Meeting the challenge of obstructive sleep apnea: developing a protocol that guides perianesthesia patient care

Caring for a patient postoperatively with a medical history of diagnosed or suspected obstructive sleep apnea (OSA) is not uncommon. OSA is estimated to be present in 2%-26% of the general population, and the National Sleep Foundation proposes that one in four Americans are at high risk for OSA. Also of concern is that the incidence of OSA may increase as our population ages. Despite published guidelines, it can be difficult to implement recommendations that include increased monitoring of patients in critical care settings, particularly when these resources are already stretched. Although health care professionals want to provide a high level of care, it is recognized that patients with OSA can place a strain on health care systems. This article reviews the impact OSA can have on the patient in the perioperative phase and the implications to care providers. Also outlined are the challenges of initiating an OSA screening tool and management protocol. Although updating an institution's policies around perioperative management of the patient with OSA is vital, it can appear to be an overwhelming task to comply with all evidence-based recommendations.