Bariatric surgery and obstructive sleep apnea: a systematic review and meta-analysis

May 5, 2023Sleep & breathing = Schlaf & Atmung

Bariatric surgery and its relationship with obstructive sleep apnea: a review and combined analysis

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Abstract

Bariatric surgery was associated with a 65% rate of remission of obstructive sleep apnea (OSA) among 2310 patients studied.

Bariatric surgery resulted in a significant reduction in body mass index (BMI) by an average of 11.9.
The apnea-hypopnea index (AHI) decreased significantly by an average of 19.3 after surgery.
There was a notable reduction in the respiratory disturbance index (RDI), averaging 33.9.
Despite these improvements, the rate of OSA remission indicates that obesity may not be the sole cause of OSA.

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BACKGROUND: Several studies evaluated the effect of bariatric surgery on obstructive sleep apnea (OSA) but findings have been inconsistent. The aim of this study was to conduct an updated systematic review and meta-analysis to investigate the effect of bariatric surgery on OSA.

METHODS: The databases for PubMed, CENTRAL, and Scopus were searched up to the 1st of December, 2021. Studies were included if they were cohort or case-control in design, included patients with diagnosis of OSA, the patients underwent any bariatric surgery, and the study performed postoperative polysomnography.

RESULTS: The total number of the included patients was 2310 patients with OSA from 32 studies. Our analysis showed that bariatric surgery was associated with significant reduction in BMI (WMD = - 11.9, 95%CI: - 13.4, - 10.4), apnea-hypopnea index (AHI) (WMD = - 19.3, 95%CI: - 23.9, - 14.6), and respiratory disturbance index (RDI) (WMD = - 33.9, 95%CI: - 42.1, - 25.7). The rate of OSA remission after the surgery was 65% (95%CI: 0.54, 0.76).

CONCLUSION: Our results suggest that bariatric surgeries are effective in reducing obesity among patients with OSA in addition to OSA severity measures. However, the low rate of OSA remission suggests that the main etiology of OSA is not only obesity but also includes other important variables such as the anatomy of the jaw.

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Bariatric surgery and obstructive sleep apnea: a systematic review and meta-analysis

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