In this historical cohort study, 471 patients who had undergone noncardiac surgery within 3 years of polysomnography were included in the study. The presence of OSA (defined as AHI ≥5/h) was associated with higher incidence of postoperative hypoxemia, overall complications, transfer to ICU, and increased hospital length of stay.
Patients with difficult mask ventilation under general anesthesia were subsequently evaluated with nocturnal polysomnography (PSG) to determine the presence of a sleep-related breathing disorder. Of 10 patients who underwent PSG, 9 demonstrated OSA and 1 had an elevated RDI (> 5) with excessive daytime sleepiness (categorized as upper airways resistance syndrome). This study suggests that anesthesiologists can identify individuals de novo with increased risk of OSA based on the difficulty of mask ventilation during surgical procedures.
The oxygen desaturation index >10 demonstrated a sensitivity of 93% and a specificity of 75% to detect moderate and severe sleep disordered breathing. Oxygen desaturation index from a high-resolution nocturnal oximeter is a sensitive and specific tool to detect undiagnosed SDB in surgical patients.
Twenty five percent developed postoperative delirium after elective knee replacement. In this study, obstructive sleep apnea was the only significant predictor using multivariate analysis.