It’s not exactly surprising to those of us involved in sleep disorders diagnosis and treatment, but a new study in the journal Anesthesology notes that undiagnosed obstructive sleep apnea (OSA) puts patients at risk of complications when undergoing surgery and anesthesia. However, a few simple questions can determine if a person may have OSA and give them an opportunity to be treated for the condition before going under the knife, according to a new study in the journal Anesthesiology.

The study reports that a new tool called STOP consists of the following four questions:

S: Do you snore loudly?
T: Do you often feel tired, fatigued or sleepy during the daytime?
O: Has anyone observed you stop breathing during sleep?
P: Do you have or are you being treated for high blood pressure?

Answering “yes” to one or more of the questions should trigger an evaluation for OSA prior to surgery.

“Identifying patients with OSA is the first step in preventing postoperative complications. Untreated OSA patients are known to have a higher incidence of difficult intubation, postoperative complications, increased intensive care admissions and greater duration of hospital stay,” Dr. Francis Chung, of the University of Toronto, said in a prepared statement.

In a companion study, Dr. Chung and colleagues also validated two other screening tools that have been used previously but not definitively validated for surgical patients: the 11-question Berlin Questionnaire and the American Society of Anesthesiologists (ASA) checklist, which contains 12 checkable items for adults and 14 for children.

NSF urges all sleep apnea patients and those who may be at risk for sleep apnea to discuss their symptoms with their healthcare providers before undergoing any surgical procedure.

This is important reading for all physicians who perform pre-operative examinations.  I hope many will take the time and consider the implications.

Steve Gardner

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