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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 1/2018

30.10.2017 | Review Article/Brief Review

Interpretation of sleep studies for patients with sleep-disordered breathing: What the anesthesiologist needs to know

verfasst von: Vina Meliana, MBBS, FANZCA, Frances Chung, MBBS, FRCPC, Christopher K. Li, MD, FRCPC, DABSM, Mandeep Singh, MBBS, MD, MSc, FRCPC

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 1/2018

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Abstract

There is increased interest in the perioperative management of patients with sleep-disordered breathing (SDB). Anesthesiologists must distill information from clinical reports to make key decisions for optimizing perioperative care. A patient with SDB may present with a sleep study report at the time of surgery. Knowledge of the essential components of such a report can help the anesthesiologist evaluate the patient and optimize the perioperative management. In this narrative review, we describe how level I (i.e., laboratory-based) polysomnography (PSG) data are collected and scored using the recommended scoring guidelines, as well as the basic information and salient features of a typical PSG report relevant to the anesthesiologist. In addition, we briefly review the indications for sleep studies, including the types of laboratory-based studies, as well as the role and limitations of portable monitors (level II-IV studies) and examples of PSG reports in the clinical context.
Literatur
1.
American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014; Available from URL: www.​aasmnet.​org (accessed September 2017).
2.
Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006-14.CrossRefPubMedPubMedCentral
3.
Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 2015; 3: 310-8.CrossRefPubMedPubMedCentral
4.
Memtsoudis SG, Besculides MC, Mazumdar M. A rude awakening—the perioperative sleep apnea epidemic. N Engl J Med 2013; 368: 2352-3.CrossRefPubMed
5.
Frey WC, Pilcher J. Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery. Obes Surg 2003; 13: 676-83.CrossRefPubMed
6.
Chung F, Memtsoudis S, Krishna Ramachandran S, et al. Society of Anesthesia and Sleep Medicine guidelines on preoperative screening and assessment of adults patients with obstructive sleep apnea. Anesth Analg 2016; 123: 452-73.CrossRefPubMedPubMedCentral
7.
Opperer M, Cozowicz C, Bugada D, et al. Does obstructive sleep apnea influence perioperative outcome? A qualitative systematic review for the Society of Anesthesia and Sleep Medicine Task Force on preoperative preparation of patients with sleep-disordered breathing. Anesth Analg 2016; 122(1321-34): 1.
8.
Kaw R, Chung F, Pasupuleti V, Mehta J, Gay PC, Hernandez AV. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Br J Anaesth 2012; 109: 897-906.CrossRefPubMed
9.
Hai F, Porhomayon J, Vermont L, Frydrych L, Jaoude P, El-Solh AA. Postoperative complications in patients with obstructive sleep apnea: a meta-analysis. J Clin Anesth 2014; 26: 591-600.CrossRefPubMed
10.
Mokhlesi B, Hovda MD, Vekhter B, Arora VM, Chung F, Meltzer DO. Sleep-disordered breathing and postoperative outcomes after elective surgery: analysis of the nationwide inpatient sample. Chest 2013; 144: 903-14.CrossRefPubMedPubMedCentral
11.
Memtsoudis S, Liu SS, Ma Y, et al. Perioperative pulmonary outcomes in patients with sleep apnea after noncardiac surgery. Anesth Analg 2011; 112: 113-21.CrossRefPubMed
12.
Mokhlesi B, Hovda MD, Vekhter B, Arora VM, Chung F, Meltzer DO. Sleep-disordered breathing and postoperative outcomes after bariatric surgery: analysis of the nationwide inpatient sample. Obes Surg 2013; 23: 1842-51.CrossRefPubMedPubMedCentral
13.
Singh M, Liao P, Kobah S, Wijeysundera DN, Shapiro C, Chung F. Proportion of surgical patients with undiagnosed obstructive sleep apnoea. Br J Anaesth 2013; 110: 629-36.CrossRefPubMed
14.
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.CrossRefPubMed
15.
Berry RB, Brooks R, Gamaldo CE, et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.3. Darien, Illinois: American Academy of Sleep Medicine; 2016; Available from URL:www.​aasmnet.​org (accessed September 2017).
16.
Blackman A, McGregor CM, Dales R, et al. Canadian Sleep Society/ Canadian Thoracic Society position paper on the use of portable monitoring for the diagnosis of obstructive sleep apnea/ hypopnea in adults. Can Respir J 2010; 17: 229-32.CrossRefPubMedPubMedCentral
