I do not like to do too many article or OT posts, but if the information could be relevant to some us, then I hope it will be acceptable.
I have just had a colonoscopy, and will be telling my Gastroenterologist about this article, and, of course, will ask him if I snored during the sedation.
From Reuters Health Information
Snoring During Colonoscopy May Indicate Sleep Apnea Apnea
NEW YORK (Reuters Health) Apr 09 - Patients who snore under conscious sedation during colonoscopy probably have obstructive sleep apnea (OSA), researchers from Lebanon suggest.
Out of 20 sedated patients who snored during colonoscopy in their study, all turned out to have sleep apnea.
Conscious sedation can alter the normal respiratory response to hypoxemia and hypercapnia and facilitate pharyngeal collapse in patients with OSA, according to Dr. Ala I. Sharara and colleagues - so endoscopy may therefore provide "a unique opportunity" to make a diagnosis that might otherwise be missed.
For the study reported online March 22nd in Gastrointestinal Endoscopy, Dr. Sharara and colleagues at the American University of Beirut Medical Center recruited 131 patients who were undergoing outpatient colonoscopy.
They found that 24 (18%) snored continuously for 10 seconds or longer during conscious sedation with meperidine and midazolam. All were lying in the left lateral decubitus position. Twenty of the snorers and 18 controls matched by age and body mass index underwent portable home polysomnography.
All 20 snorers and 4 controls had OSA, for a positive predictive value of 100% and a negative predictive value of 78%. Fourteen snorers and one control had moderate or severe OSA (p < 0.001; positive predictive value 70%, negative predictive value 94%).
The authors had also performed physical exams and assessed sleepiness using validated tools. But snoring during conscious sedation was superior to any other indicators for predicting OSA. In fact, it was the only independent predictor of OSA on multivariate analysis (odds ratio 33.3).
"Given the medical and financial burden of undiagnosed OSA, these patients should be carefully identified and referred for sleep medication evaluation," Dr. Sharara and associates conclude.
The researchers acknowledge the limitations of their study, including its small sample size and lack of capnographic monitoring.
Also, they point out, detecting OSA during endoscopy depends on the vigilance of the endoscopy team and may be affected by the type of sedatives used, depth of sedation, and patient positioning.
Gastrointest Endosc 2010.
cheers
Mars
