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.
Bibliographical noteFunding Information:
This study was supported in part by the Australian Lung Foundation, the Sir Charles Gairdner Hospital Research Fund, and the National Health and Medical Research Council of Australia (Number 109903). We thank the technical staff of the Department of Pulmonary Physiology and the West Australian Sleep Disorders Research Institute and Kieran McCaul for statistical advice. The funding sources had no role in study design, data collection, data analysis, data interpretation, or in the writing of the report.
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