Post Surgery

According to a new study publish in The Journal of the American Medical Association (JAMA), patients who have severe obstructive sleep apnea have a significantly higher risk of complications related to their heart in the first 30 days after major surgery. Unrecognized obstructive sleep apnea increases cardiovascular risks in the general population.

Sleep breathing disorder

They find that the risk of postoperative complications relate to their heart was 50% higher in patients with sleep apnea compare to those without sleep apnea, says Dr. Frances Chung, a Clinician Investigator with the Krembil Research Institute and a Professor in the Department of Anesthesiology and Pain Management at the University Health Network and University of Toronto.

Severe obstructive sleep apnea is the most common type of sleep breathing disorder and has also been associate with a higher risk of cardiac diseases, hypertension, stroke, atrial fibrillation, diabetes and cognitive impairment. It is also associate with three fold increase in death rate.

During obstructive sleep apnea, the upper airway is block by the tongue and surrounding tissues during sleep; which may result in a lack of oxygen to the brain. As a result, in the general population, obstructive sleep apnea; which is associate with a higher risk of cardiovascular complications; so including high blood pressure, angina, irregular heartbeat, heart failure and sudden death, says Dr. Chung. In this study, they want to determine whether sleep apnea would pose a similar risk to surgical patients.

The pre surgical patients

Key Findings: The authors identify 1,218 pre-surgical patients newly diagnose with sleep apnea and follow them for 30 days after their surgery. These surgical patients had a 50% higher risk of complications relate to their heart. The authors believe this is due to the sleep apnea going undiagnozed and untreat.

On further analysis, patients with severe sleep apnea were associate with a 14-fold increase in cardiac death; hence an 80% higher risk of heart injury and an almost 7-fold higher risk of heart failure. Since sleep apnea occurs while you’re asleep; 80% of men and 90% of women with sleep apnea may not even know they have it.

30% of our surgical population has unrecognized moderate to severe sleep apnea. The patients in this study were not diagnose and they were not treat before surgery. The key takeaway here is that if patients have symptoms of sleep apnea; so perhaps they should be treat before undergoing major surgery; so says Dr. Chung. Further study is need to determine how best to prevent patients with severe sleep apnea from having a higher risk of heart complications.