Journal of Sleep Disorders & Therapy
Open Access

Abstract

Effects of Metabolic Surgery on Obstructive Sleep Apnea Complicating Severe Obesity

Takenori Mineta, Keisuke Hosokawa*, Toshie Shiraishi, Ryutaro Shirahama, Takayuki Yamaguchi, Rie Hosokawa, Chiyumi Takeda, Setsuko Toyomaki, Rie Chiba, Kazue Asanuma, Ami Asaoka, Mitsuho Sato, Akira Sasaki and Tsuguo Nishijima

Background: The most important pathogenic risk factor for Obstructive Sleep Apnea (OSA) is obesity. Bariatric/ Metabolic Surgery (MS) is the most effective therapeutic strategy for severe obesity. This study aimed to determine the prevalence of severe obesity and OSA in patients who underwent MS and to identify the preoperative predictive factors associated with the effects of MS on OSA in Asians.

Methods: Polysomnography (PSG) was performed before and after surgery to determine the postoperative prevalence of OSA and evaluate the effects of MS on sleep architecture and sleep-disordered breathing indices. Apnea-hypopnea Index (AHI) of <15 events/h (omitted below) was defined as improvement, whereas an AHI of ≥ 15 was defined as no change. The preoperative factors that predict the effects of MS on OSA in the patients were analyzed to determine the prognostic factors associated with no change in preoperative data.

Results: The prevalence of OSA in patients with severe obesity in this study was 98.5%. However, rebound OSA was observed in some patients at 96-144 weeks after surgery. Only 31.1% of the patients showed improvement in AHI to <15. The preoperative predictive factors for no change in OSA were higher preoperative Apnea Index (AI) and lower mean preoperative %SpO₂.

Conclusions: Surgical weight loss substantially improved OSA associated with obesity; however, AHI gradually rebounded over time. Long-term follow-up observation of OSA using PSG should be considered in these patients. AI may help to more precisely delineate MS outcomes.

Published Date: 2024-10-07; Received Date: 2024-09-07