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For Immediate Release
February 16, 2007
Scoring Your Snore Could Save Your Life
Oklahoma City — Do you snore most nights? Has anyone
ever told you that you gasp for breath when you sleep? Do you sometimes
doze off during the day? While a little less sleep can leave you tired
the next day, chronic sleep problems, in particular sleep apnea, could
mean the difference between life and death.
And if you have sleep apnea—a disorder characterized
by brief interruptions of breathing during sleep—it could spell trouble
if you have surgery. That’s why Mercy Health Center is now wired to
monitor patients with sleep apnea after they undergo surgery. It’s also
the reason a group of Mercy anesthesiologists—all board
certified—recently urged that guidelines be put into place to determine
before surgery whether or not someone might be at risk for sleep apnea.
In addition, patients are followed throughout their hospital stay if
they are at increased risk.
“When someone is given anesthesia and powerful
narcotics in the hospital, they are at an increased risk if they have
sleep apnea. With these medicines, the body is less able to awaken
during breathing interruptions,” said Scott Maxwell, M.D., a Mercy
anesthesiologist. “An even greater obstacle is that only about 20
percent of the 12 million Americans with sleep apnea know they have it.
That means that 80 percent of people with sleep apnea aren’t even aware
they have a problem. And here in Oklahoma with a population that has a
higher rate of obesity, the chance of having sleep apnea is even
greater.”
People with sleep apnea actually stop breathing many
times in the night and the body has to actually wake itself up to
breathe after each of these interruptions. In severe cases of sleep
apnea, people have more than 40 episodes of sleep-disordered breathing
per hour. Risk factors for sleep apnea include being male, overweight
and over 40, although it can affect anyone at any age, even children.
Studies show that untreated, sleep apnea can lead to high blood
pressure, heart disease and an increased risk during and after surgery.
To ensure people with sleep apnea don’t fall through
the cracks, Mercy has put new protocols in place. Prior to a surgery at
Mercy: • A registered nurse conducts an extensive patient interview by
telephone. • A “snore score” screening further identifies a patient’s
risk and helps determine the need for a sleep study and treatment prior
to surgery. • Every patient is re-evaluated by an anesthesiologist on
the day of surgery.
After surgery, patients at risk for sleep apnea are
monitored just as closely as patients with cardiac arrhythmias. A pulse
oximetry device—which monitors the oxygen level—is placed on the
patient’s finger and the patient is continuously monitored by
technologists in a telemetry room.
“It’s likely that many hospitals around the country
are not identifying patients at risk for sleep apnea and very few are
monitoring patients as closely as we are at Mercy,” said Dr. Maxwell.
“Patients in some hospitals may have a pulse oximetry device placed on
their finger and if the patient’s oxygen level plummets, an alarm on a
little box beside the bed goes off. But the problem with that is that
someone has to hear the alarm. With telemetry, someone is always
monitoring the patient.”
In a 2008 draft of the national patient safety goals
for the Joint Commission on Accreditation of Healthcare Organizations,
it states that hospitals will be required to screen for obstructive
sleep apnea prior to surgical procedures involving anesthesia, as well
as develop protocols for before, during and after surgery.
“We already have all of these measures in place,”
said Dr. Maxwell. “There is a critical need to improve the diagnosis of
sleep-disordered breathing in surgical patients to avoid complications
during surgery and after surgery.
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