Relationship between snoring and pulmonary complication after coronary artery bypass graft surgery

Document Type : Original Article

Authors

1 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Cardiac Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: Obstructive sleep apnea and snoring are associated with high blood pressure, stroke, and cognitive impairment, as well as increased risk of perioperative heart events and respiratory failure.
Objective: This study aimed to investigate the association between snoring and pulmonary complications after coronary artery bypass graft surgery.
Methods and Materials: In this cross sectional study, 232 participants referred to two general hospitals in Mashhad, Iran from Dec 2017 to Jan 2018 for coronary artery bypass surgery were categorized to two groups of snoring and non-snoring. For each participant, a checklist including demographic information, snoring history, medical history, lung complications and laboratory findings were completed. In addition, three snoring questionnaires including STOP-BANG, Berlin and Epworth were filled out.
Results: The results showed that there were no statistically significant differences between groups in term of age (P = 0.404). There was a significant difference in oxygen saturation, duration of extubation, and length of stay in ICU and surgery ward in the snoring group. The mean score of the snoring group was significantly high according to Epworth scale (P = 0.001). Based on the Berlin and STOP-BANG questionnaire, participants with snoring had a significant risk of apnea and obstructive sleep apnea (p=0.008 and p=0.001, respectively). There was no significant difference between the history of diseases such as hypertension, diabetes, and hyperlipidemia (p>0.05).
Conclusion: In conclusion, snoring increases oxygen desaturation, time required for extubation, and the length of stay in hospital in patients scheduled for coronary artery bypass graft surgery.

Keywords

References

 1.Sabzmakani L, Hazavoiy M, Rabiy M. Predisposing,
Reinforcing, Enabling Causes in Educational Diagnosis
and Evaluation (PRECEDE). Payesh. Journal of The
Iranian Institute For Health Sciences Research 20098
(1): 76 Persian. 2009.
2.Naghibi S, Kordi MR, Maleki MJ, Yarmohammadi M.
Effect of concurrent training on hemodynamic responses
in male patients with coronary artery disease. Archives
of Rehabilitation. 2007;8(3):6-11.
3.Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish
JP, Cohen NH, Young WL. Miller's Anesthesia E-Book.
philadelphia: Elsevier Health Sciences; 2015.
4.Sleep-related breathing disorders in adults:
recommendations for syndrome definition and
measurement techniques in clinical research. The Report
of an American Academy of Sleep Medicine Task Force.
Sleep. 1999;22(5):667-89.
5.Punjabi NM. The epidemiology of adult obstructive
sleep apnea. Proceedings of the American Thoracic
Society. 2008;5(2):136-43.
6.Somers VK, White DP, Amin R, Abraham WT, Costa
F, Culebras A, et al. Sleep apnea and cardiovascular
disease: An american heart association/american college
of cardiology foundation scientific statement from the
american heart association council for high blood
pressure research professional education committee,
council on clinical cardiology, stroke council, and
council on cardiovascular nursing in collaboration with
the national heart, lung, and blood institute national
center on sleep disorders research (national institutes of
health). Journal of the American College of Cardiology.
2008;52(8):686-717.
7.Kaw R, Michota F, Jaffer A, Ghamande S, Auckley D,
Golish J. Unrecognized sleep apnea in the surgical
patient: implications for the perioperative setting. Chest.
2006;129(1):198-205.
8.Sériès F, Roy N, Marc I. Effects of sleep deprivation
and sleep fragmentation on upper airway collapsibility in
normal subjects. American journal of respiratory and
critical care medicine. 1994;150(2):481-5.
9.Eastwood PR, Platt PR, Shepherd K, Maddison K,
Hillman DR. Collapsibility of the upper airway at
different concentrations of propofol anesthesia.
Anesthesiology: The Journal of the American Society of
Anesthesiologists. 2005;103(3):470-7.
10.Kaw R, Golish J, Ghamande S, Burgess R.
Incremental risk of obstructive sleep apnea on cardiac
surgical outcomes. Journal of Cardiovascular Surgery.
2006;47(6):683.
11.Eastwood PR, Szollosi I, Platt PR, Hillman DR.
Collapsibility of the upper airway during anesthesia with
isoflurane. Anesthesiology: The Journal of the American
Society of Anesthesiologists. 2002;97(4):786-93.
12.de Jesus Danzi-Soares N, Genta PR, Nerbass FB,
Pedrosa RP, Soares FSN, César LAM, et al. Obstructive
sleep apnea is common among patients referred for
coronary artery bypass grafting and can be diagnosed by
portable monitoring. Coronary artery disease.
2012;23(1):31-8.
13.Diken ÖE, Diken Aİ, Yalçınkaya A, Gülbay B,
Acıcan T, Demir E, et al. Predictive Value of STOPBANG on OSAS-Related Complications Following
Coronary Artery Bypass Grafting. Respiratory care.
2018;63(10):1264-70.
14.Aliasgharpoor M, Eybpoosh S. QUALITY OF
SLEEP AND ITS CORRELATING FACTORS IN
RESIDENTS OF KAHRIZAK NURSING HOME.
Journal of Nursing and Midwifery Urmia University of
Medical Sciences. 2011;9(5):0-.
15.d r Johns’ personal website about the ESS. Available
at:http://epworthsleepinessscale.com/about-the-ess/.
Accessed November 21, 2011.
16.Hwang D, Shakir N, Limann B, Sison C, Kalra S,
Shulman L, et al. Association of sleep-disordered
breathing with postoperative complications. Chest.
2008;133(5):1128-34.
17.Vgontzas AN, Papanicolaou DA, Bixler EO, Hopper
K, Lotsikas A, Lin H-M, et al. Sleep apnea and daytime
sleepiness and fatigue: relation to visceral obesity,
insulin resistance, and hypercytokinemia. The Journal of
Clinical Endocrinology& Metabolism. 2000;85(3):1151-
8.
18.Alexopoulos EI, Theologi V, Malakasioti G,
Maragozidis P, Tsilioni I, Chrousos G, et al. Obstructive
sleep apnea, excessive daytime sleepiness, and morning
plasma TNF-α levels in Greek children. Sleep.
2013;36(11):1633-8.
19.Kua J, Zhao L-P, Kofidis T, Chan S-P, Yeo T-C, Tan
H-C, et al. Sleep apnoea is a risk factor for acute kidney
injury after coronary artery bypass grafting. European
Journal of Cardio-Thoracic Surgery. 2015;49(4):1188-
94.
20.Diken ÖE, Diken Aİ, Yalçınkaya A, Gülbay B,
Acıcan T, Demir E, et al. Predictive Value of STOPBANG on OSAS-Related Complications Following
Coronary Artery Bypass Grafting. Respiratory care.
2018;63(10):1264-70.
21.Amra B, Niknam N, Sadeghi MMM, Rabbani M,
Fietze I, Penzel T. Obstructive sleep apnea and
postoperative complications in patients undergoing
coronary artery bypass graft surgery: a need for
preventive strategies. International journal of preventive
medicine.2014;5(11): 

Files

Share

How to cite

Statistics