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Sleep and Anesthesia

About Anesthesia

  • An estimated 40 million anesthetics are administered each year in the United States
  • Complications from anesthesia have declined dramatically over the last 50 years

Anesthestic medications block the feeling of pain and other sensations . This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience. During anesthesia the brain is unconscious, not asleep, and the muscles of the body are relaxed. Anesthesia may involve all or part of your body and is divided into four major types:

  • Local: numbs one small area of the body. You stay awake and alert
  • General anesthesia: affects your whole body. You go to sleep and feel nothing. You have no memory of the procedure afterwardsĀ 
  • Regional anesthesia: blocks pain in an area of the body, such an arm or leg. Epidural anesthesia, which is sometimes used during childbirth, is a type of regional anesthesia
  • Conscious or intravenous (IV) sedation: uses a mild sedative to relax you and pain medicine to relieve pain. You stay awake but may not remember the procedure afterwards

About Sleep and Anesthesia

  • General anesthesia itself does not usually cause much sleep disturbance, but the surgery and any sedatives provided afterwards can
  • The muscle relaxation caused by the anesthetics can cause the airway to close off, a disorder called sleep apnea
  • Many people are unaware that they have sleep apnea, a sleep disorder where snoring, daytime sleepiness, and waking up gasping for breath are common
  • Undetected sleep apnea can result in serious complications during surgery

Undiagnosed and untreated sleep apnea (a frequent closing of the throat while sleeping) can increase the risk of complications before, during and after surgery due to the effects of anesthesia. Sedatives, analgesics and anesthetic agents all contribute to further weakness in the airways at the back of the throat, sometimes leading to serious breathing and cardiac problems. One surgical research study showed that there were serious complications in almost one in four of the patients with sleep apnea.

If you are going to be having surgery or any procedure requiring sedating anesthesia, and you have symptoms of sleep apnea, it is important that you discuss this with your doctor before your surgery. Equally, if you have trouble sleeping after surgery, ask your doctor about the medications you are taking.

References

Chung SA, Yuan H, Chung F. A systemic review of obstructive sleep apnea and its implications for anesthesiologists. Anesth Analg. 2008 Nov;107(5):1543-63. PMID: 18931212

Gupta RM, Parvizi J, Hanssen AD, Gay PC, Postoperative Complications in Patients with Obstructive Sleep Apnea Syndrome Undergoing Hip or Knee Replacement: A Case-Control Study, Mayo Clin Proc., 76(9), 897-905, 2001

Young T, Peppard PE, Gottlieb DJ, Epidemiology of Obstructive Sleep Apnea-A Population Health Perspective, AJRCCM, 165, 1217-39, 2002

Rennotte MT, Baele P, Aubert G, Rodenstein DO, Nasal Continuous Positive Airway Pressure in the Perioperative Management of Patients with Obstructive Sleep Apnea Submitted to Surgery, Chest, 107(2), 367-74, 1995

Ostermeier AM, et. al., Three Sudden Postoperative Respiratory Arrests Associated with Epidural Opioids in Patients with Sleep Apnea, Anest Analg, 85, 452-60, 1997

 

Resources

American Sleep Apnea Association

American Society of Anesthesiologists

SurgiPrep WEBLOG

American Association of Nurse Anesthetists

National Institutes of Health

WebMD