Marine Timmerman1, Damien Basille2,3, Aurélie Basille-Fantinato4, Mickaël E Baud5, Lionel Rebibo6,7, Claire Andrejak5,8,4, Vincent Jounieaux5,8,4, Jean-Daniel Lalau1,9. 1. Department of Endocrinology, Metabolic Diseases and Nutrition, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France. 2. Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France. basille.damien@chu-amiens.fr. 3. AGIR Unit, University Picardie Jules Verne, 80054, Amiens Cedex, France. basille.damien@chu-amiens.fr. 4. Sleep and Vigilance Disorder Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France. 5. Department of Respiratory Diseases and Intensive Care Unit, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France. 6. Department of Digestive Surgery, University Hospital Amiens-Picardie, 80054, Amiens Cedex, France. 7. Department of Digestive, Esogastric and Bariatric Surgery, Bichat Claude Bernard University Hospital, 46 rue Henri Huchard, F-75018, Paris, France. 8. AGIR Unit, University Picardie Jules Verne, 80054, Amiens Cedex, France. 9. PériTox Unit, UMR-I 01, University Picardie Jules Verne, 80054, Amiens Cedex, France.
Abstract
BACKGROUND: Severe obesity is associated with a high prevalence of moderate-to-severe obstructive sleep apnea syndrome (OSA). Bariatric surgery has been shown to effectively reduce excess weight and comorbidities. METHODS: We evaluated the remission rate of moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥ 15) following sleeve gastrectomy. We performed a single-center retrospective chart review of all patients who underwent preoperative polysomnography (PSG) or polygraphy before primary sleeve gastrectomy. Patients with moderate-to-severe OSA treated by continuous positive airway pressure (CPAP) also underwent postoperative PSG. Bivariate analysis was performed to evaluate the criteria associated with remission of moderate-to-severe OSA. RESULTS: From 2013 to 2018, 39 of 162 patients (24.1%) scheduled for sleeve gastrectomy (SG) presented moderate-to-severe OSA requiring CPAP. Postoperative PSG was performed in 36 patients a mean of 9.9 ± 6.1 months after SG. Mean BMI decreased from 47.4 ± 8.4 to 36.3 ± 7.1 kg/m2 (p < 0.001), and all patients reported clinical improvement of OSA symptoms. A remission of moderate-to-severe OSA was observed in 72.2% of patients with a mean decrease of AHI from 45.8 events/h to 11.3 events/h (p < 0.001). Postoperative neck circumference was the only factor associated with OSA remission. CONCLUSION: SG is associated with a rapid improvement of moderate-to-severe OSA partially as a result of a reduction of neck circumference. However, the absence of correlation with excess weight loss suggests that other weight-independent factors may also be involved.
BACKGROUND: Severe obesity is associated with a high prevalence of moderate-to-severe obstructive sleep apnea syndrome (OSA). Bariatric surgery has been shown to effectively reduce excess weight and comorbidities. METHODS: We evaluated the remission rate of moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥ 15) following sleeve gastrectomy. We performed a single-center retrospective chart review of all patients who underwent preoperative polysomnography (PSG) or polygraphy before primary sleeve gastrectomy. Patients with moderate-to-severe OSA treated by continuous positive airway pressure (CPAP) also underwent postoperative PSG. Bivariate analysis was performed to evaluate the criteria associated with remission of moderate-to-severe OSA. RESULTS: From 2013 to 2018, 39 of 162 patients (24.1%) scheduled for sleeve gastrectomy (SG) presented moderate-to-severe OSA requiring CPAP. Postoperative PSG was performed in 36 patients a mean of 9.9 ± 6.1 months after SG. Mean BMI decreased from 47.4 ± 8.4 to 36.3 ± 7.1 kg/m2 (p < 0.001), and all patients reported clinical improvement of OSA symptoms. A remission of moderate-to-severe OSA was observed in 72.2% of patients with a mean decrease of AHI from 45.8 events/h to 11.3 events/h (p < 0.001). Postoperative neck circumference was the only factor associated with OSA remission. CONCLUSION: SG is associated with a rapid improvement of moderate-to-severe OSA partially as a result of a reduction of neck circumference. However, the absence of correlation with excess weight loss suggests that other weight-independent factors may also be involved.
Authors: Vishesh K Kapur; Dennis H Auckley; Susmita Chowdhuri; David C Kuhlmann; Reena Mehra; Kannan Ramar; Christopher G Harrod Journal: J Clin Sleep Med Date: 2017-03-15 Impact factor: 4.062
Authors: P Peromaa-Haavisto; H Tuomilehto; J Kössi; J Virtanen; M Luostarinen; J Pihlajamäki; P Käkelä; M Victorzon Journal: Obes Surg Date: 2016-07 Impact factor: 4.129
Authors: S L van Veldhuisen; M F van Boxel; M J Wiezer; R N van Veen; S M M de Castro; D J Swank; A Demirkiran; E G Boerma; J W M Greve; F M H van Dielen; K Kuppens; E J Hazebroek Journal: Sleep Breath Date: 2022-05-27 Impact factor: 2.655