Babak Katiraee, MD1, Peter Powles, MD, FRACP, FRCPC, ABSM2, Dennis Hong, MD, MSc, FRCSC, FACS1, Scott B Gmora, MD, FRCSC, FACS1, Mehran Anvari, MB, BS, PhD, FRCSC, FACS1. 1Centre for Minimal Access Surgery (CMAS), Hamilton, ON, CA, 2St. Joseph’s Healthcare Hamilton
Background: Obesity is one of the risk factors for obstructive sleep apnea (OSA), increasing its risk by tenfold. Positive Airway Pressure (PAP) is a proven method of treating obstructive sleep apnea, but compliance is reported to be less than 50%. Although patients achieve important weight loss after bariatric surgery, literature is conflicting regarding improvement of obstructive sleep apnea symptoms.
Purpose: This study aims to assess the effects of bariatric surgery on sleep apnea symptoms, apnea/hypopnea index (AHI) scores, overnight oximetry and use of PAP treatment.
Methodology: A retrospective chart review was completed of patients who underwent bariatric surgery at our institution between March 2013 and September 2014. We included all patients who had completed a preoperative overnight polysomnography, had diagnoses of OSA, and were on PAP prior to surgery. Patients that did not complete a postoperative polysomnography were excluded.
Results: In total 57 patients were recruited (42 RNYGB and 15 VSG), of which 47 were woman. We observed a decrease in body weight (Kg.) of 24%, and a decrease in BMI of 23% in accordance with their post bariatric state. With respect to their sleep apnea, there was a decrease in AHI of 59% and a decrease in their Arousal Index by 34%. The lowest recorded Sa02 levels increased by 11%, while Hypoxia Time decreased by 59%. This lead to a decrease in the requirement of PAP use by 65%. Of the patients remaining on PAP, the pressures required were reduced by 25%. The average interval between surgery and follow-up polysomnography was 22 months.
Conclusions: Bariatric surgery significantly improved OSA scores and decreased PAP use in relation to decreases in BMI and body weight. It also improved oxygen saturation levels and decreased Arousal Index scores leading to better sleep quality. We consider that OSA follow up should be done routinely after bariatric surgery for patients previously on PAP.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95197
Program Number: P068
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster