Perioperative concerns in sleep apnea

Sleep apnea syndrome is one of a series of sleep-related breathing disorders, and is often under-diagnosed. Recent appreciation of the prevalence of sleep apnea and its physiologic effects has raised patient and caregiver awareness of the disorder. Few definitive data exist to guide perioperative management of patients with sleep apnea. Nevertheless, advances in the study of sleep apnea have served to highlight important aspects of anesthetic care for these patients. An improved understanding of the relationships between sleep apnea and comorbid conditions has better defined the role for preoperative treatment. Recent work has also clarified the impact of interactions between postoperative pain management strategies and sleep apnea, as well as the need for advanced postoperative monitoring. Finally, progress in our understanding of the relationship between sleep deprivation and the anesthesized state may provide new insights into relationships between the anesthetic and sleep states. The present review identifies important perioperative concerns in patients with sleep apnea and suggests management strategies.