Sleep Apnea and Heart Problems After Surgery

Sleep Apnea has made headlines again.  This time related to heart problems after surgery.  In a recent article from Reuters by Lisa Rapaport, she highlights:

Compared to patients without apnea, people with severe apnea were more than twice as likely to die of heart complications or experience serious cardiac events like heart attacks and strokes within 30 days of surgery, researchers report in JAMA.

Previous research suggests that sleep irregularities can increase the risks for a variety of cardiovascular disorders, such as clogged or hardened arteries, high blood pressure, irregular heartbeat, and stroke, as well as metabolic problems like high cholesterol, obesity and diabetes that all contribute to cardiovascular disease.

In fact, most of the rest of the statistics quoted in her article were from a research study posted in the JAMA (here and here) that are strongly indicating this evidence as a “Wake-up Call”.  There is a resounding amount of evidence pointing towards screening.  As our knowledge continues to grow, so has the necessity for screening for sleep apnea.

Anesthetics

Anesthetics used during the surgery tend to be one of the main concomitant factors amplifying the post-operative concerns.  In fact,

“Patients having surgery are particularly vulnerable because the surgery and anesthetics are likely to worsen airway obstruction,” <Dr. Matthew Chan of the Chinese University of Hong Kong> said by email.

“Biot’s respiration is an abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea.” according to Wikipedia.  I can attest, intervening upon Biot’s respiration in the sleep laboratory is immensely difficult.  Frequently tied to Opioid use, this respiratory pattern notoriously requires an advanced level of Positive Airway Pressure to resolve.  Though the pressure can be difficult to acclimate to, it’s absolutely life changing.  The author closed her article with an excellent tie back to the importance of screening.

“Even so, the results suggest that identifying patients with undiagnosed apnea prior to surgery may help reduce their risk of cardiac complications afterward, said Dr. Dennis Auckley of Case Western Reserve University and MetroHealth Medical Center in Cleveland, Ohio, who wrote an editorial that was published with the study.

That’s because the recurrent episodes of low oxygen levels that happen with sleep apnea are associated with increased blood pressure and heart rate and place significant stress on the cardiovascular system, Auckley said by email.”

This article was an excellent read.  Approximately four minutes in length.  A link to the original article has been included at the top of this Insight Post.  Please use our Modified Screener to investigate sleep apnea.  If you leave contact information for us we will definitely get in touch with you!