STOP-BANG Score for Obstructive Sleep Apnea
Note: The STOP-BANG questionnaire screens for obstructive sleep apnea (OSA) only, not central sleep apnea.
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- Clinicians may opt to modify the care of patients who are high-risk for OSA:
- Consider reducing narcotic medication doses.
- Use caution when extubating “deep” or prior to return of airway reflexes.
- Consider extended monitoring in PACU prior to discharge to an unmonitored floor.
- Consider admission to a floor with increased level of monitoring or nursing supervision.
- Patients should be counseled to bring their own CPAP machines to the hospital preoperatively if they have them.
- PAP (positive airway pressure) machines should be available in the PACU (post anesthesia care unit) or on the floor for patients who are high-risk for OSA.
- Following the perioperative period (or prior to if identified in a preoperative clinic), patients that screen as high-risk for OSA (obstructive sleep apnea) should have formal polysomnography to receive a definitive diagnosis.
- OSA (obstructive sleep apnea) is due to a mechanical obstruction of the upper airway resulting in diminished breathing (hypopnea = narrowing) or elimination of breathing (apnea = collapse and obliteration).
- The gold standard for OSA diagnosis is polysomnography.
- CPAP (continuous positive airway pressure) is the first-line treatment of OSA and is very effective in stenting open the upper airway, but patient compliance is poor.
- Matthew J. Meyer, MD