Unexpected Risks during Administration of Conscious Sedation: Previously Undiagnosed Obstructive Sleep Apnea
Authors: Vinay K. Sharma, William Galli, Alan Haber, Mark R. Pressman, Robert Stevenson, Thomas J. Meyer, Donald D. Peterson, John S. Zachariah, Giancarlo Mercogliano, Lee Greenspon
Journal: Annals of Internal Medicine (2003)

Letters21 October 2003Unexpected Risks during Administration of Conscious Sedation: Previously Undiagnosed Obstructive Sleep ApneaVinay K. Sharma, MD, William Galli, MD, Alan Haber, MD, Mark R. Pressman, PhD, Robert Stevenson, BS, Thomas J. Meyer, MD, Donald D. Peterson, MD, John S. Zachariah, MD, Giancarlo Mercogliano, MD, and Lee Greenspon, MDVinay K. Sharma, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, William Galli, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Alan Haber, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Mark R. Pressman, PhDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Robert Stevenson, BSFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Thomas J. Meyer, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Donald D. Peterson, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, John S. Zachariah, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, Giancarlo Mercogliano, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this author, and Lee Greenspon, MDFrom Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-8-200310210-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Obstructive sleep apnea is a common disorder associated with increased morbidity and mortality (1-3). It is estimated that 93% of women and 82% of men with moderate to severe sleep apnea have not received a diagnosis (4). Obstructive sleep apnea may be induced or exacerbated by depression of central nervous system activity. Anesthetics, sedatives, and hypnotics have been reported to exacerbate or induce clinically significant sleep apnea in patients with otherwise normal respiration in sleep before, during, or after surgery. Serious complications and deaths have been attributed to the effects of undetected or untreated sleep apnea ...References1. Redline S, Strohl K. Recognition and consequences of obstructive sleep apnea hypopnea syndrome. Clin Chest Med. 1998;19:1-19. [PMID: 9554214] CrossrefMedlineGoogle Scholar2. Hla KM, Young TB, Bidwell T, Palta M, Skatrud JB, Dempsey J. Sleep apnea and hypertension. A population-based study. Ann Intern Med. 1994;120:382-8. [PMID: 8304655] LinkGoogle Scholar3. Koskenvuo M, Kaprio J, Telakivi T, Partinen M, Heikkila K, Sarna S. Snoring as a risk factor for ischaemic heart disease and stroke in men. BMJ. 1987;294:16-9. [PMID: 3101779] CrossrefMedlineGoogle Scholar4. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20:705-6. [PMID: 9406321] CrossrefMedlineGoogle Scholar5. Connolly LA. Anesthetic management of obstructive sleep apnea patients. J Clin Anesth. 1991;13:461-9. [PMID: 1760169] CrossrefMedlineGoogle Scholar6. Tierney NM, Pollard BJ, Doran BRH. Obstructive sleep apnoea. Anaesthesia. 1989;44:235-7. [PMID: 2705611] CrossrefMedlineGoogle Scholar7. Keamy MF, Cadieux RJ, Kofke WA, Kales A. The occurrence of obstructive sleep apnea in a recovery room patient. Anesthesiology. 1987;66:232-4. [PMID: 3813086] CrossrefMedlineGoogle Scholar8. Hanning CD. Obstructive sleep apnoea. Br J Anaesth. 1989;63:477-88. [PMID: 2684252] CrossrefMedlineGoogle Scholar9. VanDercar DH, Martinez AP, DeLisser EA. Sleep apnea syndromes: a potential contraindication for patient-controlled analgesia. Anesthesiology. 1991;74:623-4. [PMID: 1822081] CrossrefMedlineGoogle Scholar10. Rechtshaffen A. 1968 A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. UCLA Brain Information Services/Brain Research Institute Los Angeles. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Graduate Hospital, Philadelphia, PA 19146; and Lankenau Hospital, Wynnewood, PA 19096. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSleep Apnea and Hypertension: A Population-based Study Khin Mae Hla , Terry B. Young , Tom Bidwell , Mari Palta , James B. Skatrud , and Jerome Dempsey Correction: Unexpected Risks during Administration of Conscious Sedation Metrics Cited ByPrediction of cardiopulmonary events using the STOP-Bang questionnaire in patients undergoing bronchoscopy with moderate sedationThe Value of Transesophageal Echocardiography in Transcatheter Valve Procedures: Is it Still Questionable?Adult Sleep Apnea and Related ProceduresOptimal dose of dexmedetomidine for sedation during spinal anesthesiaPostoperative Complications in Patients With Obstructive Sleep ApneaPersonal Method of Anesthesia in the OfficeDoes sleep apnea increase the risk of cardiorespiratory complications during endoscopy procedures?Persistent snoring under conscious sedation during colonoscopy is a predictor of obstructive sleep apneaAssociation of Sleep-Disordered Breathing With Postoperative ComplicationsSedation and regional anaesthesia in the adult patientAnesthesia and sleep medicine: an opportunity to be mutually informative?Unrecognized Sleep Apnea in the Surgical Patient: Implications for the Peri-operative SettingUnrecognized Sleep Apnea in the Surgical PatientObstructive Sleep Apnea and Modifications in SedationObstructive sleep apneaPerioperative treatment of patients with obstructive sleep apneaCorrection: Unexpected Risks during Administration of Conscious Sedation 21 October 2003Volume 139, Issue 8Page: 707-708KeywordsElectrocardiographyElectroencephalographyElectromyographyOutpatientsOxygenQuestionnairesRespirationSedationSleepSleep apnea ePublished: 21 October 2003 Issue Published: 21 October 2003 CopyrightCopyright © 2003 by American College of Physicians. 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