Factors contributing to acute perioperative aggravation of obstructive sleep apnea (OSA)

Depressant influences of anesthetics/sedatives/analgesics on central respiratory drive, upper airway protective reflexes, and arousal responses

Intraluminal upper airway narrowing due to post-endotracheal intubation edema, nasal packings, nasal tubes, or hematomas

Forced supine positioning

Sleep deprivation

Intense rapid eye movement (REM) rebound

Temporary suspension of continuous positive airway pressure (CPAP) therapy due to pain, anxiety, nausea, restlessness, presence of a nasogastric tube, failure to bring the equipment to the hospital, or lack of planning for postoperative application.

Rostral fluid shift

Graphic 71284 Version 3.0

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Factors contributing to acute perioperative aggravation of obstructive sleep apnea (OSA)