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Surgery

Sleep Apnea and Surgery

What Is It?

Obstructive sleep apnea is a condition that causes the soft tissue in the rear of the throat to narrow and repeatedly close during sleep. The brain responds to each of these “apnea events” by waking the person in order to resume breathing. Since apnea events can happen hundreds of times per night, sleep becomes broken and ineffective.

Could I Have Obstructive Sleep Apnea?

Obstructive sleep apnea affects 18 million people and is more common among overweight males over age 40. But it has been known to affect otherwise healthy men, women and children of any age group. If you are frequently tired upon waking and throughout the day or if you have trouble staying asleep at night, ask yourself these questions:

  • Have I been told that I snore or stop breathing during sleep?
  • Do I wake up throughout the night or constantly turn from side to side?
  • Have I been told that my legs or arms jerk while I’m sleeping?
  • Do I make abrupt snorting noises during sleep?
  • Do I feel tired or fall asleep during the day?
  • Do I still feel unrested after sleeping?

If you answered “Yes” to any or all of these questions, you could have sleep apnea, and it is important that you discuss such symptoms with your doctor.

Should I worry about sleep apnea?

When you stop breathing or breathe very slowly during your sleep, it may result in less oxygen in your blood. Over time, this lack of oxygen can lead to serious health problems. If you have sleep apnea, you may be more likely to get high blood pressure (hypertension), high blood pressure in your lungs (pulmonary hypertension), abnormal heart rate, heart attack, heart failure and stroke.

If you have sleep apnea, you may have difficulty concentrating and feel tired throughout the day. You may fall asleep during a conversation or while you are driving or working. You are also at higher risk for depression.

How is sleep apnea diagnosed?

If your doctor thinks that you may have sleep apnea, he or she may suggest a sleep study. Sleep studies find out how often you stop breathing or have slower breathing and how much oxygen you have in your blood during sleep. You may also have blood tests and X-rays. Sleep studies are usually performed through the Sleep Medicine Department at Kaiser Permanente Santa Rosa on an outpatient basis.

How is sleep apnea treated?

If you have mild sleep apnea, you may be able to treat it on your own by losing weight, developing good sleep habits, and avoiding alcohol and certain medicines before bed. If you have moderate to severe sleep apnea, you may need to use a breathing device (continuous positive airway pressure CPAP) that prevents your airway from closing during sleep. If CPAP does not work, or if large tissues are blocking your airway, you may need surgery.

Dangers During Surgery

If you do have obstructive sleep apnea and you are in need of surgery, your chances of complications are remote – but please discuss your symptoms with your doctor before the surgery! If your physician suspects that you have sleep apnea, precautions can be taken before, during and after your surgery, and this will help to minimize the possibility of complications from sleep apnea that might occur from anesthesia and surgery. There are many factors during the time of surgery which may make sleep apnea more of a problem. Some of these include the disruption of normal sleep patterns around the time of surgery, residual effects of anesthetics and the sedating effects from postoperative pain medications. Sleep apnea may even get worse for a period of time after surgery making it safer to keep some patients in the hospital overnight for otherwise outpatient procedures. This is especially true for patients with untreated known or suspected moderate to severe sleep apnea. In some cases it may be safer to postpone elective surgeries, in order to allow time for definitive sleep apnea testing and initiation of treatment, prior to surgery.

After Surgery – Now What?

If your doctor has determined that you may have undiagnosed sleep apnea, they will assist you in getting an appointment with the Kaiser Permanente Santa Rosa Sleep Lab for testing and treatment. If you have been admitted overnight for sleep apnea precautions following your surgery and you have not been tested, your doctor will try to have an appointment made for you in the Sleep Clinic prior to discharge.