Abstract
Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources.
| Original language | English |
|---|---|
| Pages (from-to) | 230-239 |
| Number of pages | 10 |
| Journal | Respirology |
| Volume | 22 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Feb 2017 |
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Anaesthetic management of sleep-disordered breathing in adults. / Hillman, David R.; Chung, Frances.
In: Respirology, Vol. 22, No. 2, 01.02.2017, p. 230-239.Research output: Contribution to journal › Article
TY - JOUR
T1 - Anaesthetic management of sleep-disordered breathing in adults
AU - Hillman, David R.
AU - Chung, Frances
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources.
AB - Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources.
KW - anaesthesia
KW - obstructive sleep apnoea
KW - perioperative management
KW - sleep
KW - sleep-disordered breathing
UR - http://www.scopus.com/inward/record.url?scp=85006710348&partnerID=8YFLogxK
U2 - 10.1111/resp.12967
DO - 10.1111/resp.12967
M3 - Article
VL - 22
SP - 230
EP - 239
JO - Asian Pacific Journal of Respirology
JF - Asian Pacific Journal of Respirology
SN - 1323-7799
IS - 2
ER -