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Sunday, 2 January 2011

Anesthesia Sleep is Actually a Coma and Implications for Snoring Evaluations

Posted on 04:30 by Unknown
On December 30, 2010, the New England Journal of Medicine published a paper titled "General anesthesia, sleep, and coma". The article goes on to describe normal sleep as well as sleep induced by anesthesia at time of surgery. What researchers have found is that anesthesia-induced sleep actually is more like a deeply unconscious coma patient than someone sleeping.

This actually makes sense to me... When a person sleeps, they can be aroused if noxious stimuli is introduced causing the person to wake up... and most likely yell at the person trying to wake them up. However, in a coma patient, the person does not "wake" up no matter what is being done to them.

During surgery, the last thing you want is for the person to wake up. As such, a coma-state would be preferred rather than a true sleep state.

This finding does have implications for snoring research as there have been several papers (see references below) in the recent past that proposed the use of anesthesia in order to pinpoint where a person's snore is coming from.

Why would this exam be helpful at all? Because one could perform a variety of endoscopic evaluations while a patient is sleeping (or rather coma) to find the culprit tissue vibration causing the snore. Is it the soft palate or nose or tongue or voicebox or a combination of factors? Such an exam is not possible if the person is "sleeping" as they would just wake up.

Without knowing where the snoring is coming from, treatment is at best a good guess.

Though at this time, insurance does not pay for this type of exam... this sleep research does potentially cause one to pause and wonder whether an exam of snoring during anesthesia is an accurate portrayal of snoring during sleep.

After all... a coma is not the same as regular sleep. It does follow that potentially, snoring during a coma is not the same as that found in regular sleep which would invalidate any exam findings regarding snoring localization.

In fact... I wouldn't be surprised if snoring sources found during anesthesia-induced coma is more severe (and potentially different) than that found during regular sleep and may needlessly lead the surgeon to pursue more aggressive snoring surgery than truly required.

Clearly, more research is needed. Indeed, in one paper published back in 1998, snoring was produced during anesthesia in 45.3% of non-snorers and could not even be produced in 18.1% of snorers!!!

References:
General anesthesia, sleep, and coma. N Engl J Med. 2010 Dec 30;363(27):2638-50. Press Release

Validity of sleep nasendoscopy in the investigation of sleep related breathing disorders. Laryngoscope. 2005 Mar;115(3):538-40.

Acoustic parameters of snoring sound to compare natural snores with snores during 'steady-state' propofol sedation. Clin Otolaryngol. 2006 Aug;31(4):341-2; author reply 342.

Propofol-induced sleep: polysomnographic evaluation of patients with obstructive sleep apnea and controls. Otolaryngol Head Neck Surg. 2010 Feb;142(2):218-24.

