Going under Anesthesia while having Central sleep apnea.

[icipher]

Hello.

I have central sleep apnea. I use an ASV machine.

I was just told by an ear nose and throat doctor that I have a deviated septum. Surgery would be required to fix this. I mentioned to him that I have central sleep apnea and I don't think he knew what that was. I am scared to go under anesthesia with CSA and the fact that during my sleep study they noted that I have bradycardia(slow heart rate while sleeping.)

Essentially, I am nervous about this procedure as it puts my in a situation where I am not in control and I cannot wear my mask. I am also scared that I will likely need an opiate for pain, and we know that opiates can cause CSA.

Can anyone provide any insight into this or share any personal stories that relate to my concerns? Is general anesthesia safe for those of us who have central apnea?

[BlackSpinner]

It is not the ENT who deals with this but the anaesthesiologist. You need to talk to the hospital and their staff about the whole thing.

[Sheriff Buford]

I have been under general anesthesia many times. Remember, most folks live several years with sleep apnea untreated, have surgical procedures, and everything turns out ok. I just got the cr*p beat outta' me by a meth-head, spent several days in the hospital and was under general anesthesia. Make sure you tell every medical person at the hospital, especially the anesthesiologist, and you should turn out fine. Best wishes!

Sheriff

[squid13]

I've had both knees replaced this year under general anesthesia without any problems. I talked to the anesthesiologist and he was well aware of my problem.

[LSAT]

I had the septoplasty surgery and had no problem. Definitely let the anesthesiologist know when they consult with you prior to the surgery.

[chunkyfrog]

Anesthesiologists are awesome. They are probably the most involved person in the surgical suite.
He (or she) has the responsibility to keep you running while the guy with the sharp things gets all the credit.
Take a list of your concerns with you to the anesthesiology consult.
A written list will not only help you remember everything, but this doc may use it to brief his staff.
It's nice when everyone is on the same page.

[Julie]

And the point is that while IN surgery, you will be monitored, possibly intubated, and given 02 at all times. It is only in the Recovery Rm that you need to arrange for Cpap. I would talk to the anesthesiologist if you're concerned about CSA, but I doubt that it would matter. And as others have said, there are thousands and thousands of people out there, UNdiagnosed (with CSA, bradycardia and who knows what else) who go through surg every day and come out the other end with no trouble.

[StuUnderPressure]

And as others have said, there are thousands and thousands of people out there, UNdiagnosed (with CSA, bradycardia and who knows what else) who go through surg every day and come out the other end with no trouble.

And it is common enough that there undoubtedly have been many with known Centrals that the anesthesiologist has had to deal with. He / She WILL know how to handle it.

Getting to talk to the anesthesiologist BEFORE the surgery date would be great. Unfortunately, sometimes one does not even know who that will be UNTIL the actual date of surgery.

[JDS74]

Since starting CPAP just over three years ago, I've had one surgery and three other procedures requiring general anesthesia.
Mine is severe complex sleep apnea that is gradully getting worse but there were no problems in any of the procedures. The anesthesiologist had access to my medical records at two differnt institutions and took care of everything.

It may help you feel better about the process if your doctor can arrange a brief meeting with someone in Anesthesiology at the hospital and have them explain the process to you. If you then have any remaining questions you can get them answered in the pre-surgery consult with the actual anesthesiologist who will be caring for you.

[lullaby]

I had a septoplasty and turbinate reduction done about a year ago. The anesthesiologist met with me before the operation and i told him then and there that i had sleep apnea. He asked what pressure i was on and all was good. Just before going into surgery, he told me that he suspected i had sleep apnea even before i told him due to the small size of my neck! I noticed that they had someone keeping an eye on me in recovery until i woke up. Not sure if they do this for everyone or maybe only those who suffer with possible apnea problems?

[Julie]

They keep many eyes on everyone, but pay closer attention to us. We're so spoiled :0).

[icipher]

Thank you for all the responses. I notice most of you have regular cpap machines, so you likely suffer from OSA. I do feel a bit better after you've all underlined how competent the anesthetists are.

I will speak with the doc further on this.

[JohnBFisher]

... I notice most of you have regular cpap machines, so you likely suffer from OSA. I do feel a bit better after you've all underlined how competent the anesthetists are. ... I will speak with the doc further on this. ...

You are correct that there is a definite difference in concern with someone with OSA vs. CSA. Talk with the anesthesiologist. See if they will allow your ASV unit into the recovery room. Sometimes the nurses fight this, since they don't know how to handle the equipment and do not want to be responsible for it. Make it VERY clear to all of them that under general anesthesia your ability to breathe on your own will be GREATLY reduced .. much lower than the norm. Show the anesthesiologist an example of a bad night / spell. Make it clear this is literally life critical.

[JohnBFisher]

Q: Is this a concern for someone with CSA (not just OSA)?

A: It is specifically true for someone with central apnea. Those of us with CSA already have problems with our respiratory drive (due to various reasons for various conditions). Anesthesia tends to suppress respiration. Don't think that's not true? Well, just go ask Michael Jackson! So if you have CSA, it makes it more important that your anesthesiologist understands that you have a lower than normal respiratory drive.

[Janknitz]

I would talk with your sleep doctor before deciding to go ahead. You may not be able to use your PAP for a while after septoplasty surgery. In your particular case, you need to weigh your options. Will the septoplasty provide enough benefit to be worth not having adequate treatment for CSA for a period of time???