There are a number of reasons why obstructive sleep apnea can increase your risk of having a complication during or after surgery. Complications may include a breathing or heart problem.
First you may be given a drug to ”put you to sleep” before the surgery. This is known as “anesthesia.” It keeps you from feeling pain during the surgery. It also prevents you from being able to breathe on your own.
As a result a breathing tube will need to be placed in our throat right after you are put to sleep. It can be hard to put the breathing tube in the narrow throat of a person with obstructive sleep apnea. Inserting the tube also can cause some swelling in the throat area.
After surgery the breathing tube is removed. But your throat still may have some swelling. This can make sleep apnea worse.
Medications can be another problem. Many of the drugs that may be given to you before, during and after surgery can cause changes in your breathing.
These medications may cause your throat muscles to relax even more. They also may cause you to breathe less deeply and less often. As a result these drugs may increase the severity of even mild sleep apnea. Breathing pauses may last longer than normal.
Medications also may keep your brain from waking you up when you have a breathing pause. This can lead to problems such as dangerously low oxygen levels and high blood pressure. You also may have too much fluid in the lungs, heart problems or a stroke.
Another potential problem is that you may not sleep well before surgery. It may be hard for you to sleep in the hospital room. You also may be anxious or in pain. As a result you may become sleep deprived. Sleep deprivation can make sleep apnea worse.
Your sleeping position also can affect your sleep apnea.
After surgery you may have to sleep on your back.
Obstructive sleep apnea tends to be worse in this position. Gravity can cause the tongue to fall back and block the opening of the airway.
Having obstructive sleep apnea does increase your risk for problems when you have surgery. But the good news is that your health-care team can minimize problems during and after surgery if they know that you have obstructive sleep apnea! They will monitor you more closely. They also will make sure that you receive the proper medications before, during and after the operation. Your doctors can select types of anesthesia and pain medications that are less likely to worsen your sleep apnea. You also will be watched closely after surgery. This may involve extra monitoring equipment to ensure that you maintain safe breathing and oxygen levels.
There are certain types of surgery that are more likely to worsen obstructive sleep apnea. Chest or upper abdominal surgery may cause you to have more breathing problems. It may be harder for you to take a deep breath. Surgery on the upper airway may cause your upper airway to swell. This will produce a narrower breathing passage.
Examples of upper-airway surgery include:
- Cervical spine procedures, anterior approach
- Uvulopalatopharyngoplasty (UPPP)
- Tonsillectomy
- Adenoidectomy
- Tongue surgery
- Surgery on the larynx (voice box, lower or thyroid neck)
But any type of surgery can increase your risk for problems when you have sleep apnea. This even includes minor procedures that don’t require you to spend a night at the hospital. Examples include a colonoscopy or bronchoscopy. These ”outpatient” procedures still may involve the use of drugs to help you relax or to relieve your pain. These medications can cause the breathing problems that were described in a previous section of this brochure.
If you know that you have obstructive sleep apnea, then be sure to tell your doctors before the surgery. If you already use CPAP therapy, then bring your mask and CPAP machine to the hospital. You should be able to use it after your surgery. If you think that you may have obstructive sleep apnea, then you should discuss this with your doctor as soon as possible. There may be time for you to have a sleep study and begin treatment before the surgery.
Even if there is not enough time for a sleep study, you should still talk to your doctors about your concerns.
Let your surgical team know about your symptoms.
This will help them ensure your safety during and after surgery.
Obstructive sleep apnea is a disorder that can increase your risk of having complications during and after surgery. It is important to discuss obstructive sleep apnea with your surgical-care providers before having any type of surgery. ‘This will help your surgical team provide the best care for you. For help with obstructive sleep apnea visit a board-certified sleep specialist in your area.