Obstructive Sleep Apnea and the Impact on Surgical Outcomes in Gynecology

IMPORTANCEObstructive sleep apnea syndrome (OSAS) is a common medical condition in the United States and affects gynecologic surgical outcomes. OBJECTIVEThe aim of this review was to improve perioperative diagnosis and management of OSAS in patients presenting for gynecologic surgery and ultimately improve perioperative outcomes. The role of preoperative evaluation and screening is also addressed. EVIDENCE ACQUISITIONMedical databases were queried for publications pertaining to OSAS complications, risk factors, screening, and perioperative management. Pertinent articles were reviewed by the study authors. RESULTSObstructive sleep apnea syndrome is underdiagnosed in the preoperative surgical population. Obesity and other risk factors for OSAS are prevalent in patients with gynecologic issues but are not fully assessed with screening prior to surgery. Effective treatment modalities, such as continuous positive airway pressure, and perioperative management strategies are available to improve patient outcomes. CONCLUSIONS AND RELEVANCEIncreased diagnosis and treatment for OSAS in the perioperative period can improve perioperative outcomes, surgical outcomes, and long-term patient outcomes. Strategies to increase effective management in patients presenting for gynecologic surgery are needed. TARGET AUDIENCEObstetricians and gynecologists, family physicians. LEARNING OBJECTIVESAfter completing this activity, the learner should be better able to (1) list the diagnostic criteria, risk factors, and adverse outcomes associated with OSAS for gynecologic surgery patients; (2) compare available screening tools for OSAS; (3) evaluate effective treatments for OSAS; and (4) assess optimal preoperative, intraoperative, and postoperative management of OSAS in gynecologic patients.