Sleep apnea influences many health conditions, which means that people with sleep apnea are more likely to find themselves on an operating table. Unfortunately, sleep apnea also increases the risks of surgery, as highlighted by two recent studies presented at the annual meeting of the American College of Chest Physicians.
The studies agree on the importance of screening for undiagnosed sleep apnea, but they don’t agree on treatment options. One of the authors notes that CPAP may not be right treatment choice. For people dealing with CPAP’s shortcomings, oral appliances offer a more attractive alternative.
Heart, Lung, and ICU Risks
Although the studies were both focused on postoperative risks related to sleep apnea, they were performed independently. One was performed at Western Reserve Health Education, and the other at our very own Henry Ford Hospital in Detroit.
The Western Reserve study looked at patients’ risk of developing atrial fibrillation after open-heart bypass surgery. Atrial fibrillation is a form of heart dysfunction in which the upper chambers of the heart pump quickly and erratically. Previous research has already linked sleep apnea with an up to six times higher risk for atrial fibrillation.
The population of this study was 200 patients receiving open heart bypass surgery from 2013 to 2015. About 15% of this population had already been diagnosed with sleep apnea and were receiving treatment. Another 20% were at high risk for sleep apnea although they were undiagnosed, while the remaining 65% were at low risk for sleep apnea.
People who were at high risk for sleep apnea but undiagnosed and not receiving treatment were most likely to develop atrial fibrillation. Nearly 70% of this group developed atrial fibrillation. The diagnosed and treated group had about the same risk for atrial fibrillation as the low risk group: just 41% developed the complication.
The Ford Hospital study had a much smaller population, 90 patients, divided between 40 patients at high risk but not diagnosed with sleep apnea, and 50 diagnosed with sleep apnea and getting treatment. This study looked at many potential postoperative complications that could require a move to the intensive care unit (ICU).
Patients at high risk for sleep apnea were more likely to develop venous thromboembolism. In venous thromboembolism a blood clot breaks loose from a vein and disrupts the function of the heart and lungs.
Can CPAP Help?
Both studies compared people with suspected sleep apnea and those who were already receiving treatment, but the authors didn’t agree about the effectiveness of treatment in these cases.
The authors of the Western Reserve study said that CPAP effectively reduced post-op risks related to sleep apnea.
But researchers in the Henry Ford Hospital study were less sure. They pointed to recent studies showing CPAP didn’t really reduce heart risks for many patients. In light of that data, it is hard to think that CPAP could be effective at reducing postoperative risks.
But the truth is that CPAP can be helpful or not, depending on whether it’s used. If someone adapts well to using CPAP, it’s a great treatment. But the fact is, many people don’t use CPAP often enough or long enough to see a real benefit.
Finding the right treatment for your sleep apnea means finding the one that will get good results for you. And that’s not always CPAP. To learn more about CPAP alternatives like oral appliance therapy, please call (248) 480-0085 today for an appointment with sleep dentist Dr. Jeffrey S. Haddad at the Michigan Center for TMJ & Sleep Wellness.