The value of sedation nasendoscopy: a comparison between snoring and non-snoring patients. Clin Otolaryngol Allied Sci. 1998 Feb;23(1):74-6.
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  • primer
  • problem
  • problems
  • procedure
  • process
  • professional
  • propel
  • protein kinase
  • provider
  • public
  • publication
  • puck
  • pulsatile
  • pumpkin
  • punishment
  • purchase
  • purulent
  • pus
  • puzzle
  • pylori
  • quickly
  • quickmark
  • r. kelly
  • radiation
  • radio
  • radioactive
  • radioactivity
  • radiological
  • radiology
  • raft
  • ragweed
  • random
  • rapid
  • raspy
  • RAST
  • reaction
  • reader
  • real-time
  • rebound
  • reckitt
  • record
  • recording
  • records
  • recurrent
  • red eyes
  • reduction
  • referral
  • reflux
  • regurgitation
  • rehm
  • removal
  • renovation
  • renovations
  • repair
  • repellant
  • replacement
  • reporter
  • research
  • residency
  • resident
  • resistance
  • response
  • resurface
  • resurfacing
  • review
  • rhinitis
  • rhinoplasty
  • richmond
  • right
  • ringing
  • rinse
  • risk
  • robert
  • robot
  • robotic
  • rock
  • roger
  • roof
  • room
  • rotating
  • routine
  • rubber
  • runny nose
  • rupture
  • ryan
  • safe
  • sale
  • saline
  • saliva
  • salivary stone
  • saltwater
  • santa claus
  • scan
  • scans
  • scar
  • scheduling
  • science
  • scientist
  • SCIT
  • scopolamine
  • scramble
  • scratch
  • screening
  • SD
  • seafood
  • search
  • seasonal
  • seaweed
  • secondhand
  • secure
  • security
  • sedated
  • sedation
  • self-pay
  • sensory
  • sepsis
  • septal
  • septo
  • septoplasty
  • septum
  • sermo
  • service
  • set
  • severe
  • sex
  • shampoo
  • shape
  • shark
  • shenandoah university
  • shop
  • shortness of breath
  • shot
  • shots
  • show
  • shrimp
  • sialadenitis
  • sialendoscopy
  • sialoadenitis
  • sickness
  • side
  • side effect
  • silent
  • silver nitrate
  • singer
  • singing
  • singing cat
  • singulair
  • singultus
  • sinuneb
  • sinuplasty
  • sinus
  • sinus fracture
  • sinus infection
  • sinus lift
  • sinus surgery
  • sinusitis
  • skating
  • skin
  • skin cancer
  • skull
  • sleep
  • sleep disorder
  • SLIT
  • sluder
  • small
  • smartphone
  • smell
  • smoke
  • smoking
  • sms
  • sneeze
  • sneezing
  • snore
  • snoring
  • snot
  • snotty nose
  • social
  • social media
  • social networking
  • soda
  • sodium
  • soft
  • song
  • sore
  • sore throat
  • sour
  • spa
  • spam
  • spanish
  • spasmodic
  • spasmodic dypshonia
  • spasmodic dysphonia
  • spasms
  • special
  • specialist
  • speech
  • speech therapy
  • spinal
  • spinning
  • spit
  • splints
  • split tube
  • spray
  • spur
  • ssnhl
  • staph
  • starvation
  • stat
  • station
  • stem
  • stereoisomer
  • sterile
  • steroid
  • steroids
  • sticky
  • stink
  • stone
  • stones
  • stops
  • storybooks
  • strange
  • strep
  • strep throat
  • stridor
  • strobe
  • stroboscopy
  • stroke
  • stuck
  • stud
  • student
  • study
  • stuffed animals
  • stuttering
  • sublingual
  • submandibular
  • submaxillary
  • sudden
  • sudden hearing loss
  • sun
  • sunblock
  • sunscreen
  • sunshine
  • superbill
  • superbowl
  • superbug
  • support
  • surgeon
  • surgery
  • surgical
  • survey
  • suture
  • swallow
  • swallowing
  • swelling
  • sword
  • symbicort
  • symphony
  • symptom
  • symptoms
  • syndrome
  • T-tube
  • tablet
  • talk
  • talking
  • tall
  • target
  • taste
  • tea
  • teacher
  • technology
  • teen
  • teenager
  • teeth
  • television
  • temperature
  • terrorism
  • terrorist
  • test
  • testing
  • tests
  • text messaging
  • the doctors
  • the onion
  • theory
  • therapy
  • thick
  • throat
  • throat cancer
  • throat clearing
  • throat-clearing
  • thrombosis
  • thrombus
  • throwing
  • thyroid
  • thyroidectomy
  • tia
  • tic
  • tic cough
  • tick
  • tilt
  • time
  • times
  • tinnitus
  • tiny
  • Tionne
  • TLC
  • TMJ
  • tobacco
  • TOCPM
  • today
  • tongue
  • tonsil
  • tonsil stones
  • tonsillectomy
  • tonsilliits
  • tonsillitis
  • tonsilloliths
  • tonsillotomy
  • tonsilolith
  • tonsiloliths
  • tony
  • tooth
  • tooth pain
  • top
  • topical
  • TORD
  • torres
  • tors
  • torticollis
  • tour
  • toxin
  • toyota
  • trach
  • tracheostomy
  • training
  • trans
  • translation
  • transmedics
  • transmission
  • transplant
  • transplantation
  • transportation
  • trauma
  • treating
  • treatment
  • tremor
  • trend
  • triangle
  • trombone
  • trouble
  • tube
  • tubes
  • tucci
  • tumor
  • turbinate coblation
  • turbinate hypertrophy
  • turbinate reduction
  • turning
  • tutorial
  • TV
  • tween
  • tweet
  • twitching
  • twitter
  • two
  • tylenol
  • tympanic
  • type
  • ulcer
  • ulpa
  • ulrich
  • ultrasound
  • unable
  • unclog
  • under
  • uninsured
  • united kingdom
  • university
  • Update
  • upper
  • upper respiratory infection
  • uppp
  • urgent
  • URI
  • urine
  • urticaria
  • usa
  • USA today
  • uva
  • uvula
  • uvulectomy
  • uvulopalatopharyngoplasty
  • vaccination
  • vaccine
  • vagal neuropathy
  • vascular
  • vasomotor
  • vasomotor rhinnitis
  • vcd
  • ventilation
  • versus
  • vertigo
  • ves
  • vessel
  • viagra
  • vibration
  • video
  • viral
  • virginia
  • virus
  • viruses
  • vit d
  • vitamin
  • vitamin A
  • vitamin d
  • vivosonic
  • vlog
  • vocal
  • vocal cord
  • vocal cord dysfunction
  • vocal cord paralysis
  • vocal cord paresis
  • vocal cords
  • vocal process
  • voice
  • voice therapy
  • voicebox
  • voicelift
  • volume
  • vomit
  • vs
  • wait
  • waiting
  • wall
  • wall street journal
  • warm
  • warrenton
  • washes
  • washington
  • washington dc
  • washington post
  • water
  • watkins
  • wax
  • wearable
  • web
  • web 2.0
  • webapp
  • Website
  • Website Update
  • wedge
  • weight gain
  • whale
  • what to do
  • wheezing
  • where
  • whisperer
  • whispering
  • white
  • who
  • whooping
  • wierd
  • wifi
  • will.i.am
  • wind
  • windows 7
  • winter
  • wire
  • wireless
  • withdrawal
  • without
  • woman
  • word
  • world
  • world voice day
  • world's
  • worlds
  • wound center
  • wp
  • wrestling
  • wrong
  • wsj
  • x-ray
  • xeomin
  • xray
  • xylitol
  • xyzal
  • youtube
  • zenker's
  • zenkers
  • zeta
  • zicam
  • zinc
  • zyrtec

