Sleep study/cpap/surgery ?

[HopeandAgony 566]

I'm trying to understand why a sleep study *may be* required by some for this surgery. I havent been told I need to have one and do not expect I will. That being said I am honestly confused about why they are so important for this surgery. Is it simply because this is an elective procedure and all bases need to be covered? I am honestly interested in understanding this and here is where my thought process lies currently. I have had 7 surgeries in the past 15 years. Six of them I was asleep for. None of them were elective, only one of them was immediate. So for the 5 that were scheduled in advance, why was a sleep study never required. Wouldn't the same logic apply? I am asking here because it is concerning, and of course if there are reasons this is needed specifically for this surgery I want to know for my own safety! But at the same time I don't want to question the Dr because I don't want him to feel like I need one...I just want to know why it's not needed for other surgeries but *may be* for this one. What's the difference?

Edited August 25, 2015 by HopeandAgony

[AmbulanceDude 6]

I think it's important because all of the medication they give you for surgery can affect your breathing. Most opiate narcotics cause respiratory depression, then if you add in sleep apnea, it becomes very dangerous.

[HopeandAgony 566]

And who decides if you need one and how is that decided?

[dhrguru 1,238]

My surgeon let the pulmonologist device if I needed one. But some surgeon's require it no matter what.

I didn't have to have one. The fact that I don't snore, wasn't tied during the day, and Diameter of the neck wasn't excessively large led the pulmonologist to say it wasn't necessary.

My hubby had a surgery with undiagnosed/treated sleep apnea and had an issue during surgery. They've told him no more elective procedures until that's taken care of. Of course being a man, he hasn't taken care of it yet yet.

[HopeandAgony 566]

This is all so informative! I do have a pretty thick neck. I did have to go to the hospital and do the pulmonary testing which was an hour of abusive breathing demands...lol. I passed those just fine, but I don't see the Dr for a few weeks still. Wonder what will happen.

Edited August 25, 2015 by HopeandAgony

[IncredibleShrinkingMan 437]

I had the pulmonologist's tests and he cleared me and waived the sleep study requirement. If you don't snore, just say that to him and you'll be out the door. They really don't want to be in the business of holding up people's surgery. NP's and PT's, though, that's another story...

[Croaker 26]

People can have profound sleep apnea without snoring!

You need to be properly evaluated. The big deal is that people with OSA (obstructive sleep apnea) halt their breathing, which leads to a drop in the oxygen content in your body. This has been proven, time and again, to be severely detrimental to health and healing. Mix that with a surgically assaulted abdominal wall and narcotics, and it can lead to issues post-operatively - both in the hospital, and at home.

This isn't just some box to be checked. It's important.

[WorkinOnMe 596]

My father just had a surgical proceedure that required general anesthesia & the anesthesiologist had to adjust what was used & how much due to his severe apnea. This is the only reason I can think of for it. I wasn't required to have one though, so not really 100% sure as to the reasons. I'd be interested in knowing why if anyone ever gets a definitive answer.

[MaMaCole 12]

My doc explained that he didn't like the chances of air being ingested and ballooning the new stomach pouch. And, that after surgery a large number of patients don't need a CPAP.

[HopeandAgony 566]

All the replies are interesting. I am still struggling with the logistics. The broad discrepancies of who and who doesn't need a sleep study leaves me perplexed. Essentially in any surgery there is an anesthesiologist at your head watching your breathing, your heart rate, the oxidation in your blood, all of your vitals... I completely agree that going in to this and knowing ahead of time is of course hugely beneficial, but is it really required?? Why, in my 5 other surgeries has this need never come up?

I had hoped someone who has had prior surgeries AND was required to have a sleep study before bariatric surgery was in the same mindset I am in and asked what makes this surgery different. And also why not all Dr's (or insurance companies) require it if it is so vital to surgery, healing, etc...

Edited August 25, 2015 by HopeandAgony

[bigfatgoodbye 82]

The test is sometime required because sleep apnea is considered a "co morbidity" for insurance purposes and may help with approval. My insurance had a specific exclusion for WLS but I had all the symptoms of sleep apnea so I had it done anyways. My doc said if I could resolve the sleep apnea I would lose 10% more of the excess weight. Not being in REM sleep for a proper amount of time makes the body produce something that makes you crave sweets which usually adds to the weight. This is how it was explained to me. I did have severe sleep apnea and the weight loss has helped tremendously.

[HopeandAgony 566]

The test is sometime required because sleep apnea is considered a "co morbidity" for insurance purposes and may help with approval. My insurance had a specific exclusion for WLS but I had all the symptoms of sleep apnea so I had it done anyways. My doc said if I could resolve the sleep apnea I would lose 10% more of the excess weight. Not being in REM sleep for a proper amount of time makes the body produce something that makes you crave sweets which usually adds to the weight. This is how it was explained to me. I did have severe sleep apnea and the weight loss has helped tremendously.

This is really interesting information that I hadn't heard before (the part of 10% extra loss as well as the REM/sweet craving connection). Although it doesn't necessarily correlate with needing the study done prior to surgery it would surely factor in after surgery. Thanks for sharing!