January 29, 2023

OSA: Silent Killer (Sleep Apnea In Surgery)

Women with CPAP device to improve her safety before surgery - it's always important to use your CPAP before surgery

Obstructive Sleep Apnea (OSA) is a prevalent and serious sleep disorder that is characterized by repeated breathing interruptions during sleep. OSA during and after anesthesia can have serious risks, but also opportunities to heal the root cause of OSA. Learn from Dr. Kaveh what happens to OSA during surgery and anesthesia.

What is Obstructive Sleep Apnea (OSA)?

OSA occurs when the upper airway becomes partially or completely blocked during sleep, leading to oxygen deprivation, decreased quality of sleep, and excessive daytime sleepiness.

What Other Conditions Can Mimic Sleep Apnea?

Many conditions can mimic OSA, including:

  • Night time panic attacks
  • Insomnia
  • Acid reflux (also called heartburn or GERD)
  • Esophageal dysfunction
  • Seizures
  • Restless leg syndrome (RLS)
  • Use of sedative drugs (especially sleep aids)
  • Narcolepsy

While these conditions may present with similar symptoms, it is important to differentiate OSA from other sleep disorders as the treatment and management differ greatly.

The Dangers of Sleep Apnea Before Anesthesia

There are many serious risks with untreated OSA before you ever come to surgery. Some examples are:

  • Car accidents
  • Heart disease, pulmonary hypertension, and strokes
  • Metabolic syndrome and diabetes
  • Liver disease
  • Memory impairment and ADHD symptoms

OSA Raises Risks of Anesthesia and Surgery

Patients with OSA undergoing anesthesia are at an increased risk for serious complications, as the combination of sleep apnea and anesthesia can further exacerbate breathing difficulties.

This is made worse when opioid pain medications are used, because they can lead to severe respiratory depression and death. These deaths can occur even days after surgery because of the residual effects of anesthesia on the brain and breathing centers. Other considerations include:

  • OSA may increase pain sensitivity after surgery
  • Patients with OSA may be more likely to stop breathing at lower doses of opioids
  • Some surgeries cannot be performed under sedation in patients with OSA
It's critical to use your CPAP before surgery to optimize your breathing after surgery

Treating OSA is Possible for Most Patients

While OSA can be a difficult condition to treat, many patients find relief through lifestyle changes and medical intervention. Powerful cures can come from

  • Quitting alcohol, especially before sleep
  • Losing weight
  • Stopping the use of sleep aids and sedative drugs (like benzodiazepines)

Psychedelic Experiences Can Inspire OSA Cures

Interestingly, I have seen psychedelic experiences under anesthesia motivate patients to make life-saving changes to cure their OSA. These experiences can help patients gain a new perspective on their health and motivate them to make the necessary changes to improve their sleep quality.

BUT Marijuana Is Not a Treatment for OSA

However, it is important to note that marijuana should not be used to treat OSA as it can further exacerbate breathing difficulties.

In conclusion, OSA is a serious and dangerous sleep disorder that has serious risks to overall health, in addition to anesthesia. Patients with OSA who undergo anesthesia are at an increased risk for serious complications and should use their CPAP before surgery. By quitting alcohol, losing weight, and avoiding sedative drugs, patients may be able to cure OSA and reduce their risk for serious health problems. Additionally, psychedelic experiences under anesthesia may help to catalyze the changes necessary to improve sleep quality, but marijuana should not be used as a treatment for OSA.

Visit Dr. Kaveh in San Francisco to experience how psychedelic medicine can help you overcome depression, anxiety, addiction, and chronic pain.

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