17.
Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice guideline. J Clin Sleep Med 2017; 13: 479-504.CrossRefPubMedPubMedCentral
18.
Collop NA, Tracy SL, Kapur V, et al. Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med 2011; 7: 531-48.PubMedPubMedCentral
19.
20.
Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8: 597-619.PubMedPubMedCentral
21.
Ramar K, Dort LC, Katz SG, et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 2015; 7: 773-827.
22.
Aurora RN, Casey KR, Kristo D, et al. Practice parameters for the surgical modification of the upper airway for obstructive sleep apnea in adults. Sleep 2010; 33: 1408-13.CrossRefPubMedPubMedCentral
23.
Morgenthaler TI, Kapen S, Lee-Chiong T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep 2006; 29: 1031-5.CrossRefPubMed
24.
Bonnet MH, Doghramji K, Roehrs T, et al. The scoring of arousal in sleep: reliability, validity, and alternatives. J Clin Sleep Med 2007; 3: 133-45.PubMed
25.
Eckert DJ, Younes MK. Arousal from sleep: implications for obstructive sleep apnea pathogenesis and treatment. J Appl Physiol 1985; 2014(116): 302-13.
26.
27.
28.
Lesser DJ, Haddad GG, Bush RA, Pian MS. The utility of a portable recording device for screening of obstructive sleep apnea in obese adolescents. J Clin Sleep Med 2012; 8: 271-7.PubMedPubMedCentral
29.
Ng SS, Chan TO, To KW, et al. Validation of a portable recording device (ApneaLink) for identifying patients with suspected obstructive sleep apnoea syndrome. Intern Med J 2009; 39: 757-62.CrossRefPubMed
30.
Erman MK, Stewart D, Einhorn D, Gordon N, Casal E. Validation of the ApneaLink for the screening of sleep apnea: a novel and simple single-channel recording device. J Clin Sleep Med 2007; 3: 387-92.PubMedPubMedCentral
31.
Pépin JL, Guillot M, Tamisier R, Lévy P. The upper airway resistance syndrome. Respiration 2012; 83: 559-66.CrossRefPubMed
32.
De Godoy LB, Palombini LO, Guilleminault C, Poyares D, Tufik S, Togeiro SM. Treatment of upper airway resistance syndrome in adults: where do we stand? Sleep Sci 2015; 8: 42-8.CrossRefPubMedPubMedCentral
33.
Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/American College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes on Health). Circulation 2008; 118: 1080-111.CrossRefPubMed
34.
Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F. Obstructive sleep apnoea and cardiovascular disease. Lancet Respir Med 2013; 1: 61-72.CrossRefPubMed
35.
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.CrossRefPubMedPubMedCentral
36.
37.
Gami AS, Olson EJ, Shen WK, et al. Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol 2013; 62: 610-6.CrossRefPubMed
38.
Gami AS, Howard DE, Olson EJ, Somers VK. Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med 2005; 352: 1206-14.CrossRefPubMed
39.
Mutter TC, Chateau D, Moffatt M, Ramsey C, Roos LL, Kryger M. A matched cohort study of postoperative outcomes in obstructive sleep apnea: could preoperative diagnosis and treatment prevent complications? Anesthesiology 2014; 121: 707-18.CrossRefPubMed
40.
Chung F, Zhou L, Liao P. Parameters from preoperative overnight oximetry predict postoperative adverse events. Minerva Anestesiol 2014; 80: 1084-95.PubMed
41.
Chung F, Liao P, Yang Y, et al. Postoperative sleep-disordered breathing in patients without preoperative sleep apnea. Anesth Analg 2015; 120: 1214-24.CrossRefPubMed
42.
Cooksey J, Mokhlesi B. Postoperative complications in obesity hypoventilation syndrome and hypercapnic OSA: CO2 levels matter! Chest 2016; 149: 11-3.CrossRefPubMed
43.
Isono S, Sha M, Suzukawa M, et al. Preoperative nocturnal desaturations as a risk factor for late postoperative nocturnal desaturations. Br J Anaesth 1998; 80: 602-5.CrossRefPubMed
44.
Abdelsattar ZM, Hendren S, Wong SL, Campbell DA Jr, Ramachandran SK. The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study. Sleep 2015; 38: 1205-10.CrossRefPubMedPubMedCentral
45.
Nagappa M, Mokhlesi B, Wong J, Wong DT, Kaw R, Chung F. The effects of continuous positive airway pressure on postoperative outcomes in obstructive sleep apnea patients undergoing surgery: a systematic review and meta-analysis. Anesth Analg 2015; 120: 1013-23.CrossRefPubMed
46.
