Obesity Surgery

, Volume 28, Issue 9, pp 2720–2726 | Cite as

Prevalence and Prediction of Obstructive Sleep Apnea Prior to Bariatric Surgery—Gender-Specific Performance of Four Sleep Questionnaires

  • Christian M. HorvathEmail author
  • Juri Jossen
  • Dino Kröll
  • Philipp C. Nett
  • Florent Baty
  • Anne-Kathrin Brill
  • Sebastian R. Ott
Original Contributions



Bariatric surgery (BS) is a treatment option for morbid obesity leading to substantial and sustained weight loss in adults. As obstructive sleep apnea (OSA) is highly prevalent in obese subjects and may increase the perioperative risk, screening for OSA is recommended prior to BS. In clinical routine, BS is performed more frequently in women. Therefore, we sought to assess the gender-specific performance of four sleep questionnaires (Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOPBang, and NoSAS) to predict moderate to severe OSA in the morbidly obese population.

Material and Methods

We applied all four questionnaires to patients scheduled for BS with polygraphic OSA screening at our institution between 2012 and 2015 and performed gender-specific sensitivity analyses.


We included 251 bariatric patients (76% female, median age 39 years, median BMI 42.0 kg/m2). OSA (AHI > 5/h; AHI > 15/h) was present in 43% (females 35%, males 68%; p < 0.001) and 21% (females 13%, males 45%; p < 0.001). STOPBang and NoSAS performed markedly better than ESS and FSS. With the exception of the ESS, all sleep questionnaires allowed better OSA prediction in women than in men.


In obese patients scheduled for BS, a gender-specific difference was observed in the performance of the evaluated OSA screening questionnaires. This needs to be considered when these questionnaires are used. Our results underline the need for better gender-specific OSA screening algorithms in morbidly obese patients.


Obesity Bariatric surgery Sleep-disordered breathing Obstructive sleep apnea 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the local ethics committee (KEK 2017-00772).

Informed Consent

Due to the retrospective nature of the study, informed patient consent was waived.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Christian M. Horvath
    • 1
    • 2
    Email author
  • Juri Jossen
    • 1
  • Dino Kröll
    • 3
  • Philipp C. Nett
    • 3
  • Florent Baty
    • 2
  • Anne-Kathrin Brill
    • 1
  • Sebastian R. Ott
    • 1
  1. 1.Department of Pulmonary Medicine, InselspitalUniversity Hospital and University of BernBernSwitzerland
  2. 2.Department of Pneumology and Sleep MedicineKantonsspital St. GallenSt. GallenSwitzerland
  3. 3.Department of Visceral Surgery and Medicine, InselspitalUniversity Hospital and University of BernBernSwitzerland

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