Obesity Surgery

, Volume 24, Issue 1, pp 22–31

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

  • M. J. L. Ravesloot
  • A. A. J. Hilgevoord
  • B. A. van Wagensveld
  • N. de Vries
Original Contributions

DOI: 10.1007/s11695-013-1023-y

Cite this article as:
Ravesloot, M.J.L., Hilgevoord, A.A.J., van Wagensveld, B.A. et al. OBES SURG (2014) 24: 22. doi:10.1007/s11695-013-1023-y

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.

Keywords

Bariatric surgery Sleep apnea Obstructive Obesity Body mass index Polysomnography 

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

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • M. J. L. Ravesloot
    • 1
  • A. A. J. Hilgevoord
    • 2
  • B. A. van Wagensveld
    • 3
  • N. de Vries
    • 1
  1. 1.Department of Otolaryngology/Head and Neck SurgerySt. Lucas Andreas HospitalAmsterdamThe Netherlands
  2. 2.Department of Clinical NeurophysiologySt. Lucas Andreas HospitalAmsterdamThe Netherlands
  3. 3.Department of SurgerySt. Lucas Andreas HospitalAmsterdamThe Netherlands