Should We Have General Sleep Apnea Screening For All Surgical Patients?

People who suffer from obstructive sleep apnea (experiencing repeated cessation of breathing during sleep) are at greater risk from surgery. For example, it is well known that surgical patients with obstructive sleep apnea often present difficulties with intubation in advance of surgery, run a higher risk of complications during and particularly after surgery, more often require admission to intensive care and frequently stay longer in hospital.The problem however is that in very many cases patients are not known to suffer from obstructive sleep apnea at the time of surgery and indeed it is only when complications arise as a result of their surgery that their condition comes to light and by then of course it is too late. So what can be done?The problem of course is that many people suffer from sleep apnea without even being aware of it and, although hospitals do screen patients for a variety of conditions, surgical patients are not routinely screened for sleep apnea because the only reliable way to diagnose it is using an overnight sleep study, which is far too time consuming and, of course, too expensive.The answer may however lie in a simple new questionnaire devised by a team of Canadian anesthesiologists.The four question form to be completed by surgical patients simply asks whether they snore loudly, they are tired and sleepy during the day, they have every had anybody witness the fact that they stop breathing during sleep and they are being (or have been) treated for high blood pressure. The answers to these questions are then taken together with other routinely collected information such as the patients gender, age and body mass index and an assessment is made about whether or not the patient is likely to pose a risk for surgery.In the case of high risk patients anesthesiologists can then not only select appropriate anesthetic techniques, but they can also ensure that the necessary equipment is to hand in the operating theater to cope with possible complications.Only time will tell how effective this new idea will work but, if the questionnaire proves successful it will certainly save hospitals a lot of time and money and patients a good deal of unnecessary suffering.