Bariatric surgery and obstructive sleep apnea: a systematic review and meta-analysis.

Abstract

Several studies evaluated the effect of bariatric surgery on obstructive sleep apnea (OSA) but findings have been inconsistent. The aim of this study was to conduct an updated systematic review and meta-analysis to investigate the effect of bariatric surgery on OSA. The databases for PubMed, CENTRAL, and Scopuswere searched up to the 1st of December, 2021. Studies were included if they were cohort or case-control in design, included patients with diagnosisof OSA, the patients underwent any bariatric surgery, and the study performed postoperative polysomnography. The total number of the included patients was 2310 patientswith OSA from 32 studies. Our analysis showed that bariatric surgery was associated with significant reduction in BMI (WMD = - 11.9, 95%CI: - 13.4, - 10.4), apnea-hypopnea index (AHI) (WMD = - 19.3, 95%CI: - 23.9, - 14.6), and respiratory disturbance index (RDI) (WMD = - 33.9, 95%CI: - 42.1, - 25.7). The rate of OSA remission after the surgery was 65% (95%CI: 0.54, 0.76). Our results suggest that bariatric surgeries are effective in reducing obesity among patients withOSA in addition to OSA severity measures. However, the low rate of OSA remission suggests that the main etiology of OSA is not only obesity but also includes other important variables such as the anatomy of the jaw.