Review
Biochemistry & Molecular Biology
Piotr Kaczmarski, Filip Franciszek Karuga, Bartosz Szmyd, Marcin Sochal, Piotr Bialasiewicz, Dominik Strzelecki, Agata Gabryelska
Summary: There is an association between obstructive sleep apnea (OSA) and pain modulation, which is related to the pathophysiological changes in OSA and various pain mechanisms. Characteristic changes in OSA, such as nocturnal hypoxemia, sleep fragmentation, and systemic inflammation, have a curtailing impact on pain perception. Pain management in OSA patients may cause problems due to alterations in neuropeptide systems and overexpression of opioid receptors.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Clinical Neurology
Po-Yang Tsou, Christopher M. Cielo, Melissa S. Xanthopoulos, Yu-Hsun Wang, Pei-Lun Kuo, Ignacio E. Tapia
Summary: This study found an association between obstructive sleep apnea (OSA) diagnosis and complications in sickle cell disease (SCD) patients. OSA was associated with a 50% increase in the odds of neurologic complications in children with SCD.
Review
Clinical Neurology
Carla Freire, Luiz U. Sennes, Vsevolod Y. Polotsky
Summary: Opioid misuse can lead to high mortality, mainly due to respiratory depression. Studies have shown that opioid use may cause sleep-disordered breathing and increase the risk of obstructive sleep apnea. Variability in individual responses to opioids and differences in methodology can contribute to conflicting research results.
JOURNAL OF CLINICAL SLEEP MEDICINE
(2022)
Review
Anesthesiology
Crispiana Cozowicz, Stavros G. Memtsoudis
Summary: The prevalence of obstructive sleep apnea (OSA) worldwide has reached 1 billion people, posing significant risks in the perioperative setting. Critical determinants of perioperative risk in OSA patients include changes in upper airway anatomy, diminished upper airway dilator muscle capability, disparities in arousal thresholds, and ventilatory control instability. Preoperative screening, heightened awareness, and postoperative care adjustments are important considerations. Anesthetic agents and sedatives worsen upper airway collapsibility, while the utilization of neuromuscular blockade increases the risk for respiratory compromise. Opioid analgesia is complex in OSA, with patients being prone to opioid-induced respiratory depression along with increased pain sensitivity. Regional anesthesia and multimodal analgesia are recommended to reduce perioperative complications. Health care institutions are allocating resources to enhance patient safety, and evidence-based perioperative management strategies are needed to address the challenges posed by the rising prevalence of OSA and the lack of evidence on the efficacy of costly measures. Screening algorithms, monitoring, and risk predictors are urgently needed for extended postoperative surveillance and care for OSA patients. The perioperative community is faced with the challenge of developing feasible pathways and measures to increase patient safety and prevent complications in patients with OSA.
ANESTHESIA AND ANALGESIA
(2021)
Review
Cardiac & Cardiovascular Systems
Yerem Yeghiazarians, Hani Jneid, Jeremy R. Tietjens, Susan Redline, Devin L. Brown, Nabil El-Sherif, Reena Mehra, Biykem Bozkurt, Chiadi Ericson Ndumele, Virend K. Somers
Summary: Obstructive sleep apnea is common among middle-aged and older adults and often underrecognized, especially in patients with heart disease. Screening and treatment for sleep-disordered breathing should be considered for cardiac patients, with follow-up sleep testing to assess treatment effectiveness.
Article
Medicine, General & Internal
Ozlem Oner, Mustafa Cenk Ecevit, Ali Necati Gokmen
Summary: This study conducted a bibliographic analysis of obstructive sleep apnea (OSA), which has reached epidemic proportions and is a frequent cause of perioperative morbidity and mortality. The most cited publication in the field of anesthesiology and reanimation was the Society for Ambulatory Anesthesia Consensus Statement on Preoperative Selection of Adult Patients with Obstructive Sleep Apnea Scheduled for Ambulatory Surgery published in the journal Anesthesia and Analgesia by Joshi et al. Furthermore, the number of publications on OSA and anesthesia has rapidly increased in the last decade.
Article
Clinical Neurology
Sara Wasef, Soodaba Mir, Clodagh Ryan, Rida Waseem, Geoff Bellingham, Alia Kashgari, Jean Wong, Frances Chung
Summary: The study found that over half of patients using opioids for chronic pain and newly diagnosed with sleep apnea declined attendance for sleep clinic review or treatment. The adherence rate of positive airway pressure therapy was only 55%.
JOURNAL OF CLINICAL SLEEP MEDICINE
(2021)
Article
Anesthesiology
Carolyne Pehora, David Faraoni, Soichiro Obara, Reshma Amin, Brenda Igbeyi, Adel Al-Izzi, Aman Sayal, Aarti Sayal, Conor Mc Donnell
Summary: The study aimed to determine the incidence and risk factors of PRAEs in children with SDB undergoing general anesthesia. Factors associated with PRAEs were identified, suggesting potential for developing a predictive model and improving preoperative risk assessment.
ANESTHESIA AND ANALGESIA
(2021)
Article
Clinical Neurology
Xia Sun, Jintao Yu, Jia Luo, Shan Xu, Ning Yang, Yan Wang
Summary: There is a significant association between obstructive sleep apnea (OSA) and postoperative adverse events. The severity of OSA increases the risk of complications, while preoperative diagnosis and continuous positive airway pressure (CPAP) therapy can reduce the risks. CPAP treatment can help reduce the incidence of postoperative complications.
Review
Clinical Neurology
Lynn M. Baniak, Staci L. Orbell, Faith S. Luyster, Richard Henker, Patrick J. Strollo Jr
Summary: Untreated obstructive sleep apnea (OSA) can increase the risk of airway collapse and sleep deprivation in surgical patients, leading to complications and longer hospital stays. This study developed an evidence-based clinical care pathway for managing OSA in orthopedic surgery patients, which includes screening, education, airway management, medications, and monitoring. However, there is a lack of evidence on interventions to reduce postoperative complications during the perioperative period and after discharge to unmonitored environments. Further research is needed in these areas.
SLEEP MEDICINE REVIEWS
(2023)
Review
Medicine, General & Internal
Yanru Ou, Dandan Zong, Ruoyun Ouyang
Summary: This article explores the relationship between obstructive sleep apnea (OSA) and epigenetics, and provides better diagnostic methods and treatment options. Epigenetic modifications, including post-translational modifications in DNA and histone proteins, and regulation of non-coding RNAs, are involved in the progression of OSA and various multiorgan injuries. This article offers deeper insights into the disease mechanism of OSA and potential applications of targeted diagnosis, treatment, and prognosis in OSA complications.
CHINESE MEDICAL JOURNAL
(2023)
Review
Medicine, General & Internal
Pei-Kang Liu, Tzu-Yu Chiu, Nan-Kai Wang, Sarah R. Levi, Ming-Ju Tsai
Summary: Obstructive sleep apnea (OSA) is a common sleep disorder that can lead to ocular consequences, clinicians should understand the eye diseases in patients with OSA and provide comprehensive care.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Anesthesiology
Toby N. Weingarten, Juraj Sprung
Summary: This review highlights the common yet often undiagnosed obstructive sleep apnea (OSA) in adult surgical patients, emphasizing their heightened sensitivity to anesthetic agents and opioid analgesics, as well as increased risk for postoperative pulmonary complications. Recent findings reveal repetitive apneic spells in OSA patients during the immediate postoperative period, especially on the first postoperative night. Close monitoring is necessary for OSA patients experiencing respiratory depression in the postanesthesia recovery unit.
CURRENT OPINION IN ANESTHESIOLOGY
(2022)
Article
Medicine, Research & Experimental
Angela Alnemri, Sarah Sussman, Leonard Estephan, Callum Hamilton, Matthew Stewart, Tingting Zhan, Adam Thaler, Ashwin Ananth, Maurits Boon, Colin Huntley, Patrick Hunt
Summary: This study compared the cost and time spent in surgical and postoperative courses in patients with obstructive sleep apnea (OSA) undergoing surgery with either total intravenous anesthesia (TIVA) or inhalational anesthesia. The results showed that the total cost was higher in the TIVA nasal surgery group, but this increased cost was offset by lower supply, anesthesia, and recovery room costs. Additionally, the TIVA cohort had shorter recovery times.
Review
Medicine, General & Internal
Almala Pinar Ergenekon, Yasemin Gokdemir, Refika Ersu
Summary: Obstructive sleep apnea (OSA) is a condition characterized by recurrent blockage of the upper airway, affecting both obese and otherwise healthy children. Medical treatment options for OSA in children, including positive airway pressure treatment, are effective but have low adherence rates. This review article aims to summarize these treatment options.
JOURNAL OF CLINICAL MEDICINE
(2023)
