Obstructive sleep apnea and surgery: wake up for the problem!
نویسندگان
چکیده
Obstructive sleep apnea (OSA) is a common disease characterized by repetitive obstruction of the upper airways during sleep. It is now recognized that OSA is much more prevalent than previously thought. For instance, one recent study of a representative sample of the city of São Paulo, Brazil, found that 33% of the adult population presented OSA syndrome as defined by full polysomnography showing an apnea-hypopnea index above 5 events/hour plus symptoms or an apnea-hypopnea index > 15 events per hour independent of symptoms. The prevalence of OSA may be even higher among specific populations for at least 2 reasons. Firstly, because OSA shares several risk factors with common conditions such as obesity, hypertension and diabetes and secondly, OSA once present triggers a series of pathways that may negatively affect co-morbid conditions such as high blood pressure and insulin resistance. Independently of the exact mechanism, it is well Known that among patients with established diagnosis of hypertension, resistant hypertension and metabolic syndrome the prevalence of OSA is strikingly high and varies from 30 to 70%. The recognition of OSA among surgical patients is particularly important. Despite the fact that awareness is still low, one should anticipate a high prevalence of OSA solely based solely on the presence of the demographic and clinical conditions commonly observed in this population. In addition, although not fully established, it is clear that there may be an association between unrecognized OSA and the increased risk of post operative complications. Finally, the pre-operative setting is a good time to investigate comorbidities because patients may be more receptive to lifestyle and medical interventions. On the other hand, a major limitation in the recognition of OSA is the limited access to the full polysomnography that is considered the gold standard method for OSA diagnosis. In this context, screening questionnaires are important in facilitating identification of OSA patients and in keeping down costs. In this issue of the Portuguese Journal of Pulmonology, Pereira and
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ورودعنوان ژورنال:
- Revista portuguesa de pneumologia
دوره 19 4 شماره
صفحات -
تاریخ انتشار 2013