Obstructive sleep apnoea and perioperative medicine: a growing concern

Author:

Chambers Tom1,Ruparelia Prina1,Ellis Georgia2,Bishop Thomas2,Gooneratne Mevan2,Singh Nanak1

Affiliation:

1. Department of Respiratory Medicine, Barts Health NHS Trust, London, UK

2. Department of Anaesthesia, The Royal London Hospital, London, UK

Abstract

Obstructive sleep apnoea represents a sizable public health and economic burden. Owing to rising obesity rates, the prevalence of obstructive sleep apnoea is increasing, and it is a condition that is significantly underdiagnosed. Exacerbated by the COVID-19 pandemic, the backlog of elective surgeries is also sizable and growing. A combination of these factors means that many patients due to have surgery will have obstructive sleep apnoea, either diagnosed or otherwise. Patients with obstructive sleep apnoea have a significantly increased risk of operative complications, but the evidence base for optimum perioperative management of these patients is limited. This article reviews sleep apnoea, its prevalence and its impact on operative management and perioperative outcomes for patients. The evidence base for screening and treating undiagnosed obstructive sleep apnoea is also comprehensively assessed. Finally, a pathway to manage patients with possible undiagnosed obstructive sleep apnoea is proposed, and areas for further research identified.

Publisher

Mark Allen Group

Subject

General Medicine

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