Obesity and Obstructive Sleep Apnea
It’s estimated that 60 to 90 percent of obese patients may suffer from obstructive sleep apnea. OSA causes the soft tissue in the rear of the throat to narrow and repeatedly close during sleep. The brain responds to each of these “apnea events” by waking the person in order to resume breathing. Since apnea events can happen hundreds of times per night, sleep becomes broken and ineffective.
During surgery, OSA can make the patient’s airway difficult to handle due to the anesthetic relaxing the airway. Additionally, residual effects of anesthesia can make it more difficult for the patient to wake up and take a breath. These complications can lead to death, so it is critical that the anesthesiologist be aware of a potential issue prior to surgery.
Frances Chung, MD, created the STOP questionnaire that is widely used to screen anyone for the possibility of sleep apnea. If you are obese and facing surgery, it is especially important that you ask yourself these questions and discuss the results with your physician:
S: Do you Snore loudly? (loud enough to be heard behind closed doors)
T: Do you often feel Tired, fatigued, or sleepy during daytime?
O: Has anyone Observed you stop breathing during sleep?
P: Do you have or are you being treated for high blood Pressure?
If a patient answers "yes" to two or more of these questions, they are ranked as being at high risk for OSA. In some cases, a diagnosis of OSA may lead to more preoperative testing and/or postponement of non-urgent procedures.
For more information about OSA, please see the ASA’s section devoted to the topic here.