Features  |   July 2017
Sleep-Disordered Breathing and Perioperative Outcomes - Current Controversies
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Central and Peripheral Nervous Systems / Pain Medicine / Respiratory System / Sleep Medicine / Features
Features   |   July 2017
Sleep-Disordered Breathing and Perioperative Outcomes - Current Controversies
ASA Monitor 07 2017, Vol.81, 16-18.
ASA Monitor 07 2017, Vol.81, 16-18.
Sleep-disordered breathing (SDB) includes obstructive sleep apnea (OSA), central sleep apnea and obesity hypoventilation syndrome. OSA is an increasingly common disease1,2  of particular concern to anesthesiologists as it is associated with increased perioperative complications.3  It is estimated that the prevalence of OSA in the United States is on a rise probably because of the aging population and increase in obesity. However, another possibility could be related to the liberalization of OSA definition (i.e., use of a lower threshold for defining hypopnea).2  The apnea-hypopnea index (AHI), which comprises the number of apneic and hypopneic events per hour, is used to diagnose and determine the severity of OSA. OSA is common in patients with heart failure, atrial fibrillation, diabetes mellitus and chronic obstructive pulmonary disease. Therefore, it is suggested that OSA should be considered as a spectrum of diseases characterized by a severity spectrum akin to systemic blood pressure or cholesterol levels, rather than a diagnosis with rigid AHI cutoff.2  Nevertheless, it appears that moderate to severe OSA, defined as an AHI of >15, appears to be clinically relevant. Therefore, individuals with mild OSA (AHI <15) and at low risk for comorbidities could be treated conservatively.2 
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