Persistent moderate or severe obstructive sleep apnea after laparoscopic Roux-en-Y gastric bypass: which patients?

May 29, 2016Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Which patients continue to have moderate or severe sleep apnea after gastric bypass surgery

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

In a study of 437 patients, 25.9% still experienced moderate to severe obstructive sleep apnea (OSA) after bariatric surgery.

Among 205 patients who underwent both pre- and postoperative sleep studies, the median apnea-hypopnea index (AHI) was 32.3/hr.
A postoperative AHI of less than 15/hr was achieved in 152 patients, indicating no or mild OSA.
Predictive factors for persistent moderate to severe OSA included being aged 50 or older, having a preoperative AHI of 30/hr or more, experiencing less than 60% excess weight loss, and having hypertension.
The follow-up period averaged 8.6 months post-surgery, with a significant portion of patients lost to follow-up (53.1%).
The area under the curve for predicting persistent OSA was 0.772, suggesting a moderate level of predictive accuracy.

AI simplified

BACKGROUND: Patients with severe obesity and obstructive sleep apnea (OSA) might decide to undergo bariatric surgery to improve this disease or, more specifically, to become independent of continuous positive airway pressure (CPAP) therapy, which is generally indicated in case of moderate and severe OSA. Knowledge of this topic is important for patient education on expectations of surgical outcome.

OBJECTIVES: To evaluate the prevalence and phenotypes of patients with persistent moderate to severe OSA after bariatric surgery.

SETTING: Obesity Center Amsterdam, Amsterdam, the Netherlands.

METHODS: Patients who underwent a laparoscopic Roux-en-Y gastric bypass, had a preoperative apnea-hypopnea index (AHI)≥15/hr, and of whom a follow-up AHI/hr was available were included.

RESULTS: Out of 437 patients, 205 underwent pre- and postoperative polysomnography; 232 (53.1%) were lost to follow-up. Median AHI was 32.3/hr (range, 15-138) and mean body mass index was 46 (standard deviation 7.2) kg/m. A postoperative AHI<15/hr was achieved in 152 patients (74.1%), whereas 53 (25.9%) still had moderate or severe disease 8.6 (standard deviation 4.8) months postoperatively. Predictive factors for persistent moderate to severe disease were age≥50 years, preoperative AHI≥30/hr, excess weight loss (EWL)<60%, and hypertension (area under the curve: .772). 2

CONCLUSION: After bariatric surgery, around three quarters of the moderate to severe OSA patients had no or mild OSA, whereas one quarter (25.9%) still had moderate to severe OSA. Age≥50 years, preoperative AHI≥30/hr, EWL<60%, and hypertension were predictive factors for this persistent postoperative AHI≥15/hr.

Full Text

Full text is available at the source.

View full text ↗View full text (XML) ↗

Persistent moderate or severe obstructive sleep apnea after laparoscopic Roux-en-Y gastric bypass: which patients?

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief