scholarly journals Admission of Patients With Obstructive Sleep Apnea Undergoing Ambulatory Surgery in Otolaryngology—Head and Neck Surgery

2021 ◽  
pp. 000348942110487
Author(s):  
Vincent Wu ◽  
Nick Lo ◽  
R. Jun Lin ◽  
Molly Zirkle ◽  
Jennifer Anderson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Head And Neck ◽  
Ambulatory Surgery ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Secondary Outcome ◽  
Asa Score ◽  
Obstructive Sleep ◽  
Type Of Surgery

Objectives: Within Otolaryngology—Head and Neck Surgery (OHNS), obstructive sleep apnea (OSA) patients are frequently encountered. To implement policies and screening measures for admission of OSA patients undergoing ambulatory surgery, actual rates of admission must first be determined. We aimed to evaluate rates and reasons for admission of OSA patients after ambulatory OHNS surgery. Methods: Retrospective chart review was undertaken of all OSA patients undergoing elective day-surgery OHNS procedures at a tertiary center from January 1, 2018 to December 31, 2019. The primary outcome measure was percentage of OSA patients admitted to hospital after ambulatory OHNS surgery. Secondary outcome measures included reasons for admission. American Society of Anesthesiologists (ASA) score, perioperative complications, and patient demographics were captured. Results: There were 118 OSA patients, out of 1942 cases performed during the review period. Thirty-eight were excluded as the procedures were not considered ambulatory. The remaining 80 OSA patients were included for analysis, with an average age of 51.7, SD 13.8, and 30 (38%) females. The admission rate was 47.5% (38/80 patients). Admitted patients were older ( P = .0061), and had higher ASA ( P = .039). Indication for surgery or type of surgery did not differ among admitted and non-admitted patients. The majority of patients, 97% (37/38 patients), were admitted for post-operative monitoring. Conclusion: More than half of OSA patients did not require admission to hospital after ambulatory OHNS surgery, unaffected by indications for surgery or type of surgery. Higher ASA score and older age were found in admitted as compared to non-admitted patients.

Geriatric Otolaryngology

2021 ◽  
Author(s):  
Christian Caceres ◽  
Kourosh Parham
Keyword(s):  
Obstructive Sleep Apnea ◽  
Hearing Loss ◽  
Sleep Apnea ◽  
Head And Neck ◽  
Malignant Neoplasms ◽  
Geriatric Syndromes ◽  
Healthcare Needs ◽  
Age Related ◽  
Obstructive Sleep ◽  
Age Related Hearing Loss

With increasing life expectancy, the unique healthcare needs of the older patient are being better appreciated. To address these growing needs, which differ from those of the average adult patient, otolaryngologists must acquire new knowledge and competencies. This chapter provides a broad overview of geriatric otolaryngology and highlights subspecialty topics where otolaryngologists are called upon to administer care. These include age-related hearing loss, balance disorders, sinonasal disease, voice and swallowing disorders, obstructive sleep apnea and head and neck cancer. Geriatric concerns in each of these specific areas have to be addressed in the broader context of geriatric syndromes in coordination with geriatricians or other geriatric-trained providers to advance an integrated, team-based approach to maintaining or restoring the older patients’ well-being. This review contains 3 figures, 2 tables and 161 references Keywords: Cognitive decline, delirium, frailty, age-related hearing loss, presbystasis, presbylarynx, immunosenecense, presbynasalis, vasomotor rhinitis, chronic sinusitis, age-related oflactory decline, dysphagia, head and neck malignant neoplasms, obstructive sleep apnea, geriatric syndromes and perioperative optimization.

High Prevalence of Obstructive Sleep Apnea among Patients with Head and Neck Cancer

2005 ◽  
Vol 34 (05) ◽  
pp. 304 ◽  
Author(s):  
Richard J. Payne ◽  
Michael P. Hier ◽  
Karen M. Kost ◽  
Martin J. Black ◽  
Anthony G. Zeitouni ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Head And Neck Cancer ◽  
Sleep Apnea ◽  
Head And Neck ◽  
Neck Cancer ◽  
Obstructive Sleep ◽  
High Prevalence

Postoperative Changes in Sleep-disordered Breathing and Sleep Architecture in Patients with Obstructive Sleep Apnea

2014 ◽  
Vol 120 (2) ◽  
pp. 287-298 ◽  
Author(s):  
Frances Chung ◽  
Pu Liao ◽  
Balaji Yegneswaran ◽  
Colin M. Shapiro ◽  
Weimin Kang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Slow Wave Sleep ◽  
Sleep Architecture ◽  
Secondary Outcome ◽  
Apnea Hypopnea Index ◽  
Postoperative Changes ◽  
Obstructive Sleep ◽  
Disordered Breathing