Kushida CA, Chediak A, Berry RB, et al. Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the manual titration of positive airway pressure in patients with obstructive sleep apnea. J Clin Sleep Med 2008; 4: 157-71.
47.
Joosten SA, O’Driscoll DM, Berger PJ, Hamilton GS. Supine position related obstructive sleep apnea in adults: pathogenesis and treatment. Sleep Med Rev 2014; 18: 7-17.CrossRefPubMed
48.
Subramani Y, Singh M, Wong J, Kushida CA, Malhotra A, Chung F. Understanding phenotypes of obstructive sleep apnea: applications in anesthesia, surgery, and perioperative medicine. Anesth Analg 2017; 124: 179-91.CrossRefPubMedPubMedCentral
49.
Chung F, Liao P, Elsaid H, Shapiro CM, Kang W. Factors associated with postoperative excerbation of sleep-disordered breathing. Anesthesiology 2014; 120: 299-311.CrossRefPubMed
50.
Joosten SA, Hamza K, Sands S, Turton A, Berger P, Hamilton G. Phenotypes of patients with mild to moderate obstructive sleep apnoea as confirmed by cluster analysis. Respirology 2012; 17: 99-107.CrossRefPubMed
51.
Wiegand L, Zwillich CW, Wiegand D, White DP. Changes in upper airway muscle activation and ventilation during phasic REM sleep in normal men. J Appl Physiol 1985; 1991(71): 488-97.
52.
Shea SA, Edwards JK, White DP. Effect of wake-sleep transitions and rapid eye movement sleep on pharyngeal muscle response to negative pressure in humans. J Physiol 1999; 520: 897-908.CrossRefPubMedPubMedCentral
53.
54.
Nilius G, Wessendorf T, Maurer J, et al. Predictors for treating obstructive sleep apnea with an open nasal cannula system (transnasal insufflation). Chest 2010; 137: 521-8.CrossRefPubMed
55.
Raveendran R, Wong J, Singh M, Wong DT, Chung F. Obesity hypoventilation syndrome, sleep apnea, overlap syndrome: perioperative management to prevent complications. Curr Opin Anaesthesiol 2017; 30: 146-55.PubMed
56.
Castro-Añón O, Pérez de Llano LA, De la Fuente Sánchez S, et al. Obesity-hypoventilation syndrome: increased risk of death over sleep apnea syndrome. PLoS One 2015; 10: e0117808.CrossRefPubMedPubMedCentral
57.
Chau EH, Lam D, Wong J, Mokhlesi B, Chung F. Obesity hypoventilation syndrome: a review of epidemiology, pathophysiology, and perioperative considerations. Anesthesiology 2012; 117: 188-205.CrossRefPubMed
58.
Mokhlesi B. Obesity hypoventilation syndrome: a state-of-the-art review. Respir Care 2010; 55: 1347-65.PubMed
59.
Nowbar S, Burkart KM, Gonzales R, et al. Obesity-associated hypoventilation in hospitalized patients: prevalence, effects, and outcome. Am J Med 2004; 116: 1-7.CrossRefPubMed
60.
Kaw R, Bhateja P, Paz Y Mar H, et al. Postoperative complications in patients with unrecognized obesity hypoventilation syndrome undergoing elective noncardiac surgery. Chest 2016; 149: 84-91.
61.
62.
Mokhlesi B, Tulaimat A, Faibussowitsch I, Wang Y, Evans AT. Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea. Sleep Breath 2007; 11: 117-24.CrossRefPubMed
63.
Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet 2009; 373: 82-93.CrossRefPubMed
64.
65.
Rivas M, Ratra A, Nugent K. Obstructive sleep apnea and its effects on cardiovascular diseases: a narrative review. Anatol J Cardiol 2015; 15: 944-50.CrossRefPubMed
66.
Fleetham J, Ayas N, Bradley D, et al. Canadian Thoracic Society 2011 guideline update: diagnosis and treatment of sleep disordered breathing. Can Respir J 2011; 18: 25-47.CrossRefPubMedPubMedCentral
67.
Yumino D, Bradley TD. Central sleep apnea and Cheyne-Stokes respiration. Proc Am Thorac Soc 2008; 5: 226-36.CrossRefPubMed
68.
Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J. Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations. Anesth Analg 2015; 120: 1273-85.CrossRefPubMed
69.
Farney RJ, Walker JM, Boyle KM, Cloward TV, Shilling KC. Adaptive servoventilation (ASV) in patients with sleep disordered breathing associated with chronic opioid medications for non-malignant pain. J Clin Sleep Med 2008; 4: 311-9.PubMedPubMedCentral
Metadaten
Titel
Interpretation of sleep studies for patients with sleep-disordered breathing: What the anesthesiologist needs to know
verfasst von
Vina Meliana, MBBS, FANZCA
Frances Chung, MBBS, FRCPC
Christopher K. Li, MD, FRCPC, DABSM
Mandeep Singh, MBBS, MD, MSc, FRCPC
Publikationsdatum
30.10.2017
Verlag
Springer US
Erschienen in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 1/2018
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-017-0988-8

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