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Sleep Apnea and Anesthesia: a Safe Combination?

If you need to undergo surgery and have a sleeping disorder, it is important to discuss this with your doctor as the combination of sleep apnea and anesthesia raises the risk of complications during and after surgery.



The problem with sleep apnea and anesthesia is related to the sedative effect that anesthesia has on the body and its functions such as breathing, which can cause potentially serious problems for those whose breathing is already restricted due to obstructive sleep apnea.

The problems with using anesthesia for sleep apnea sufferers has to do with the fact that sedatives and anesthesia can cause the patient to have difficulties breathing during surgery. In some cases, they may completely stop breathing, which, in extreme cases, makes it necessary for the patient to undergo an emergency tracheotomy to restore their breathing functions. 

General anesthesia itself can result in temporary obstructive sleep apnea while the patient is still under the effect of anesthesia, meaning that they have temporary pauses in breathing while they are still asleep due to the anesthesia. 

 

Anesthesia is a sedative which can relax the muscles and cause the soft palate or tongue to fall back and create a blockage in the upper air passage at the back of the throat. Of course, for patients who already have breathing problems while sleeping such as obstructive sleep apnea, the use of anesthesia will only exacerbate these effects

 

sleep apnea and anesthesiaThis is why it is so important to be open and honest with your surgeon before undergoing any surgical procedure, as sleep apnea and anesthesia requires special precautions to be taken to ensure the patients safety.

However, the main problem is that majority of people suffering from sleep apnea are completely unaware of their sleeping disorder and have never been diagnosed. This is what makes sleep apnea and anesthesia such a dangerous combination, as it can be difficult for your surgeon to know if you have a sleeping disorder and prepare for any possible complications arising from it. 

While general anesthesia is still typically administered on patients with obstructive sleep apnea, knowing about it beforehand will allow the surgeon and the anesthesiologist to help prepare themselves for any risks or complications. This is why it is so important to be completely honest with your surgeon when they are performing their pre-operative assessment. 

There are a few common factors which may help make it easier for your surgeon to determine if you have sleep apnea, as there is a very common patient profile. The typical person with sleep apnea is an overweight male over the age of forty, but nonetheless, sleep apnea occurs in both sexes and people of all ages, including children. 

So, in order to determine whether or not you may suffer from sleep apnea, your surgeon or anesthesiologist will probably ask you a whole host of questions about your sleeping patterns. These questions can range from if you snore, and if so, how frequent or loud your snoring is. They may also ask you if anyone has ever told you that you stop breathing during sleep. 

sleep apnea and anesthesiaAnother common question that they will ask is whether you easily fall asleep during the day, or wake up feeling excessively tired or fatigued, and also whether you frequently wake up with headaches or an overly dry mouth. 

Finally, they may also ask whether or not you have ever undergone a sleep study, and in cases where they have a strong feeling that you might have sleep apnea, they may actually insist on you undergoing a sleep study before they will perform the surgery. All of this will allow them to have a better overview of your health so they can decide if you may have problems from sleep apnea and anesthesia during surgery.

How to Prepare for Complications Arising from Anesthesia for Sleep Apnea Sufferers

If your surgeon or anesthesiologist determines that you may have sleep apnea, then in most cases the surgeon will decide to place a tube down your throat and connect you to an artificial breathing machine or respirator which will ensure that you remain breathing throughout the procedure. In many cases, the tube will remain in place until you have completely woken up from the anesthesia and recovered from its effects. 

If you use a CPAP machine and are undergoing a procedure that requires you to stay in the hospital overnight, then your doctor will most likely recommend that you bring your CPAP machine to the hospital with you. In some cases, it may also be necessary to use your CPAP machine in the post-op recovery room as well. 

Alternatives to Anesthesia for Sleep Apnea Patients

When a surgeon or anesthesiologist believes a patient is at risk for complications arising from sleep apnea, the anesthesiologist will most likely avoid giving you the standard pre-op sedative or narcotic. Depending on the surgical procedure that you are having, the anesthesiologist may also decide to only give you a regional anesthetic to numb the particular area where the surgery is taking place. 

This is especially useful in surgeries being performed on the limbs, and even some abdominal surgeries. For procedures taking place below the waist, your anesthesiologist may decide to give you an epidural or spinal anesthetic. 

This type of anesthetic is most commonly used for women giving birth, however for patients with sleep apnea, it can also be effective for almost any surgery taking place below the ribcage, as it will effectively numb the entire lower half of the body. 

sleep apnea and anesthesiaHowever, there is one major problem involved with either an epidural or with regional anesthesia, and this is the fact that the patient will be fully awake throughout the procedure. 

If you decide to go this route, you need to be aware of the fact that you may hear hammering, drilling, or other discomforting noises during the surgery. 

Still, no matter what you decide to do, anesthesia for sleep apnea patients can be quite safe as long as the surgeon is aware of the problem and all precautions are taken.


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