Abstract Background: Anesthetics, analgesics, and surgery may profoundly affect sleep architecture and aggravate sleep-related breathing disturbances. The authors hypothesized that patients with preoperative polysomnographic evidence of obstructive sleep apnea (OSA) would experience greater changes in these parameters than patients without OSA. Methods: After obtaining approvals from the Institutional Review Boards, consented patients underwent portable polysomnography preoperatively and on postoperative nights (N) 1, 3, 5, and 7 at home or in hospital. The primary and secondary outcome measurements were polysomnographic parameters of sleep-disordered breathing and sleep architecture. Results: Of the 58 patients completed the study, 38 patients had OSA (apnea hypopnea index [AHI] >5) with median preoperative AHI of 18 events per hour and 20 non-OSA patients had median preoperative AHI of 2. AHI was increased after surgery in both OSA and non-OSA patients (P < 0.05), with peak increase on postoperative N3 (OSA vs. non-OSA, 29 [14, 57] vs. 8 [2, 18], median [25th, 75th percentile], P < 0.05). Hypopnea index accounted for 72% of the postoperative increase in AHI. The central apnea index was low (median = 0) but was significantly increased on postoperative N1 in only non-OSA patients. Sleep efficiency, rapid eye movement sleep, and slow-wave sleep were decreased on N1 in both groups, with gradual recovery. Conclusions: Postoperatively, sleep architecture was disturbed and AHI was increased in both OSA and non-OSA patients. Although the disturbances in sleep architecture were greatest on postoperative N1, breathing disturbances during sleep were greatest on postoperative N3.

Obstructive Sleep Apnea and Ambulatory Surgery

2019 ◽  
Vol 129 (2) ◽  
pp. 327-329 ◽  
Author(s):  
Richard D. Urman ◽  
Frances Chung ◽  
Tong J. Gan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Ambulatory Surgery ◽  
Obstructive Sleep

scholarly journals Risk Assessment of Obstructive Sleep Apnea in a Population of Patients Undergoing Ambulatory Surgery

2010 ◽  
Vol 06 (05) ◽  
pp. 467-472 ◽  
Author(s):  
Tracey L. Stierer ◽  
Christopher Wright ◽  
Anu George ◽  
Richard E. Thompson ◽  
Christopher L. Wu ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Ambulatory Surgery ◽  
Obstructive Sleep

scholarly journals A randomized controlled trial of CBT-I and PAP for obstructive sleep apnea and comorbid insomnia: main outcomes from the MATRICS study

SLEEP ◽  
2020 ◽  
Vol 43 (9) ◽  
Author(s):  
Jason C Ong ◽  
Megan R Crawford ◽  
Spencer C Dawson ◽  
Louis F Fogg ◽  
Arlener D Turner ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Concomitant Treatment ◽  
Clinical Endpoint ◽  
Comorbid Insomnia ◽  
Obstructive Sleep ◽  
Treatment Models

Abstract Study Objectives To investigate treatment models using cognitive behavioral therapy for insomnia (CBT-I) and positive airway pressure (PAP) for people with obstructive sleep apnea (OSA) and comorbid insomnia. Methods 121 adults with OSA and comorbid insomnia were randomized to receive CBT-I followed by PAP, CBT-I concurrent with PAP, or PAP only. PAP was delivered following standard clinical procedures for in-lab titration and home setup and CBT-I was delivered in four individual sessions. The primary outcome measure was PAP adherence across the first 90 days, with regular PAP use (≥4 h on ≥70% of nights during a 30-day period) serving as the clinical endpoint. The secondary outcome measures were the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) with good sleeper (PSQI <5), remission (ISI <8), and response (ISI reduction from baseline >7) serving as the clinical endpoints. Results No significant differences were found between the concomitant treatment arms and PAP only on PAP adherence measures, including the percentage of participants who met the clinical endpoint. Compared to PAP alone, the concomitant treatment arms reported a significantly greater reduction from baseline on the ISI (p = .0009) and had a greater percentage of participants who were good sleepers (p = .044) and remitters (p = .008). No significant differences were found between the sequential and concurrent treatment models on any outcome measure. Conclusions The findings from this study indicate that combining CBT-I with PAP is superior to PAP alone on insomnia outcomes but does not significantly improve adherence to PAP.

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