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Assessment of the Effect of Bariatric Surgery on Obstructive Sleep Apnea at Two Postoperative Intervals

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Abstract

Background

Studies have reported significant improvement of obstructive sleep apnea (OSA) in obese patients after bariatric surgery (BS). Weight loss following BS is rapid in the first few months, but it can take at least 1 year to reach the final result. The aim of this study is to measure the effect of BS on various clinical, respiratory, and sleep parameters of OSA at two postoperative intervals.

Methods

Prospectively, all patients being evaluated for BS underwent a polysomnography (PSG). Patients diagnosed with OSA preoperatively were invited to undergo a PSG at least 6 months postoperatively and if OSA persisted, again at least 12 months postoperatively.

Results

One hundred ten patients underwent a first postoperative PSG 7.7 months after surgery. The mean apnea–hypopnea index (AHI) significantly decreased from 39.5 to 15.6/h. In 58.2 %, the AHI was reduced to below 10 and in 25.5 % to below 5. Fifty patients underwent a first PSG 7.1 months and a second PSG 16.9 months after surgery. The mean AHI decreased from 49.1 to 22.7 to 17.4/h following BS.

Conclusions

BS initiates dramatic improvement and even remission of clinical and sleep parameters during the first 7 months, which continues at a slower rate over the next 10 months. We recommend a follow-up PSG after surgery to check for residual disease and if necessary retritration of continuous positive airway pressure, which may lead to higher treatment compliance.

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Abbreviations

AI:

Apnea index

AHI:

Apnea–hypopnea index

BMI:

Body mass index

BS:

Bariatric surgery

CPAP:

Continuous positive airway pressure

DI:

Desaturation index

ENT:

Ear nose and throat

ESS:

Epworth sleepiness scale

IFSO:

International Federation for the Surgery of Obesity

LAGB:

Laparoscopic gastric banding

LRYGB:

Laparoscopic gastric bypass

OHS:

Obesity hypoventilation syndrome

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

SaO2 :

Oxygen saturation

SG:

Sleeve gastrectomy

WHO:

World Health Organization

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Acknowledgments

Many thanks to the contribution of P.M.M. Sickinger, project manager at the Amsterdam Obesity Centre of the Sint Lucas Andreas Ziekenhuis.

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No external funding was used for this study.

Conflict of Interest

The authors do not have any commercial associations that might be a conflict of interest in relation to this article.

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Correspondence to M. J. L. Ravesloot.

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Ravesloot, M.J.L., Hilgevoord, A.A.J., van Wagensveld, B.A. et al. Assessment of the Effect of Bariatric Surgery on Obstructive Sleep Apnea at Two Postoperative Intervals. OBES SURG 24, 22–31 (2014). https://doi.org/10.1007/s11695-013-1023-y

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