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Sleep apnoea 

Sleep apnoea
Chapter:
Sleep apnoea
Author(s):

Chris Dodds

DOI:
10.1093/med/9780199564217.003.0023
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date: 03 December 2020

Sleep disorders that are affected by problems related to the upper airway have been recognized for at least the past 50 years. The impact that patient characteristics such as facial morphology, dynamic changes in airway tone with sleep state, and surgical procedures on the head and neck have on the incidence or risk of obstructive sleep apnoea (OSA) is still being identified. This growing understanding does inform the surgical treatment options being considered and will have an, often significant, influence on outcome.

OSA is characterized by repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen saturation.

The underlying pathophysiology of OSA is an essential element in assessing the predisposition of a given patient to OSA either before surgery or afterwards. The improvement in airway control and chemoreceptor sensitivity following effective treatment is vital for safe anaesthesia, but if the treatment is mechanical, e.g. by continuous positive airway pressure (CPAP) devices, these must be available at all times during the peri-operative period or an alternative airway such as a tracheostomy must be considered.

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