Pre-operative screening for sleep disordered breathing: obstructive sleep apnoea and beyond

Area of Science:

• Anesthesiology
• Pulmonology
• Sleep Medicine

Background:

• Sleep disordered breathing (SDB) encompasses conditions causing abnormal nocturnal gas exchange, significantly impacting peri-operative management.
• Obstructive sleep apnoea and hypoventilation disorders are key SDB types requiring pre-operative consideration.
• Patients with SDB may present with minimal symptoms, necessitating thorough pre-operative screening.

Purpose of the Study:

• To review SDB types and pre-operative screening methods.
• To elucidate the pathophysiology of SDB and its peri-operative implications.
• To outline peri-operative management and treatment strategies for SDB patients.

Main Methods:

• Literature review of SDB pathophysiology, screening tools, and peri-operative management strategies.
• Analysis of clinical implications for surgical patients with SDB.
• Synthesis of current evidence on positive airway pressure therapy and post-operative monitoring.

Main Results:

• SDB requires careful pre-operative assessment due to potential for peri-operative complications.
• Screening for SDB is vital, as patients can be minimally symptomatic.
• Therapeutic interventions like positive airway pressure (PAP) and surgical delay must be weighed against surgical urgency.

Conclusions:

• Effective peri-operative management of SDB involves early screening, diagnosis, and tailored treatment plans.
• Utilizing PAP therapy and appropriate post-operative monitoring can mitigate respiratory and cardiovascular risks.
• Optimizing SDB management improves clinical outcomes in the peri-operative period.