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Sleep Apnea and Surgery

What is sleep apnea?

While you sleep, your throat structures relax and may partially block your air passage, making it harder to breathe.  If the entire passage becomes blocked and you can’t breathe at all, you have sleep apnea. Since the lungs aren’t getting fresh air, the brain tells the body to wake up just enough to tighten the muscles of the throat and unblock the air passage. With a loud gasp, breathing begins again. This process may be repeated over and over again throughout the night, making your sleep fragmented and light.  Even though you don’t remember waking up so many times during the night, you feel tired all day. The lack of sleep and fresh air can also strain your lungs, heart, and other organs. Sleep apnea can cause or worsen other medical conditions, including hypertension, heart failure and diabetes. 

Why should I be concerned about surgery and sleep apnea?

Treating sleep apnea is especially important for patients having surgery. Because of the sedating effects of anesthesia and narcotic pain medications, patients who have undiagnosed sleep apnea have a higher rate of complications, longer hospital stays and higher mortality rates. 


All patients having surgery at University Medical Center of Princeton at Plainsboro are screened for their risk of sleep apnea using a STOPBANG questionnaire before surgery. 

Throat structures block the flow of air to the lungs.

These risk factors are:


Snoring loudly 
Tiredness during the daytime
Observed apnea
High blood Pressure
Body Mass Index greater than 35
Age over 50 years
Neck circumference greater than 16.5 inches
Male Gender 

How will my condition be monitored?

If you have three or more risk factors, or you have already been diagnosed with sleep apnea, you will be closely monitored after surgery. A continuous pulse oximetry monitor will be applied to your finger to measure the oxygen in your blood (see figure at left). If you are experiencing apnea while you sleep, the oxygen level in your blood will decrease and the monitor will alarm. Your nurse can also view the monitor from the nurse’s station. This monitoring will continue until the morning after surgery. 


If your oxygen level drops, your nurse will make appropriate changes to your plan of care, which may include:
                                                 • Notifying your doctor and the anesthesiologist.
                                                 • Keeping the head of your bed elevated to improve your breathing.
                                                 • Applying oxygen via a nasal cannula or a mask.
                                                 • Changing your pain medications if they cause too much sedation. 
                                                 • Contacting a sleep medicine specialist.


If you have three or more risk factors, it is important that you follow up with your physician or a sleep medicine specialist after your hospital discharge. Sleep apnea can cause or worsen other serious medical conditions and should be diagnosed and treated.

If you would like to schedule an appointment at the Sleep Center at University Medical Center of Princeton at Plainsboro, please call 609.853.7520. Our Sleep Center, fully accredited by the American Academy of Sleep Medicine, offers a high level of clinical expertise and provides comprehensive services in sleep medicine for adults and children, while utilizing the latest advancements in treating sleep disorders. For more information, visit





The health information provided in this publication is for general education purposes and is not intended to constitute medical advice.  The information should not be used for diagnosis or treatment, nor should it be used to replace the advice of licensed healthcare professionals.  Health concerns or questions should be discussed with your physician.  If you have any concerns about your health, please contact your healthcare provider.