Abstract
Obstructive sleep apnea (OSA) is the most prevalent breathing disorder in sleep, affecting up to 20 % of the population, with approximately 5 % experiencing excessive daytime sleepiness [1, 2]. The total economic burden of OSA including health-care costs, lost productivity, accidents, and loss of quality of life is substantial, accounting for billions of dollars per year, and is expected to increase [3]. As such, procedures related to improvement of OSA symptoms, as well as unrelated procedures in patients with OSA will likely increase in prevalence. Anesthesiologists and otolaryngologists will therefore face the challenges inherent to this patient population and a thorough understanding of the scope of the disease state is crucial.
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References
Young T, Finn L, Peppard PE, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31:1071–8.
Young T, Peppard PE, Gottlieb D. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165:1217–39.
Alghanim N, Comondore VR, Fleetham J, et al. The economic impact of obstructive sleep apnea. Lung. 2008;186:7–12.
Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28:499–521.
Hillman DR, Platt PR, Eastwood PR. Anesthesia, sleep, and upper airway collapsibility. Anesthesiol Clin. 2010;28:443–55.
Iber C, Ancoli-Israel S, Cheeson A, et al. The AASM manual for the scoring of sleep and associated events, rules, terminology and technical specifications. Westchester: American Academy of Sleep Medicine; 2007.
Mickelson SA. Preoperative and postoperative management of obstructive sleep apnea patients. Otolaryngol Clin North Am. 2007;40:877–89.
Young T, Evans I, Finn I, et al. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20:705–6.
Mitchell RB, Boss EF. Pediatric obstructive sleep apnea in obese and normal-weight children: impact of adenotonsillectomy on quality-of-life and behavior. Dev Neuropsychol. 2009;34(5):650–61.
Broderick M, Guilleminault C. Neurological aspects of obstructive sleep apnea. Ann NY Acad Sci. 2008;1142:44–57.
Woodson BT, Franco R. Physiology of sleep disordered breathing. Otolaryngol Clin North Am. 2007;40(4):691–711.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.
Patel SR, White DP, Malhotra A, et al. Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: results of a meta-analysis. Arch Intern Med. 2003;163(5):565–71.
Doghramji K, Jabourian ZH, Pilla M, Farole A, Lindholm RN. Predictors of outcome for uvulopalatopharyngoplasty. Laryngoscope. 1995;105:311–4.
Fujita S, Conway W, Sicklesteel J, Witting R, Zorick F, Roehrs T, Roth T. Evaluation of the effectiveness of uvulopalatopharyngoplasty. Laryngoscope. 1985;95:70–4.
Friedman M, Ibrahim H, Bass L. Clinical staging for sleep-disordered breathing. Otolaryngol Head Neck Surg. 2002;127(1):13–21.
Iwanaga K, Hasegawa K, Shibata N, Kawakatsu K, Akita Y, Suzuki K, Yagisawa M, Nishimura T. Endoscopic examination of obstructive sleep apnea syndrome patients during drug-induced sleep. Acta Otolaryngol Suppl. 2003;550:36–40.
Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003;290:1906–14.
Zanation A, Senior B. The relationship between extraesophageal reflux (EER) and obstructive sleep apnea (OSA). Sleep Med Rev. 2005;9(6):453–8.
Gross JB, Bachenberg KL, Benumof JL, et al. Practice guidelines for the perioperative management of patients with obstructive sleep apnea: A report by the American Society of Anesthesiologists Task Force on perioperative management of patients with obstructive sleep apnea. Anesthesiology. 2006;104:1081–93.
Gupta RM, Parvizi J, Hanssen AD, Gay PC. Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case–control study. Mayo Clin Proc. 2001;76:897–905.
Hwang D, Shakir N, Limann B, et al. Association of sleep-disordered breathing with postoperative complications. Chest. 2008;133:1128–34.
Liao P, Yegneswaran B, Vairavanathan S, et al. Postoperative complications in patients with obstructive sleep apnea: a retrospective matched cohort study. Can J Anesth. 2009;56:819–28.
Kim JA, Lee JJ, Jung HH. Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty. Laryngoscope. 2005;115:1837–40.
Marshall NS, Wong KKH, Liu PY, et al. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep. 2008;31:1079–85.
Bolden N, Smith CE, Auckley D. Avoiding adverse outcomes in patient with obstructive sleep apnea (OSA): Development and implementation of a perioperative OSA protocol. J Clin Anesth. 2009;21:286–93.
Chung F, Ward B, Ho J, et al. Perioperative identification of sleep apnea risk in elective surgical patients, using the Berlin questionnaire. J Clin Anesth. 2006;19:130–4.
Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812–21.
Gay P, Weaver T, Loube D, et al. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep. 2006;29:381–401.
Kaye DM, Mansfield D, Naughton MT. Continuous positive airway pressure decreases myocardial oxygen consumption in heart failure. Clin Sci (Lond). 2004;106:599–603.
Jain SS, Dhand R. Perioperative treatment of patients with obstructive sleep apnea. Curr Opin Pulm Med. 2004;10:482–8.
Shahar E, Whitney CW, Redline S, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. Am J Respir Crit Care Med. 2001;163:19–25.
Dincer HE, O’Neill W. Deleterious effects of sleep-disordered breathing on the heart and vascular system. Respiration. 2006;73:124–30.
Mehra R, Benjamin EJ, Shahar E, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: the sleep heart health study. Am J Respir Crit Care Med. 2006;173:910–6.
