Evolution of treated obstructive sleep apneas syndrome after bariatric surgery: an observational retrospective study

Surg Obes Relat Dis. 2024 Sep 10:S1550-7289(24)00799-8. doi: 10.1016/j.soard.2024.08.038. Online ahead of print.

Abstract

Background: The resolution of obstructive sleep apneas syndrome (OSAS) following bariatric surgery appears to be promising for the majority of patients although this resolution does not necessarily exhibit a linear correlation with weight loss. Previous small-scale studies have pinpointed a younger age and preoperative weight under 100kg as predictive factors of OSAS improvement OBJECTIVES: The primary objective was to evaluate the evolution of OSAS in patients treated with continuous positive airway pressure (CPAP). Additionally, we tried to identify potential predictive factors for OSAS improvement postsurgery.

Setting: Brest Hospital, France, University Hospital.

Methods: In this retrospective, observational study we analyzed a cohort of 44 patients who underwent bariatric surgery, between January 2015 and December 2021. Each patient underwent respiratory polygraphy (RP) or polysomnography (PSG) before and after the surgical procedure. We collected CPAP data (including effective pressure and adherence) before and during the 6 months following the intervention.

Results: Within the study population, 68.18% of patients exhibited improved OSAS, as defined as an apnea-hypopnea index of less than 15 per hour. A higher mean oxygen saturation prior to surgery emerged as the sole predictive factor for OSAS improvement. CPAP adherence and therapeutic pressure value, 2 rarely studied parameters, did not show significant difference between improved and nonimproved patients.

Conclusions: The rate of OSAS resolution after surgery is 68.18%, with only a higher mean oxygen saturation before surgery identified as a predictive factor for OSAS resolution.

Keywords: Apnea-hypopnea index; Bariatric surgery; CPAP; Morbid obesity; Obstructive sleep apneas syndrome; Sleep recording.