Does sleeve gastrectomy improve obstructive sleep apnea?

Abstract

BackgroundThe prevalence of obstructive sleep apnea (OSA) increases with obesity. Bariatric surgery provides a significant weight loss for morbidly obese patients. The aim of this study was to evaluate the effect of sleeve gastrectomy on OSA symptoms, sleep parameter, continuous positive airway pressure (CPAP) use in OSA patients with morbid obesity. MethodsSixty consecutive patients for whom morbid obesity surgery was planned were enrolled. All patients underwent physical examination, anthropometric measurements, chest radiography, pulmonary function tests, electrocardiography, measurement of daytime sleepiness with the Epworth sleepiness scale (ESS), Berlin Questionnaire, STOP BANG Questionnaire, and full night polysomnography (PSG). Patients with apnea–hypopnea index (AHI) ⩾15/h were instructed to use CPAP. A second PSG was conducted 6–12months postoperatively. ResultsTwenty patients continued the study. The mean duration for follow up was 8.25±0.96months. There was statistically significant improvement in ESS, Berlin Questionnaire, and STOP BANG Questionnaire (p<0.001). Also, there was statistically significant improvement in anthropometric measures (p<0.001). There was statistically significant improvement in spirometric data (p⩽0.01). There was statistically significant improvement in sustained sleep efficiency, basal oxygen saturation, minimal oxygen saturation, oxygen desaturation index, arousal index and AHI (p<0.001). There was a significant reduction in the number of patients who need CPAP after surgery (p=0.002) with decrease in the required CPAP pressure after surgery (p=0.041). ConclusionSleeve gastrectomy improves OSA symptoms, sleep parameter, and decreases the need and pressure of CPAP in OSA patients with morbid obesity.