Comparison of upper airway collapse during general anaesthesia and sleep

• Published in: The Lancet (British edition) Vol. 359; no. 9313; pp. 1207 - 1209
• Main Authors: Eastwood, Peter R, Szollosi, Irene, Platt, Peter R, Hillman, David R
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 06-04-2002; Lancet; Elsevier Limited
• Subjects: Adult; Anesthesia; Anesthesia, General - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Atmospheric pressure; Biological and medical sciences; Breathing; Data collection; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Muscles; Patients; Reflexes; REM sleep; Respiration; Respiratory system; Respiratory tract; Sensitivity analysis; Sleep; Sleep Apnea, Obstructive - classification; Sleep Apnea, Obstructive - etiology; Sleep disorders; Sleep, REM; Surgery; Australia; Human; Comparison measurement; Symptomatology; Association; Prevalence; Respiratory disease; Anesthesia; Cardiovascular disease; General anesthesia; Respiratory tract collapse; Rapid eye movement sleep
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(02)08224-7

Measurement of the collapsibility of the upper airway while a patient is awake is not a good guide to such collapsibility during sleep, presumably because of differences in respiratory drive, muscle tone, and sensitivity of reflexes. To assess whether a relation existed between general anaesthesia and sleep, we measured collapsibility of the upper airway during general anaesthesia and severity of sleep-disordered breathing in 25 people who were having minor surgery on their limbs. Anaesthetised patients who needed positive pressure to maintain airway patency had more severe sleep-disordered breathing than did those whose airways remained patent at or below atmospheric pressure. Such an association was strongest during rapid-eye-movement (REM) sleep. Our findings suggest that sleep-disordered breathing should be considered in all patients with a pronounced tendency for upper airway obstruction during anaesthesia or during recovery from it.