In a sample of 2,018 patients who underwent measurement of fasting lipid levels and nocturnal recording for assessment of obstructive sleep apnea, total cholesterol and LDL were not associated with the oxygen desaturation index. However, nocturnal intermittent hypoxemia and OSA severity were associated with higher triglycerides and lower HDL-C, independent of confounders. This may provide a mechanism through which OSA is associated with cardiovascular risk.
In a sample of 5,003 midlife men and women, shorter sleep (< 5 hours per night) was associated with higher levels of CRP and IL-6 and in longitudinal analyses, a greater increase in sleep duration was associated with a significant 5-year increase in CRP and IL-6.
The authors “analyzed data from approximately 400 hospitals in the United States. Perioperative outcomes were compared between patients receiving general, neuraxial, or combined neuraxial-general anesthesia. “They concluded that “neuraxial anesthesia may convey benefits in the perioperative outcome of SA patients undergoing joint arthroplasty.”
In this large nationally representative sample, despite the increased association of SDB/OSA with postoperative cardiopulmonary complications, the diagnosis of SDB/OSA was negatively, rather than positively, associated with in-hospital mortality and resource use.
The authors developed and validated a score for the prediction of postoperative respiratory complications, a simple, 11-point score that can be used preoperatively by anesthesiologists to predict severe postoperative respiratory complications. Independent predictors for reintubation were: American Society of Anesthesiologist Score 3 or more, emergency surgery, high-risk surgical service, history of congestive heart failure, and chronic pulmonary disease.
Excellent review on this topic.
During propofol anaesthesia, pharyngeal occlusion persists despite large increases in genioglossus EMG, in the presence of a preserved mechanical response to electrical stimulation.
The STOP-Bang score was validated in 310 obese and morbidly obese surgical patients. For identifying severe OSA, a STOP-Bang score of 4 has high sensitivity of 88 %. For confirming severe OSA, a score of 6 is more specific.