While sleep and anesthesia are different states of consciousness, they have shared characteristics, based on activation of shared neurophysiological pathways. Similarities are apparent in their effects on muscle activation and ventilatory control. Their similar influences on respiratory and upper airway function suggest that detection of disordered breathing in one state has relevance for the other, allowing at-risk patients to be identified. These considerations extend beyond upper airway obstruction to include hypoventilation, periodic breathing and disordered gas exchange. Sleep disruption can also affect postoperative cognitive function, providing a further reason for identifying and dealing with sleep disorders preoperatively where the opportunity exists. Arousal suppression is a critical difference between the states. The capacity of arousal protects patients with disordered breathing during sleep, whereas a basic aim of general anesthesia is to suppress arousal. This makes such patients highly vulnerable to asphyxia until anesthesia is reversed and rousability restored.
|Title of host publication||Sleep Disorders Medicine|
|Subtitle of host publication||Basic Science, Technical Considerations and Clinical Aspects: Fourth Edition|
|Place of Publication||USA|
|Publisher||Springer Dordrecht Heidelberg New York|
|Number of pages||9|
|Publication status||Published - 2 May 2017|
Hillman, D., Kaw, R., & Lydic, R. (2017). Sleep and anesthesia: Different states with shared pathophysiological traits. In S. Chokroverty (Ed.), Sleep Disorders Medicine: Basic Science, Technical Considerations and Clinical Aspects: Fourth Edition (4 ed., pp. 143-151). Springer Dordrecht Heidelberg New York. https://doi.org/10.1007/978-1-4939-6578-6_10