untreated OSA. Some of them include:
You are at risk for OSA if you:
• High blood pressure
• Are overweight
• Heart Attack
• Have high blood pressure
• Stroke
• Are male
• Irregular heart beat (arrhythmia)
• Are over 50 years old
• Coronary artery disease
• Are male with a neck size of 17 inches or more
• Car crashes (from falling asleep while driving)
• Are female with a neck size of 16 inches or more
• Increased risk after surgery
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Are there other treatment options?
Other forms of treatment depend on the cause and
have varying degrees of success. These include:
• A dental device to keep jaw forward during sleep
• Nasal valves to slow the out-breath to increase
pressure in the throat (and perhaps keep it open)
Loud snoring is a classic sign of OSA
How is OSA Diagnosed?
There are two screening tools that are used to see if
you might have OSA. STOP-BANG checks for signs
and risk factors as discussed earlier (overweight, high
blood pressure, etc.). The Epworth Sleepiness Scale
looks at your level of daytime sleepiness.
If you are found to be at high risk for OSA, your
provider will refer you to a sleep center for a sleep
study. During a sleep study, various tests are done
while you sleep. These tests look at the following:
• Brain waves
• Breathing effort
• Surgery (used with severe OSA) to correct
problems with face structures (rare and only when
other treatments have not helped)
How does having OSA increase my risk
after surgery?
Anesthesia and pain medications sedate you and relax
your airway muscles. The effects of anesthesia can
linger for a day or so after surgery. Combine that with
pain medications, and you are likely to have more and
longer apneic spells. If left unchecked, these can lead
to serious health problems and even death.
During surgery and recovery, you are constantly being
watched. However, after you go to your hospital room
or home (with a Same Day Surgery), you are not being
watched all the time. This is the time when you are
most at risk following surgery.
• Oxygen levels
How can I decrease my surgery risk if I
have OSA?
• How the above results vary based on body position
and stage of sleep.
1. Primary care providers (PCP) screen for OSA.
• Air flow through the nose and mouth
What is the treatment for OSA?
The goal of treatment for OSA is to keep the airway
open so breathing does not stop during sleep. The
most common and effective treatment for OSA is
Continuous Positive Airway Pressure (CPAP).
With CPAP, air is constantly blown into the airway
by a pump and tight-fitting face mask. Although it
takes some getting used to, most people adjust to it,
especially after getting better sleep.
Is there anything I can do myself to
help treat OSA or reduce my risk?
Here is how we help decrease your risk with surgery:
2. If you are found to be at risk for OSA, you are
referred to a sleep center to have a sleep study
done. Ideally this will be done before your surgery.
3. If you are diagnosed with OSA, you will be fitted
with a CPAP mask and machine to use whenever
you are asleep.
4. You will be asked to bring in your mask and
machine for use while you are in the hospital.
5. You will be monitored carefully during your stay.
When you are discharged, you will be reminded to
use your CPAP machine whenever you are asleep.
Lifestyle changes may help mild OSA:
• Weight loss
• Not sleeping on your back
• Avoiding alcohol and sedatives
6245PH 12/2012
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