Obstructive Sleep Apnea (OSA)
Conditions
Keywords
Obstructive sleep apnea (OSA), continuous positive airway pressure(CPAP), surgery, anesthesia
Brief summary
Objective of the study: To determine whether Perioperative Auto-CPAP treatment prevent postoperative worsening of OSA and improve nocturnal oxygen saturation in surgical patients with moderate and severe OSA.
Detailed description
The patients will be approached by the study coordinators at the preoperative clinic. If the patient is interested in participating the study, STOP-Bang and Epworth questionnaires will be implemented to determine the risk for OSA.If the patients are classified as high risk of having OSA, they are scheduled for an overnight sleep study at home. The patients with Apnea-Hypopnea Index (AHI)\>15 from the sleep study will be randomized into two study groups: Perioperative CPAP group or control group (routine care). In the perioperative CPAP group, patients will be treated with auto-CPAP for 2-3 nights preoperatively and 5 nights postoperatively. All patients will undergo sleep study on the third postoperative night and be monitored by a pulse oximeter for 2-3 nights preoperatively and 5 nights postoperatively.
Interventions
DEVICEauto-titrated CPAP
Patients will be treated with auto-CPAP preoperatively for 2-3 nights preoperatively and 5 nights postoperatively during their sleep.
DEVICEControl
Patients in this group will receive routine care, undergo sleep study on the third postoperative night and be monitored by a pulse oximeter for oxygen saturation level for 2-3 nights preoperatively and 5 nights postoperatively during their sleep.
Sponsors
University Health Network, Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
the patients who meet the following criteria will be recruited * Patients who are scheduled for inpatient surgery that required a minimum of three nights of hospital stay * Age: \>18 and \<80 years old. * Identified as high risk of having OSA or diagnosed with OSA without using CPAP.
Exclusion criteria
* Undergoing nasal, eye, head/neck surgery, intracranial or cardiac/thoracic surgery. * Unwilling or unable to give informed consent. * Currently undergoing treatment for sleep apnea including CPAP. * Requiring prolonged postoperative ventilation. * New York Heart Association functional class III and IV. * Having valvular heart disease, dilated cardiomyopathy, implanted cardiac pacemaker, or unstable angina. * Having myocardial infarction or cardiac surgery within 3 months. * Having chronic obstructive pulmonary disease, or asthma. * Having a presence of tracheostomy, facial, neck, or chest wall abnormalities. * Having abdominal aortic aneurysm surgery, chemotherapy, or immunosuppressive therapy within 3 months. * Visiting preoperative clinic less than 3 days before scheduled surgery date. * On nasogastric tube postoperatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Apnea-hypopnea index | On the third night after surgery | Apnea-hypopnea index. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nocturnal oxygen desaturation index (ODI) and percentage of time with SaO2<90%(CT90) | 2-3 nights before surgery and 5 nights after surgery | Nocturnal oxygen desaturation index (ODI) and percentage of time with SaO2\<90%(CT90). |
Countries
Canada
Outcome results
None listed