Review of Obstructive Sleep Apnea and the Peri-Operative Management of Patients in a Resource-Limited Setting

Obstructive sleep apnea (OSA) patients suffer from recurrent asphyxia, airway obstruction, and hypoxia. Poor awareness among Africans precludes diagnosis and pre-surgery optimization. Vital diagnostic tools such as polysomnography (PSG) are largely inaccessible to patients and anesthesia providers in low-resourced countries. In particular, Africans have genetic, inflammatory, and social-cultural factors predisposing them to sleep difficulty. The perioperative mortality risk in OSA patients has a linear relationship with the disease severity. Anesthesia considerations including difficult airway, desaturation, ventilatory failure, and inadvertent intensive care unit (ICU) admission, promote perioperative fatality. This article reviews the diagnosis, anesthesia concerns, optimization, and perioperative management of OSA in poorly resourced settings.