If You Have Sleep Apnea, Read This Before Surgery

Sleep apnea is a condition that causes people to stop breathing during sleep. The lapses in breathing can significantly lower sleep quality, decrease oxygen levels, and lead to serious health consequences.

Anesthesia is a common treatment used before surgery to keep a person asleep during the procedure. Sleep apnea can make anesthesia a lot riskier.

This article explains how anesthesia can affect people with sleep apnea, both before and after surgery. It discusses the risks they may face and how healthcare providers evaluate those risks.

Women sleeping with sleep apnea machine

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How Sleep Apnea Affects Anesthesia

Sleep apnea causes abnormal breathing during sleep. Sleep studies show that breathing can become restricted or even stop in people with sleep apnea. The intermittent breathing interruptions can disrupt sleep throughout the night.

General anesthesia relies on a combination of different medications to put people to sleep for surgery or other procedures. While under general anesthesia, people are entirely unconscious. They do not feel pain and are unaware of what is happening.

General anesthesia can suppress upper airway muscles. This means it can reduce breathing, slow down your breathing rate, and decrease oxygen levels. For this reason, general anesthesia can be dangerous for people with sleep apnea.

Sleep apnea can also make it harder to wake up from surgery and take breaths.

Types of Sleep Apnea

The two types of sleep apnea are obstructive sleep apnea and central sleep apnea.

Concerns Related to Surgery

Sleep apnea is such a common condition in the United States that between 22% and 82% of all adults who undergo surgery have it.

With such a high prevalence, people with sleep apnea should be aware of the following potential problems related to surgery:

  • Difficult ventilation or intubation
  • Postoperative airway obstruction
  • Complications arising from other health problems
  • Postoperative hypoxia (low oxygen levels)
  • Increased risk for respiratory failure and cardiac issues
  • Increased risk of transfer to an intensive care unit after surgery

Concerns After Surgery

Following surgery, your healthcare team will monitor you. They will watch for possible complications of sleep apnea and anesthesia that include:

  • Hypoxia (low oxygen)
  • Low heart rate
  • Changes in sleep or REM (rapid eye movement) cycle
  • Cardiac arrest

Your healthcare team may continue to treat you with continuous positive airway pressure (CPAP), a common sleep apnea treatment, following surgery.

Risk Factors

Factors that make people more likely to have sleep apnea include:

  • Lifestyle factors, such as drinking alcohol, smoking, and having obesity
  • Adult age
  • Family history and genetics

Healthy lifestyle changes you can make to prevent sleep apnea include:

  • Eat a heart-healthy diet
  • Maintain a healthy weight
  • Exercise
  • Avoid alcohol and tobacco use
  • Maintain good sleep hygiene

Talk to Your Healthcare Provider

If you have sleep apnea and will be having surgery, it's crucial to talk to your healthcare provider about how anesthesia may affect you. You may also want to research the effects and risks of sleep apnea and anesthesia before visiting your healthcare provider. Bring your notes with you to your appointment.

Questions you may want to ask include:

  • What's causing my sleep apnea?
  • Can I reduce or eliminate my sleep apnea before surgery?
  • How can I best prepare for surgery?

Your healthcare provider will also be able to answer questions about how anesthesia may affect you after the procedure, based on your specific medical history.

If you have recently been diagnosed or suspect you may have sleep apnea, you may also want to ask your provider additional questions, such as:

  • Why have I been feeling so sleepy during the day?
  • What tests can confirm that I have sleep apnea?
  • What treatments will help my sleep apnea?
  • What is a CPAP machine?
  • What is an oral appliance for sleep apnea?
  • What are my risks of sleep apnea if untreated?
  • What lifestyle changes can I make to reduce or eliminate my sleep apnea?

Summary

Sleep apnea causes abnormal breathing and restricts breathing during sleep. The continuous cessation of breathing interrupts sleep throughout the night and leads to chronic daytime sleepiness and other health issues.

Since general anesthesia can suppress upper airway muscles and reduce breathing, it may also increase sleep apnea occurrences and decrease oxygen levels during surgery. Sleep apnea can also make waking up from surgery more difficult.

Sleep apnea during surgery also puts people at a higher risk for cardiac or respiratory issues during surgery. It can increase the need for intensive care treatment following surgery.

A Word From Verywell

Having surgery can be frightening, but it's essential to be screened for sleep apnea before surgery to help reduce potential complications. Talk to your healthcare provider about your medical history and what you can do before surgery to reduce your risks.

Frequently Asked Questions

  • Can you die from sleep apnea?

    It is possible to die while sleeping if you have sleep apnea. Researchers have found that sleep apnea causes abnormal heart rhythms, which in some cases can lead to sudden cardiac death. Sleep apnea is also a risk factor for other health conditions like heart disease and heart arrhythmias. Heart disease is the number one cause of death for adults in the United States.

  • Can anesthesia with sleep apnea cause death?

    People with sleep apnea are at a higher risk for some postoperative problems that could potentially cause death, including:

    • Postoperative airway obstruction
    • Complications arising from other health problems
    • Postoperative "hypoxia," or low oxygen levels
    • Increased risk for respiratory failure and cardiac issues
  • What does sleep apnea sound like?

    People with sleep apnea snore loudly and have intermittent periods of silence where their breathing slows or completely stops.

  • Can sleep apnea be cured?

    A CPAP machine or oral appliance can reduce sleep apnea symptoms, but they cannot cure it. The only way to stop sleep apnea is to lose weight and maintain a healthy weight, or undergo surgery to remove extra tissue from the throat or palate.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Stansbury RC, Strollo PJ. Clinical manifestations of sleep apnea. J Thorac Dis. 2015;7(9):e298-310. doi:10.3978/j.issn.2072-1439.2015.09.13

  2. American Society of Anesthesiologists. General anesthesia.

  3. National Heart, Lung, and Blood Institute. Sleep apnea.

  4. Fassbender P, Herbstreit F, Eikermann M, Teschler H, Peters J. Obstructive sleep apnea-a perioperative risk factor. Dtsch Arztebl Int. 2016;113(27-28):463-9. doi:10.3238/arztebl.2016.0463

  5. Wolfe RM, Pomerantz J, Miller DE, Weiss-Coleman R, Solomonides T. Obstructive sleep apnea: preoperative screening and postoperative careJ Am Board Fam Med. 2016;29(2):263-275. doi:10.3122/jabfm.2016.02.150085

  6. Blackwell JN, Walker M, Stafford P, Estrada S, Adabag S, Kwon Y. Sleep apnea and sudden cardiac deathCirc Rep. 2019;1(12):568-574. doi:10.1253/circrep.CR-19-0085

  7. Centers for Disease Control and Prevention. Heart disease facts.

  8. Sleep Foundation. How weight affects sleep apnea.