Better guidance urgently needed for ‘epidemic’ of sleep apnea in surgical patients

Although as many as 25 percent of patients undergoing surgery suffer from sleep apnea, few hospitals have policies to help manage the risks of this condition during surgery, and there is little evidence to help guide anesthesiologists and surgeons caring for these patients. In a new editorial in the New England Journal of Medicine, Stavros Memtsoudis, M.D., Ph.D., director of Critical Care Services at Hospital for Special Surgery, New York City, calls for a new research initiative to identify the safest and most effective ways to manage patients with sleep apnea.
Sleep apnea, a disorder in which a person frequently stops breathing for short periods during sleep, not only makes for a restless night but also puts the person at increased risk of high blood pressure, diabetes, heart attack and stroke. But although the condition is more common than diabetes, and poses particular hazards during surgery, relatively little research has been done to help guide clinicians.
‘Patients with sleep apnea may be at risk for many complications during surgery, including airway blockage and intubation problems,’ said Dr. Memtsoudis. ‘But that’s not all: we know that apnea affects many other organ systems as well. The American Society of Anesthesiologists published guidelines in 2006 to help us take better care of patients with sleep apnea, but there was