The mission of SASM is to advance standards of care for clinical problems shared by Anesthesiology and Sleep Medicine, including peri-operative management of sleep disordered breathing, and to promote interdisciplinary communication, education and research in matters common to anesthesia and sleep.
Society of Anesthesia and Sleep Medicine
The Society of Anesthesia and Sleep Medicine (SASM) has been founded to encourage exploration of the substantial common ground that exists between Anesthesiology and Sleep Medicine and the anesthetic and sleep states.
The Society’s objectives are to:
- Encourage the cross fertilization of ideas between anesthesiology and sleep medicine.
- Promote clinical and epidemiological studies determining the associations between sleep disorder breathing and perioperative risk.
- Examine methods of minimizing perioperative risk of upper airway obstruction or ventilatory insufficiency in predisposed individuals.
- Explore the use of non-invasive positive airway pressure therapies to prevent and treat perioperative upper airway obstruction or hypoventilation.
- Stimulate research examining the relationships in respiratory, neurophysiological, neuropsychological and neuropharmacological function between anesthesia and sleep.
Sleep and Anesthesia: The Common Ground
Anesthesia and sleep share many features:
- Common mechanisms are involved in the unconsciousness of each state. This unconsciousness is accompanied by muscle relaxation, decreased breathing effort and increased upper airway collapsibility.
- People with excessively collapsible upper airways during sleep (obstructive sleep apnoea) often prove to have “difficult” upper airways during anesthesia and vice versa: upper airway behavior in one state often predicts behavior in the other.
- Similarly, hypoventilation (under-breathing) is often observed during sleep in patients with lung or chest wall disorders (including obesity and muscle weakness) in the absence of evidence of hypoventilation during wakefulness. Sleep hypoventilation deserves exploration as a predictor of breathing problems during anesthesia and postoperative pulmonary complications.
- Understanding the shared mechanisms determining unconsciousness in sleep and anesthesia is basic to understanding the nature of anesthesia itself. It is notable that sleepiness appears to decrease anesthetic requirements, as does performing anesthesia late at night rather than during the day.
- Anesthesia alone appears to have some of the restorative powers of sleep but, because of pain and other factors, sleep loss is common postoperatively and may adversely affect recovery from surgery
These and related issues require further exploration.