Obstructive sleep apnea and anesthesia: What are the risks?

Obstructive sleep apnea (OSA) can cause significant complications during recovery from anesthesia. For this reason, it's important to tell your anesthesiologist that you have OSA before surgery so that he or she can take precautions to minimize the risks.

Obstructive sleep apnea occurs when the muscles in the back of your throat relax during sleep. When these muscles relax, your airway narrows or closes as you breathe in and your breathing is momentarily interrupted. This may reduce the amount of oxygen supplied to your brain. Your brain senses that you've stopped breathing and briefly rouses you from sleep so that you can reopen your airway.

General anesthesia can impair the function of airway muscles, resulting in more frequent episodes of interrupted breathing. In addition, residual effects from sedating pain medications and anesthesia make it harder for you to wake up and take a breath.

For these reasons, you may be monitored for a longer period after surgery than someone who doesn't have obstructive sleep apnea. Many people with OSA require assisted breathing (mechanical ventilation) until fully awake. If you have been prescribed a device that provides continuous positive airway pressure (CPAP), make sure you bring it with you. The CPAP device can be used in the recovery room to help you to keep breathing normally.

When you return home after surgery, it's a good idea to arrange for someone to be with you during the initial period when you are recovering from anesthesia and surgery. If this person observes that you're having trouble breathing, he or she should wake you — or if that isn't effective, seek emergency medical help.