Abstract
obstructive Sleep Apnea Syndrome (OSAS) is a serious confition that compromises the quality of life and survival of patients. Its main risk fator in adults is obesity and the gold standard test for diagnosis is polysomnography (PSG), mainly through the apneia-hypopnea index (AHI). Objective: to analyze the sleep pattern of obese patients with indication for bariatric surgery, determining the main polisomnographic parameters compromised by obesity. This work is a cross-sectional study with analysis of polysomnography perfomed in patients with obesity in the peroperative period of bariatric surgery at a clinic in Vitória da Conquista/BA during 2017. The Epi Info 7 platform was used for analysis of the data. 58 polysomnographic reports were analyzed, with 56,9% morbdly obese and 43,1% non-morbid. The prevalence of OSAS was 70,68% and de AHI ranged from zero to 84,6 with a mean of 19,47±22,89 e/h. morbidly obese, compared to "non-morbid", had a longer saturation time below 80% and 90% (0,4±0,93 vs. 0,12±0,45 e 4,87±7,38 vs. 1,36±2,87 respectively; p-value=0,02 in both), worse index respiratory disorders ((29,24±25,36 vs. 16,88±16,21; p-value=0,02), higher AHI (24,71±25,68 vs. 12,56±16,67; p-value=0,02), higher hypopnea index values (16,41±17,10 vs. 6,99±8,52; p-value=0,006) and lower minimum saturation (78,24±9,80 vs. 85,24±6,33; p-value=0,004). the high prevalence of OSAS found confirms its indication in the preoperative period of bariatric surgery. The main respiratory event involved in most individuals with OSAS was the hypopnea index.
Highlights
The Obstructive Sleep Apnea and Hypopnea Syndrome (OSAHS) is a sleep-related respiratory disorder characterized by upper airway obstruction that results in a cycle of hypoxemia, increased work of breathing, and frequent micro-arousals[1]
The research followed the recommendations of the American Academy of Sleep Medicine (AASM) regarding polysomnographic criteria, which classify OSAHS taking into account the apnea/hypopnea index (AHI), which reflects the number of apneas and hypopneas per hour of sleep
The variables studied were age, sex, weight, body mass index (BMI), height, total sleep time (TST), sleep latency (LATENCY), REM sleep latency (REMLAT), sleep efficacy (SE), non-REM sleep time 1 (NREM1), non-REM sleep time 2 (NREM2), non-REM sleep time 3 (NREM3), REM sleep time (REM), time wake after sleep onset (WASO), Arousals Index (AROUI), Periodic Limb Movements Index (PLM), Respiratory Disturbances Index (RDI), Apnea-Hypopnea Index (AHI), Apnea Index (AI), Hypoapnea Index (HI), average saturation (AVSAT), minimum saturation (MINSAT), time with blood oxygen saturation below 90% (SAT
Summary
The Obstructive Sleep Apnea and Hypopnea Syndrome (OSAHS) is a sleep-related respiratory disorder characterized by upper airway obstruction that results in a cycle of hypoxemia, increased work of breathing, and frequent micro-arousals[1]. As obesity represents a very prevalent and reversible risk factor for OSAHS in adults[2], its global increase directly impacts the syndrome rates[3]. OSAHS is related to several morbidities, such as SAH, acute myocardial infarction, stroke, traffic accidents, among others, and is considered a public health problem[11]. It chronically alters the sensitivity of the peripheral chemoreflex, causes cardiovascular
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