title: Obstructive sleep apnea syndrome and perioperative complications: a systematic review of the literature.
abstract: Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Stony Brook University Medical Center, HSC T 17-040, Stony Brook, NY 11794, USA. Tajender.Vasu@sbumed.org
authors.forename: Tajender S
authors.initials: TS
authors.lastname: Vasu
authors.forename: Ritu
authors.initials: R
authors.lastname: Grewal
authors.forename: Karl
authors.initials: K
authors.lastname: Doghramji
mesh_terms: D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D019990:Perioperative Care; D059035:Perioperative Period; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology