Sleep-Disordered Breathing and Perioperative Outcomes - Current Controversies

Sleep-disordered breathing (SDB) includes obstructive sleep apnea (OSA), central sleep apnea and obesity hypoventilation syndrome. OSA is an increasingly common disease^1,2  of particular concern to anesthesiologists as it is associated with increased perioperative complications.³  It is estimated that the prevalence of OSA in the United States is on a rise probably because of the aging population and increase in obesity. However, another possibility could be related to the liberalization of OSA definition (i.e., use of a lower threshold for defining hypopnea).²  The apnea-hypopnea index (AHI), which comprises the number of apneic and hypopneic events per hour, is used to diagnose and determine the severity of OSA. OSA is common in patients with heart failure, atrial fibrillation, diabetes mellitus and chronic obstructive pulmonary disease. Therefore, it is suggested that OSA should be considered as a spectrum of diseases characterized by a severity spectrum akin to systemic...