title: Health effects of identifying patients with undiagnosed obstructive sleep apnea in the preoperative clinic: a follow-up study.
abstract: BACKGROUND
  Undiagnosed obstructive sleep apnea (OSA) is a highly prevalent breathing disorder. The purpose of this study was to determine the effects of preoperative screening and subsequent treatment for OSA on the health of patients.
  
  
  METHODS
  We conducted a two-year follow-up study of patients previously enrolled in a large prospective study in which patients were given the STOP questionnaire for OSA screening (n = 2,467). All patients who underwent a polysomnography were considered eligible (n = 211) and were asked to complete a paper-based mailed questionnaire. The severity of OSA, comorbidities, and treatment modalities and their effects were evaluated from the returned questionnaire. Research ethics board approval was obtained and returning the questionnaire implied informed patient consent.
  
  
  RESULTS
  The response rate was 67%. One hundred twenty-eight (82%) of the 156 patients who responded had OSA established by polysomnography. Among these 128 patients with OSA, 88 (69%) were prescribed continuous positive airway pressure (CPAP) therapy and 40 (31%) were prescribed other (non-CPAP) treatment. Among those 88 patients receiving CPAP, 40 (45%) were compliant and 48 (55%) were non-compliant. The CPAP compliant patients had a greater reduction in medication for comorbidities than the CPAP non-compliant or the other treatment group (38% vs 3% vs 0%, respectively; P < 0.001). A significant improvement in snoring, sleep quality, and daytime sleepiness was reported by CPAP compliant users compared with CPAP non-compliant or other treatment groups (P < 0.001).
  
  
  CONCLUSIONS
  The preoperative patients who were identified to have OSA and were compliant with CPAP use may have health benefits in terms of improved snoring, sleep quality, and daytime sleepiness. Timely diagnosis and treatment compliance may reduce symptoms of OSA and severity of associated comorbidities along with a reduction in medications.
authors.affiliation: Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
authors.forename: Vanita
authors.initials: V
authors.lastname: Mehta
authors.forename: Rajeev
authors.initials: R
authors.lastname: Subramanyam
authors.forename: Colin M
authors.initials: CM
authors.lastname: Shapiro
authors.forename: Frances
authors.initials: F
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012913:Snoring / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires