Sedation Dentistry and Anesthesia – Obstructive Sleep Apnea Important Considerations
Dr. Thomas Peltzer in Connecticut provides sedation dentistry to patients throughout Connecticut and has extensive anesthesia training in helping patients with Obstructive Sleep Apnea during Dental Sedation.
1. Obstructive sleep apnea (OSA) is the most common breathing disorder occurring during sleep. It is characterized by partial or complete obstruction of the upper airway during sleep despite continuing ventilatory efforts. [1]
2. Approximately 20% of adults may suffer from OSA, with nearly 7% exhibiting moderate-to-severe OSA. However, up to 80% of patients with OSA are undiagnosed and thus untreated.
3. Patients with OSA are at a higher risk of peri-procedure complications such as respiratory depression and decreased pharyngeal muscle tone, which may exacerbate airway obstruction, leading to hypoxia, hypercarbia, arrhythmias, and ultimately, cardiopulmonary arrest. Dr. Peltzer, your dentist anesthesiologist, must be made aware of your sleep apnea condition and will ask specific questions about the severity of your sleep apnea.
4. Unrecognized (or diagnosed) OSA is one of the major causes of peri-procedure complications. [2,3,4]
OSA and Ambulatory (Office Based) Surgery
1. Use of sedatives and anesthetics, muscle relaxants and opioids, may worsen or trigger upper airway obstruction and apnea.
2. These drugs also decrease the natural responses to low oxygen and high carbon dioxide levels in the blood.
3. The stress of surgery (depending on its length and invasiveness) itself can cause an exacerbation of OSA symptoms, which typically occur several days after surgery. Dr. Peltzer will advise you as to specific actions you should take to ensure your uneventful recovery and return to your normal activities.[1]
Selected References
1. Joshi G. The Patient With Sleep Apnea Syndrome for Ambulatory Surgery. http://www.utswanesthesia.com/education/images/stories/PDF%20Documents/ Patient_with_Sleep_Apnea_Syndrome_for_Ambulatory_Surgery.pdf
2. http://www.rightdiagnosis.com/o/obstructive_sleep_apnea/prevalence.htm
3. Stierer TL; Wright C; George A; Thompson RE; Wu CL; Collop N. Risk assessment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery. J Clin Sleep Med. 2010. 6:467-472.
4. Ravesloot MJ, van Maanen JP, Hilgevoord AA, van Wagensveld BA, de Vries N. Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery. Eur Arch Otorhinolaryngol. 2012. 269:1865-1871.
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