Arzt M, Young T, Finn L, et al. Association of sleep-disordered breathing and the occurrence of stroke. Am J Respir Crit Care Med. 2005;172:1447–51.
Coughlin SR, Mawdsley L, Mugarza JA, et al. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25:735–41.
Seet E, Chung F. Obstructive sleep apnea: preoperative assessment. Anesthesiol Clin. 2010;28:199–215.
Gami AS, Howard DE, Olson EJ, et al. Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med. 2005;352:1206–14.
Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 1981;89(6):923–34.
DeRowe A, Gunther E, Fibbi A, et al. Tongue-base suspension with a soft tissue to bone ancjor for obstructive sleep apnea: preliminary clinical results of a new minimally invasive technique. Otolaryngol Head Neck Surg. 2000;122:100–3.
Riley RW, Guilleminault C, Powel NB, et al. Palatopharyngoplasty failure, cephalometric roentgenograms, and obstructive sleep apnea. Otolaryngol Head Neck Surg. 1985;93:240–4.
Riley RW, Powel NB, Guilleminault C. Inferior sagittal osteotomy of the mandible with hyoid myotomy-suspension: a new procedure for obstructive sleep apnea. Otolaryngol Head Neck Surg. 1986;94:589–93.
Hörmann K, Baisch A. How I do it: the hyoid suspension. Laryngoscope. 2004;114:1677–9.
Lee NR, Woodson T. Genioglossus muscle advancement via a trephine osteotomy approach. Operative Techniques. Otolaryngol Head Neck Surg. 2000;11:150.
Lee NR. Genioglossus muscle advancement techniques for obstructive sleep apnea. Oral Maxillofacial Surg Clin North Am. 2002;14:377.
Li KK, Powel NB, Riley RW, Troell RJ, Guilleminault C. Long-term results of maxillomandibular advancement surgery. Sleep Breath. 2000;4:137–9.
Li KK, Riley RW, Powel NB, Guilleminault C. Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations. J Oral Maxillofac Surg. 2002;67:27–33.
Li KK, Riley RW, Powel NB, Troell RJ, Guilleminault C. Overview of Phase II surgery for obstructive sleep apnea syndrome. Ear Nose Throat J. 1999;78:851–7.
Sharma VK, Galli W, Haber A, et al. Unexpected risks during administration of conscious sedation: previously undiagnosed obstructive sleep apnea. Ann Intern Med. 2003;139:707–8.
Fairbanks DNF. Uvulopalatopharyngoplasty complications and avoidance strategies. Otolaryngol Head Neck Surg. 1990;102:239–45.
Siyam MA, Benhamou D. Difficult endotracheal intubation in patients with sleep apnea syndrome. Anesth Analg. 2002;95:1098–102.
Kim JA, Lee JJ. Preoperative predictors of difficult intubation in patients with obstructive sleep apnea syndrome. Can J Anesth. 2006;53:393–7.
American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003; 98:1269–77.
Terris DJ, Clerk AA, Norbash AB, et al. Characterization of post-operative edema following laser assisted uvulopalatoplasty using MRI and polysomnography. Laryngoscope. 2009;106:124–8.
Meoli AL, Rosen CL, Kristo D, et al. Clinical practice review committee; American academy of sleep medicine. Upper airway management of the adult patient with obstructive sleep apnea in the perioperative period–avoiding complications. Sleep. 2003;26:1060–5.
Neligan PJ, Malhotra G, Fraser M, et al. Continuous positive airway pressure via the Boussignac system immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesthesiology. 2009;110:878–84.
Mickelson SA, Hakim I. Is postoperative intensive care monitoring necessary after uvulopalatopharyngoplasty? Otolaryngol Head Neck Surg. 1998;119(4):352–6.
Kezirian EJ, Weaver EM, Yueh B, Khuri SF, Daley J, Henderson WG. Risk factors for serious complication after uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg. 2006;132(10):1091–8.
Troell RJ, Powell NB, Riley TW, et al. Comparison of postoperative pain between laser assisted uvulopalatoplasty, uvulopalatopharyngoplasty, and radiofrequency volumetric tissue reduction of the palate. Otolaryngol Head Neck Surg. 2000;122:402–9.
Kaw R, Michota F, Jaffer A, et al. Unrecognized sleep apnea in the surgical patient: implications for the perioperative setting. Chest. 2006;129:198–205.
Chung SA, Yuan H, Chung F. A systemic review of obstructive sleep apnea and its implications for anesthesiologists. Anesth Analg. 2008;107:1543–63.
Bolden N, Smith CE, Auckley D, et al. Perioperative complications during use of an obstructive sleep apnea protocol following surgery and anesthesia. Anesth Analg. 2008;105:1869–70.
Kezirian EJ, Weave EM, Yueh B, et al. Incidence of serious complications after uvulopalatopharyngoplasty. Laryngoscope. 2004;114:450–3.
Hathaway B, Johnson JT. Safety of uvulopalatopharyngoplasty as outpatient surgery. Otolaryngol Head Neck Surg. 2006;134:542–4.
Seet E, Chung F. Management of sleep apnea in adults - functional algorithms for the perioperative period: Continuing Professional Development. Can J Anaesth. 2010;57:849–64.
Gali B, Whalen FX, Schroeder D, et al. Identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment. Anesthesiology. 2009;110:869–87.
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Weiner, M.M., Lin, F.Y., Jang, D.W., Malkin, B.D. (2013). Adult Sleep Apnea and Related Procedures. In: Levine, A., Govindaraj, S., DeMaria, Jr., S. (eds) Anesthesiology and Otolaryngology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4184-7_9
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