Obstructive Sleep Apnea
Conditions
Brief summary
The study aims to evaluate the effect of non-supine positioning in the treatment of surgical patients with obstructive sleep apnea. The hypothesis is that non-supine positioning will result in a decrease in acute hypoxic events, defined as the number of apneas/hypopneas per hour of sleep.
Detailed description
This is a prospective, randomized controlled trial that will comprise of two stages. Stage 1 is a pilot study of 30 patients at high risk or diagnosed with obstructive sleep apnea who are scheduled for routine surgery. These patients will be randomized 1:1:1 to standard of care (0 degree bed angle), 30 degree bed angle, or 60 degree bed angle. Acute hypoxic events will be analyzed pre and post-op in the randomly assigned bed position. PACU nurses will also be surveyed for patient-favored non-supine positioning (30 vs. 60 degrees). Stage 2 will be a larger, powered trial to evaluate the efficacy of just one bed angle (30 or 60 degrees) based on the Stage 1 results.
Interventions
OTHERbed positioning
Sponsors
Englewood Hospital and Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Minimum 1 night postoperative hospital stay * More than 18 and less than 80 years old * Identified as high risk of OSA (SACS \> 15) or a history of OSA without CPAP treatment
Exclusion criteria
* Unwilling or unable to give informed consent * Undergoing nasal, eye, head/neck surgery, intracranial or cardiac/thoracic surgery * Currently undergoing treatment for sleep apnea including CPAP * Requiring prolonged postoperative ventilation * NYHA functional class III and IV * Valvular heart disease, dilated cardiomyopathy, implanted cardiac pacemaker, or unstable angina * Myocardial infarction or cardiac surgery within 3 months * Chronic obstructive pulmonary disease, or asthma * Presence of tracheostomy, facial, neck, or chest wall abnormalities * Abdominal aortic aneurysm surgery, chemotherapy, or immunosuppressive therapy within 3 months * Visiting preoperative clinic less than 3 days before surgery * Requiring postoperative nasogastric tube
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acute Hypoxic Index (AHI) | 3 days | study will look at the effect of bed positioning on Acute Hypoxic Index (AHI), which is defined as the number of apneas/hypopneas per hour of sleep |
Countries
United States
Outcome results
None listed