Positioning of Surgical Patients With Sleep Apnea

Englewood Hospital and Medical Center

Overview

The study aims to evaluate the effect of non-supine positioning in the treatment of surgical patients with obstructive sleep apnea. The hypothesis is that non-supine positioning will result in a decrease in acute hypoxic events, defined as the number of apneas/hypopneas per hour of sleep.

This is a prospective, randomized controlled trial that will comprise of two stages. Stage 1 is a pilot study of 30 patients at high risk or diagnosed with obstructive sleep apnea who are scheduled for routine surgery. These patients will be randomized 1:1:1 to standard of care (0 degree bed angle), 30 degree bed angle, or 60 degree bed angle. Acute hypoxic events will be analyzed pre and post-op in the randomly assigned bed position. PACU nurses will also be surveyed for patient-favored non-supine positioning (30 vs. 60 degrees). Stage 2 will be a larger, powered trial to evaluate the efficacy of just one bed angle (30 or 60 degrees) based on the Stage 1 results.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Conditions

Obstructive Sleep Apnea

Interventions

bed positioningOTHER

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Minimum 1 night postoperative hospital stay * More than 18 and less than 80 years old * Identified as high risk of OSA (SACS \> 15) or a history of OSA without CPAP treatment Exclusion Criteria: * Unwilling or unable to give informed consent * Undergoing nasal, eye, head/neck surgery, intracranial or cardiac/thoracic surgery * Currently undergoing treatment for sleep apnea including CPAP * Requiring prolonged postoperative ventilation * NYHA functional class III and IV * Valvular heart disease, dilated cardiomyopathy, implanted cardiac pacemaker, or unstable angina * Myocardial infarction or cardiac surgery within 3 months * Chronic obstructive pulmonary disease, or asthma * Presence of tracheostomy, facial, neck, or chest wall abnormalities * Abdominal aortic aneurysm surgery, chemotherapy, or immunosuppressive therapy within 3 months * Visiting preoperative clinic less than 3 days before surgery * Requiring postoperative nasogastric tube

Locations (1)

Englewood Hospital and Medical Center

Englewood, New Jersey, United States

Outcomes

Primary Outcomes

Acute Hypoxic Index (AHI)

study will look at the effect of bed positioning on Acute Hypoxic Index (AHI), which is defined as the number of apneas/hypopneas per hour of sleep

Time frame: 3 days

Data from ClinicalTrials.gov

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