Oxygen Supplementation Study in Obstructive Sleep Apnea (OSA) Patients
Condition: Obstructive Sleep Apnea
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
Study type: Interventional

Summary: 
      Hypotheses:

        1. Postoperative oxygen therapy significantly improves postoperative oxygenation in OSA
           surgical patients.

        2. Postoperative oxygen therapy do not significantly increase the number of apnea episodes
           and the duration of apnea episodes.

        3. Postoperative oxygen therapy do not significantly increase arterial carbon dioxide(CO2)
           level in OSA surgical patients.
    

Detailed description: 
      When patients visit the preoperative clinic for their scheduled surgery, the study
      coordinator will talk to patients. If they are interested in the study, he/she will ask the
      patient to answer a couple of questionnaires to see if the patient is qualified for the
      study. Patients will be asked to answer the STOP-Bang questionnaire to find out if patient is
      at high risk for sleep apnea. If the result shown that patient are at high risk for sleep
      apnea, the study coordinator will explain the study to you in detail and go over the consent
      form. The coordinator will answer all questions patient may have. If patient give consent to
      participate the study; the coordinator will schedule a sleep study with a sleep monitor at
      patient home at a convenient time before surgery. After telephone confirmation, the sleep
      technician will visit your home on the evening of scheduled date to set up the sleep study
      monitor and a device to measure the blood oxygen level. It would take 20~25 minutes to hook
      up for over night sleep study. The sleep technician will visit patient's again the next
      morning to pick up the devices. The recordings of sleep study will be scored by a certified
      sleep technologist. As a study participant, patient will be randomly (by chance) assigned
      into one of the following groups:

        -  Control group: Patients will be managed by the anesthesiologists and surgeons as per
           routine practice.

        -  Oxygen therapy group: Besides during surgical procedure routine care provided by
           anesthesiologists and surgeons, patients will receive postoperative oxygen
           supplementation with nasal prong (through nostril) at 3 liters/ min during the first 3
           nights after surgery.

      Regardless what group patients are in, their blood oxygen saturation will be monitored by a
      pulse oximeter for 1 night preoperatively and 3 nights postoperatively during their sleep.
      The blood carbon dioxide will be monitored for first 2 postoperative nights with a portable
      transcutaneous CO2 device (TCM400). On the third postoperative night, all study patients will
      also be monitored simultaneously by a portable carbon dioxide device(TCM400) and portable
      sleep device. For carbon dioxide monitoring, a probe will be attached to patient's arm which
      is connected to a portable device placed besides patient's bed. Our research staff will hook
      up the device and remove it from patient.
    

Intervention name(s): Oxygen therapy; Control group
Intervention type(s): Other; Other
Intervention description(s): Besides perioperative routine care provided by anesthesiologists and surgeons, patients will receive postoperative oxygen supplementation with nasal prolong at 3 liters/min during the first 3 nights after surgery.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Obstructive sleep apnea; Oxygen therapy; Surgery; Anesthesia