The online version of this article (doi:10.1186/1754-9493-8-13) contains supplementary material, which is available to authorized users.
The authors specifically do not have any financial conflict of interest related to the sponsor of this study, Heinen + Löwenstein, Bad Ems, Germany. The authors declare that they have no competing interests.
JR: study design, data acquisition and analysis, drafted the article. PS: Critical revision for intellectual content, final approval of the article. SH: Study design, critical revision of the article, final approval of the article. TB: Analysis and data interpretation, final approval of the article. MP: Critical revision for intellectual content, final approval of the article. RC: Acquisition of data, analyzed and interpreted data, final approval of the article. AW: Contributed to concept and design, final approval of the article.
Major surgery might have a modulating effect on nocturnal breathing patterns. The incidence and course of perioperative sleep-disordered breathing in individuals without a previous diagnosis of obstructive sleep apnea has not been investigated sufficiently so far.
In this study, polygraphic recordings have been obtained from 37 inpatients without a diagnosis of obstructive sleep apnea syndrome during the preoperative night before and six nights following major surgical procedures.
Eligible patients consenting to participate in this study underwent polygraphic recordings including four items (O2-saturation, pulse, nasal air flow and snoring) during the study period. Polygraphic data obtained from the postoperative recordings were compared to preoperative recordings.
Median (IQR [range]) apnea-hypopnea-index (AHI) for the whole group was 6,0 (2,5 - 14,7 [0–32,6]) in the preoperative night and increased in the following six nights post surgery: second night: 5,6 (2,6-15,0 [1,1 - 59,3]); third night: 16,9 (5,6 - 38,8 [2,9 - 64,3]); fourth night: 11,6 (5,9 - 17,3 [0,4 - 39,3]); fifth night: 15,2 (5,7 - 22,2 [0,2 - 55,5]); sixth night: 22,5 (5,2 - 35,4 [0,2 - 67,7]). AHI-scores of the third to sixth night post surgery differed significantly from data observed in the preoperative night.
A significant increase in the AHI occurred frequently after major surgical procedures in the late postoperative period. Sleep-disordered breathings in the late postoperative period deserve attention, as they potentially increase the risk of postoperative complications.
Authors’ original file for figure 113037_2013_223_MOESM1_ESM.tiff
Kaw R, Golish J, Ghamande S, Burgess R, Foldvary N, Walker E: Incremental risk of obstructive sleep apnea on cardiac surgical outcomes. J Cardiovasc Surg (Torino). 2006, 47: 683-689.
Rosenberg J, Kehlet H: Postoperative mental confusion–association with postoperative hypoxemia. Surgery. 1993, 114: 76-81. PubMed
Iber CA-IS, Chesson A, Quan SF for the American Academy of Sleep Medicine: The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, 1st ed. 2007, Westchester, Illinois: American Academy of Sleep Medicine
Blake DW, Chia PH, Donnan G, Williams DL: Preoperative assessment for obstructive sleep apnoea and the prediction of postoperative respiratory obstruction and hypoxaemia. Anaesth Intensive Care. 2008, 36: 379-384. PubMed
Kapur VK: Obstructive sleep apnea: diagnosis, epidemiology, and economics. Respir Care. 2010, 55: 1155-1167. PubMed
Finkel KJ, Searleman AC, Tymkew H, Tanaka CY, Saager L, Safer-Zadeh E, Bottros M, Selvidge JA, Jacobsohn E, Pulley D, Duntley S, Becker C, Avidan MS: Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center. Sleep Med. 2009, 10: 753-758. 10.1016/j.sleep.2008.08.007. CrossRefPubMed
Gross JB, Bachenberg KL, Benumof JL, Caplan RA, Connis RT, Cote CJ, Nickinovich DG, Prachand V, Ward DS, Weaver EM, Ydens L, Yu S, American Society of Anesthesiologists Task Force on Perioperative Management: 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: 1081-1093. 10.1097/00000542-200605000-00026. quiz 1117–1088 CrossRefPubMed
- Incidence of perioperative sleep-disordered breathing in patients undergoing major surgery: a prospective cohort study
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II