Abstract
ObjectiveObesity is associated with a high incidence of obstructive sleep apnoea (OSA). Bariatric surgery is postulated to lead to OSA resolution, but there is inconclusive evidence on its efficacy. We used objective measurements to determine the rate of resolution or improvement of OSA in patients who had bariatric procedures in our unit.ResultsData was analysed on all patients with OSA who underwent bariatric procedures [laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG)] between June 2012 and September 2016 in our unit. 47 patients (26.7%) were diagnosed with OSA. Mean age was 48.5 years. 63.8% were female. 43 required nocturnal continuous positive airway pressure (CPAP) support. Procedures were LRYGB (n = 26) and LSG (n = 21). Mean excess weight loss was 56.1%. Mean start apnoea-hypopnoea index (AHI) on CPAP was 6.4 events/hr and end AHI was 1.4 events/h. 14 patients (32.6%) had complete OSA resolution and 12 (27.9%) showed improvement in pressure support requirements. We demonstrated that 55.3% of patients had resolution or improvement in OSA following bariatric surgery. However, there was a high rate of non-attendance of follow-up appointments. Future efforts will involve analysis of the reasons for this to ensure more robust monitoring.
Highlights
Obstructive sleep apnoea (OSA) is strongly correlated with obesity
There were no significant differences in age, sex or start weight and body mass index (BMI) between the laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) groups
Of the 43 who were started on continuous positive airway pressure (CPAP), the pre-operative apnoea-hypopnoea index (AHI) and CPAP settings were available for 38 patients
Summary
Of 176 patients in the database, 47 were formally diagnosed with OSA (26.7%). 63.8% of patients were female with a mean age of 48.5 years. There were no significant differences in age, sex or start weight and BMI between the LRYGB and LSG groups. 4 patients were deemed not to require CPAP therapy after review in the sleep clinic. Of the 43 who were started on CPAP, the pre-operative AHI (whilst on CPAP therapy) and CPAP settings were available for 38 patients. There was a significant decrease in the mean AHI post-operatively (p < 0.0001). At the end of the study period, 21 patients were still on CPAP therapy (44.7%) compared with 91.5% at the beginning. Mean EWL was greater in the LRYGB group compared with the LSG group (p = 0.036) and end AHI appeared lower in this group (p = 0.039). Correlation analyses were performed between EWL and end AHI and CPAP requirements, where available.
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