Mismanagement of obstructive sleep apnea may result in finding these patients dead in bed

Excerpt

The first step in fixing a problem is identifying the problem. Accordingly, this issue of the Journal includes a survey by Cordovani et al. on the perioperative management of patients with obstructive sleep apnea (OSA) which proves very helpful in that regard.1 The authors found that approximately half of Canadian anesthesiologists screen for OSA, and approximately half work in a hospital with a functional OSA policy. In my opinion, these main findings most probably correspond with those in the USA. On the one hand, these findings represent an improvement when compared with just 15-20 years ago—there has been a large increase in the number of doctors who systematically screen for OSA and an increase in the number of institutions that have a functional OSA management policy—and such practices decrease the chance of OSA mismanagement. On the other hand, many anesthesiologists still do not screen for OSA and many institutions do not have a working OSA policy, and such practices increase the chance of OSA mismanagement. The real problem with the lack of OSA screening and institutional OSA management policy is that these institutions are largely ignoring the OSA disease, and as a result, they may find some postoperative OSA patients dead in bed (DIB). …