Sleep Apnea and Hip Replacement Surgery

Why is it Important to Diagnose Sleep Apnea before Hip Replacement Surgery?

Many people who suffer from chronic pain have trouble sleeping. But could your insomnia have a different cause?

Sleep apnea is one of the most difficult diseases to diagnose, especially when the symptoms are masked by other problems. It’s all too easy to think that you wake up tired because your hip pain kept you awake throughout the night, or that you nap so easily during the day because the constant aching is wearing you out.

These complaints, however, are also very common sleep apnea symptoms.

Diagnosing sleep apnea before you undergo hip replacement surgery is extremely important. Whether you will be undergoing partial or total hip replacement, you will be receiving heavy doses of sedatives and anesthesia. If your doctors are unaware that you suffer from sleep apnea, these sedatives can be highly dangerous, or even fatal.

What is Sleep Apnea?

To understand why untreated sleep apnea is a particular risk for people undergoing hip replacement surgery, you first need to understand this disorder. Sleep apnea is a chronic condition which causes a patient to stop breathing for short periods of time throughout the night.

The most common strain of this disorder is called obstructive sleep apnea. With obstructive sleep apnea, the inability to breathe is caused by something blocking your airways. For example, the throat muscles themselves can relax too much, constricting the airway and making it impossible to breathe properly.

Sleep apnea is a dangerous condition, which can deprive the blood of much-needed oxygen, and which can lead to heart attack, stroke, and other serious health threats.

Why is Sleep Apnea Difficult to Diagnose?

How is it possible that something as traumatic as being unable to breathe could go unnoticed? Most people don’t realize it, but the body rarely stores short-term memories while it sleeps. It is common to briefly wake many times throughout the night, but usually we don’t remember the interruptions.

People who are suffering from the pain that leads to hip replacement surgery are even more likely to miss the tell-tale warning signs, since the sleep apnea symptoms are so similar to the insomnia that many chronic pain sufferers experience.

Why is Sleep Apnea Dangerous for People Undergoing Hip Replacement Surgery?

Sedatives can have a negative effect on people who suffer from obstructive sleep apnea. The relaxation that comes with sedation also causes the muscles lining the air passages to relax, which can exacerbate the blockage.

Sedatives also work to suppress the respiratory system, and slow your rate of breathing. In a sleep apnea patient, this can be particularly dangerous.

Additionally, some people must be intubated before, during, or after hip replacement surgery. Intubation can irritate the lining of the throat and cause swelling, which can make episodes of sleep apnea more frequent and more severe.

How Can I Tell if I Have Sleep Apnea?

The first step to evaluating your risk is to know the common sleep apnea symptoms. Ask yourself whether you experience the following:

Frequent or nightly snoring

Waking up feeling exhausted and groggy

Falling asleep during the day, or at inappropriate times

Irritability and personality changes

Difficulty remembering things well

Depression

It can also help to know whether you are at increased risk for obstructive sleep apnea. Risk factors include:

Obesity

Smoking
Hypothyroidism
Receding chin
Enlarged tonsils, or throat surgery in your past
One of the most common ways that sleep apnea is diagnosed is by having a family member or loved one monitor you while you sleep, to determine if you stop breathing at any time.

If you are suffering from two or more of the above sleep apnea symptoms, you should talk to your doctor, even if you have believe the signs are caused by your hip pain. Your doctor will normally prescribe a visit to a sleep clinic, which can monitor you and determine if you are suffering from apnea.

How is Sleep Apnea Normally Treated?

The most common sleep apnea treatment is the use of a CPAP machine. A CPAP machine helps to keep your airways under pressure, which prevents them from collapsing and causing an obstruction.

This machine is usually used together with a CPAP mask, which fits over the patient’s nose and/or mouth.

In severe cases, surgery may be used to correct the obstruction that is triggering sleep apnea symptoms.

Sleep Apnea Care Before Hip Replacement Surgery

Special care must be taken to ensure that sleep apnea patients do not incur serious difficulties due to the sedatives used during hip replacement surgery. This begins with a thorough pre-surgery screening.

Before you are prepped for surgery, you should discuss your condition with your anesthesiologist. Make sure that he or she knows about any experiences you have had with sedatives in the past, whether they were positive or negative. Ask about the plan for managing your sleep apnea before, during, and after surgery.

It is also a good idea to explore alternatives to general anesthetic. In general, three types of sedatives are available for use during surgery: general, regional, and local.

General anesthetic simply “knocks you out,” and when you wake again, the surgery is over. This is appealing to many people, but this kind of sedative also bears the highest risk, especially for sleep apnea patients.

Local anesthetic is usually too mild to be effective during hip replacement surgery.

Regional anesthetic, however, could be an alternative for you. An epidural or a spinal block can provide a pain-free operation with a much lower risk of breathing problems. Regional anesthetic has other benefits as well, including a faster recovery time and less bleeding during surgery.

You should carefully discuss the risks and benefits of each type of anesthesia before your hip replacement surgery.

Sleep Apnea Care During Hip Replacement Surgery

Especially if you and your doctor decide to proceed with general anesthesia, it is important to take extra precautions to handle potential sleep apnea complications during surgery.

It is common to have an anesthesiologist on hand during major surgery, and it is important for him or her to know that you have an increased risk of having trouble breathing during the surgery. It might be prudent to have a doctor who is qualified to do an emergency tracheotomy on hand, in case an emergency arises.

Sleep Apnea Care After Hip Replacement Surgery

Sleep apnea patients require additional monitoring after their hip replacement surgery is over. The recovery period, when you are waking from general anesthesia, is particularly crucial. If you have been intubated during surgery, it is oftentimes a good idea to continue artificial respiration until you are fully conscious once again.

The recovery period after hip replacement surgery should also be carefully monitored, and for a longer time period than for other patients. Outpatient surgery is generally considered unwise for sleep apnea patients for this reason. The lingering effects of the sedative in the blood stream can exacerbate sleep apnea problems, and intubation can cause additional blockage in the airways.

If you generally use a CPAP machine to treat your sleep apnea, you should bring it to the hospital and use it while recovering from your hip surgery.

Because sleep apnea so often goes unrecognized, and because the anesthetics used during hip surgery can dangerously exacerbate the condition, it is important to talk to your doctor if you show any of the signs and symptoms of this sleeping disorder. By following the advice in this article, you can have a safer and more successful hip operation.

Also see; minimally invasive hip operations.

About The Author:
Sandra Grauschopf is a successful author and regular contributor to http://www.hip-replacement-care.com. Sandra Grauschopf is a freelance writer and internet marketing expert who has been writing professionally both on and off the web for over 10 years. Ever since she was a child, she has enjoyed researching and sharing her knowledge about topics like sleep apnea, CPAP machines and sleep disorders..