Blog Archive

  • ▼  2011 (190)
    • ►  September (26)
    • ►  August (22)
    • ►  July (20)
    • ►  June (15)
    • ►  May (10)
    • ►  April (18)
    • ►  March (12)
    • ►  February (33)
    • ▼  January (34)
      • Why Do We Have Earwax?
      • A Crime For Doctors to Ask About Guns?
      • Link Between Oral Sex and Head & Neck Cancer
      • Allegra Going Over-The-Counter March 2011!
      • Bottles / Vials for Allergy Drops (Under Tongue) I...
      • Dr. Chang a Northern Virginia Top Doctor for 2011
      • Migraine Headaches Associated with Allergies & Res...
      • Patulous Eustachian Tube Video
      • Fauquier Hospital Now Offers 24 Hour Multichannel ...
      • Woman Undergoes Successful Voicebox Transplant
      • Videos on Visual Illusions
      • New Video on Vocal Cord Surgery Produced
      • Wireless and Cell Phones Increase Risk of Brain Tu...
      • Dr. Chang Now a Contributing Author to Better Heal...
      • Updated Google App Translates English<->Spanish Co...
      • ENT Robotic Surgery
      • U.S. Rep. Gabrielle Gifford Gets a Tracheostomy Af...
      • What is the Perfect Tablet Computer for Healthcare?
      • Tongue Piercing Infections
      • Fauquier ENT Is Now Searchable on Trunk.ly!
      • Chronic Hives Due to Vitamin D Deficiency
      • Dr. Chang Receives Patients' Choice Award for 2010
      • Dr. Chevalier Jackson, Laryngologist Extraordinaire
      • Cigarette Ad Blast From the Past
      • Singulair May Help Reduce Tonsil and Adenoid Enlar...
      • Twins Die after Tonsillectomy and Adenoidectomy
      • How to Use an EpiPen??? There's An App for That!
      • Clinical Guidelines For Tonsillectomy in Children ...
      • Avoidable Pediatric Radiation Exposure
      • Surgery Costs for Self-Pay Patients
      • Cocaine the Soft Drink Being Sold in the United St...
      • Simple Rubber Device Mimics Complex Birdsongs & Im...
      • Anesthesia Sleep is Actually a Coma and Implicatio...
      • Should You Have Surgery Far From Home???
  • ►  2010 (267)
    • ►  December (23)
    • ►  November (18)
    • ►  October (32)
    • ►  September (30)
    • ►  August (35)
    • ►  July (16)
    • ►  June (27)
    • ►  May (22)
    • ►  April (27)
    • ►  March (11)
    • ►  February (13)
    • ►  January (13)
  • ►  2009 (43)
    • ►  December (11)
    • ►  November (13)
    • ►  October (19)
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