Obstructive sleep apnea (OSA) is a common, underdiagnosed condition affecting up to 20–30% of surgical patients and is characterized by recurrent upper airway obstruction and intermittent hypoxia (1,9). In the perioperative setting, OSA increases risk for respiratory complications due to anesthesia, sedatives, and opioids (6,10). This study evaluates whether OSA is associated with increased postoperative respiratory complications in adult surgical patients compared to those without OSA. A focused narrative review using systematic methods was conducted with PubMed and related databases to identify studies published from 2015–2025. Search terms included obstructive sleep apnea, perioperative, anesthesia, and respiratory complications. Inclusion criteria included adult surgical populations reporting outcomes such as hypoxemia, airway obstruction, reintubation, or respiratory failure. Pediatric and non-surgical studies were excluded. Twelve studies (systematic reviews, meta-analyses, and cohort studies) were included. Data were reviewed and summarized, with study quality assessed. OSA was consistently associated with increased postoperative respiratory complications, with approximately 1.5–2.5 times higher odds of cardiopulmonary complications and ICU admission, particularly hypoxemia and ICU utilization (2,3,5). Screening tools such as STOP-BANG and interventions including CPAP and enhanced monitoring were associated with improved outcomes (4,7,8). Limitations include observational designs, residual confounding, and variability in OSA definitions. OSA is an independent risk factor for postoperative respiratory complications. These findings highlight the importance of improved screening and perioperative management strategies to reduce complications and optimize patient outcomes.
