Sleep apnea is a complex condition, often the result of a combination of anatomy, lifestyle, and health. The impacts of the condition can be far-reaching, including an increased risk of serious health harms in many situations.
Sleep apnea can even lead to potential harms when you are seeking medical care. For example, sleep apnea has been associated with anesthesia complications and longer healing times.
Now a new study shows just how much sleep apnea can increase your risks for anesthesia complications related to intubation and other interventions. This reminds us how important sleep apnea diagnosis can be to help you avoid many different complications.
A 70-Year Meta-Analysis
For this study, reported at the 2018 meeting of the International Anesthesia Research Society, researchers conducted a meta-analysis of studies published between 1946 and 2016 that:
- Analyzed an adult population
- Identified patients with sleep apnea using polysomnography, charts, or questionnaires
- Reported at least one difficult airway event
They initially identified over 4000 studies, although only 16 actually met the inclusion criteria upon close analysis. The data in the included studies was large, though, from a total of over 200,000 patients. This gave them adequate grounds for comparing people with sleep apnea and those without.
They found that, overall, people with sleep apnea were 3.44 times more likely to experience an adverse event related to intubation. They were 3.39 times more likely to have difficult mask ventilation, 4.12 times more likely to have difficult intubation and difficult mask intubation. But there was one intervention that didn’t have more difficulty for people with sleep apnea: laryngeal mask airway. Researchers noted that this approach could be used to help people with sleep apnea whose airway was otherwise hard to secure.
Researchers also pointed out that this difficulty related directly to the situations where people with sleep apnea experienced serious harms. These patients, they noted, “usually . . . could not be reintubated in the PACU [post-anesthesia care unit]. Clinicians could have performed a planned intubation . . . in the OR, but the [patients] stop breathing or desaturate during an emergency intubation.” This results in events such as “brain damage and hypoxic brain injuries.” If patients with sleep apnea are identified before surgery, doctors and nurses could be prepared for airway difficulties, resulting in fewer serious complications.
Get Tested for Sleep Apnea
Most stories like this contain very good news. Sleep apnea can cause complications, but there are usually ways to avoid or reduce complications.
But they also carry a warning: we need to know we have sleep apnea to be able to take those steps. And, unfortunately, most people with sleep apnea are still undiagnosed. Having undiagnosed and therefore untreated sleep apnea not only makes you more likely to need surgery from heart complications or accidents. It also makes you more likely to experience complications from surgery and other treatments.
The solution is clear: we need to do a better job of diagnosing sleep apnea. Though better screening can help, diagnosis should ideally happen before you go to the hospital. This may be something your doctor isn’t going to take care of. It may be up to you. If you are experiencing symptoms of sleep apnea, it’s time to talk to a sleep dentist about getting a sleep test.