Sedation during endoscopy for patients at risk of obstructive sleep apnea.
BACKGROUND
Obstructive sleep apnea (OSA) has become increasingly prevalent in the United States and often goes undiagnosed.


OBJECTIVE
To assess the proportion of patients undergoing routine endoscopic procedures who are at risk of OSA and to determine whether these patients are at risk of sedation-related hypoxia.


METHODS
Prospective case-control study at an academic medical center.


METHODS
Patients undergoing routine EGD and colonoscopy were administered the Berlin Questionnaire, a brief validated survey that stratifies patients into high or low risk of OSA. Data on pulse oximetry and oxygen use were collected.


METHODS
Rates of transient hypoxia, defined as a pulse oximetry measurement less than 92% requiring an increase in supplemental oxygen were compared between the high- and low-risk OSA groups.


RESULTS
Of the 261 prospectively recruited patients, 28 were excluded for violating study protocol. Ninety (39%) of the remaining 233 patients were scored as being at high risk of OSA. There was no significant difference in the rate of transient hypoxia between the high- and low-risk groups (odds ratio 1.48; 95% CI, 0.58-3.80).


CONCLUSIONS
Single-center study. OSA was not confirmed with a sleep study.


CONCLUSIONS
Approximately one third of patients undergoing routine outpatient endoscopic procedures at a university hospital scored as being at high risk of OSA. There was no significant difference in the rates of transient hypoxia between high- and low-risk groups, suggesting that the majority of patients with no diagnosis of OSA can undergo conscious sedation for routine endoscopic procedures with standard monitoring practices.
Khiani
Vijay S
VS
Department of Medicine, Division of Gastroenterology, Yale University, New Haven, Connecticut, USA. vijay.khiani@gmail.com
Salah
Wajeeh
W
Maimone
Santo
S
Cummings
Linda
L
Chak
Amitabh
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003113:Colonoscopy; D016292:Procedural Sedation / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis; D011795:Surveys and Questionnaires; D055815:Young Adult