PT  - JOURNAL ARTICLE
AU  - Robert M. Wolfe
AU  - Jonathan Pomerantz
AU  - Deborah E. Miller
AU  - Rebecca Weiss-Coleman
AU  - Tony Solomonides
TI  - Obstructive Sleep Apnea: Preoperative Screening and Postoperative Care
AID  - 10.3122/jabfm.2016.02.150085
DP  - 2016 Mar 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 263--275
VI  - 29
IP  - 2
4099  - http://www.jabfm.org/content/29/2/263.short
4100  - http://www.jabfm.org/content/29/2/263.full
SO  - J Am Board Fam Med2016 Mar 01; 29
AB  - The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other causes. Almost a quarter of patients entering a hospital for elective surgery have OSA, and >80% of these cases are undiagnosed at the time of surgery. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, and general anesthesia, as well as from the effects of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed. For adults, preoperative screening using the STOP or STOP-Bang questionnaires can help to identify adult patients at increased risk of OSA. In the pediatric setting, a question about snoring should be part of every preoperative examination. For patients with known OSA, continuous positive airway pressure should be continued postoperatively. Continuous pulse oximetry monitoring with an alarm system can help to prevent apneic catastrophes caused by OSA in the postoperative period.