No association existed between obstructive sleep apnea (OSA) and postoperative delirium after risk adjustment in the context of usual care in the intensive care unit (ICU), according to study results published in JAMA Network Open.

Associations between OSA, continuous airway pressure therapy, and postoperative delirium were analyzed in patients admitted to an ICU after major surgery undergoing routine Confusion Assessment Method testing. The main outcome measure was delirium within 7 days of surgery.

Of the 7792 patients admitted to an ICU after major surgery, 2044 patients had either diagnosed or likely OSA. Of the 2044 patients with OSA, 897 (44%) experienced postoperative delirium within 7 days of surgery, compared with 2740 of 5748 (48%) patients without OSA. Furthermore, preoperative positive airway pressure adherence did not significantly affect the rates of postoperative delirium.

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“This retrospective cohort of patients admitted to the ICU after surgery found a decreased rate of delirium among patients with OSA, which was eliminated by adjustment for confounding factors,” the study authors concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


King CR, Fritz BA, Escallier K, et al. Association between preoperative obstructive sleep apnea and preoperative positive airway pressure with postoperative intensive care unit delirium [published April 20, 2020]. JAMA Netw Open. doi: 10.1001/jamanetworkopen.2020.3125