2005 Abstracts: Objective Evidence That Bariatric Surgery Improves Obesity-Related Obstructive Sleep Apnea
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Objective Evidence That Bariatric Surgery Improves Obesity-Related Obstructive Sleep Apnea
Rodrigo Gonzalez, Krista L. Haines, Taylor Martin, Ali Kandil, Robert Dragotti, Lana G. Nelson, Lisa Saff-Koche, Scott F. Gallagher, Michel M. Murr, University of South Florida Health Science Center, Tampa, FL
BACKGROUND: Obstructive sleep apnea (OSA) is prevalent in more than 50% of morbidly obese and bariatric patients. Symptomatic improvement in OSA has been reported following surgically induced weight loss in small cohorts. However, objective evidence documenting the resolution of OSA and correction of sleep parameters after surgically induced weight loss is scant. The aim of this study is to provide objective evidence that surgically induced weight loss improves obesity-related OSA.
METHODS: Prospectively collected data on patients who underwent Roux-en-Y gastric bypass (RYGB) for clinically significant obesity and who completed preoperative and postoperative polysomnography (sleep study) were reviewed. Patients with symptomatic OSA underwent preoperative polysomnography; the severity of OSA was categorized by the Respiratory Disturbance Index [RDI: absent (0-5), mild (6-20), moderate (21-40) and severe (>40)]. Preoperative C-PAP or BiPAP were prescribed to all patients with OSA and were continued post-operatively. Patients were referred for polysomnography at 6-9 months postoperatively or when weight loss exceeded 75 lb. Continuous data were compared using Mann-Whitney U-test. Results are median (range). A p<0.05 was significant. RESULTS: To date 46 patients have completed preoperative and postoperative polysomnography; Severity of preoperative OSA as measured by RDI was mild: 8 patients; moderate: 9 patients; severe: 27 patients and unknown: 2 patients). None of these patients developed peri-operative respiratory insufficiency or required tracheostomy at the time of RYGB. At a median of 9 (4-35) months postoperatively; Body Mass Index significantly decreased from 55 (39-84) Kg/m2 to 41 (25-61) Kg/m2 (p<0.001), C-PAP levels significantly decreased from 11 (6-21) to 1 (0-11) cm H2O (p<0.001) and postoperative polysomnography demonstrated significant improvement in RDI and other sleep parameters as shown in table (all *p values are <0.001).| Preoperative | Postoperative | |
| RDI | 49 (7-203) | 8.5 (0-75)* |
| Oxygen saturation | 83 (39-97) | 89 (75-98)* |
| Sleep efficiency | 77 (42-95) | 86 (70-95)* |
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