Long-term Effects of Gastric Bypass Surgery in Patients with Obstructive Sleep Apnea

Author(s): Nathir Obeidat, Saif Aldeen AlRyalat*, Khaled Al Oweidat, Mahmoud Abu-Khalaf, Asma Btoush, Mohammad Al-Essa, Zaina Obeidat, Mohammed Obeidat, Ayman Wahbeh

Journal Name: Current Respiratory Medicine Reviews

Volume 16 , Issue 1 , 2020

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Background: Obstructive sleep apnea is a common disorder involving, intermittent mechanical obstruction of the upper airway during sleep. Obesity is the most powerful risk factor for obstructive sleep apnea.

Objective: This study aimed to investigate the long-term effect of Roux-en-Y gastric bypass bariatric surgery on patients with obstructive sleep apnea.

Methods: This study included patients were referred for bariatric surgery (Roux-en-Y gastric bypass) to control symptoms and complications of obesity during a 5-year period. An overnight sleep study was performed for each patient before and after the bariatric surgery, to study its effect on different obstructive sleep apnea-related variables.

Results: This study included 179 patients (mean age 35.9 ± 10.7 years). The mean duration from preoperative assessment to postoperative assessment was 2.4 ± 2.2 years. The mean change in body mass index and weight showed a decrease of 16.0 ± 16.0 kg/m2 and48.7 ± 25.9 kg, respectively. The apnea hypopnea index decreased by a mean of 22.6 ± 26.3 events/hour.

Conclusion: We concluded that a decrease in the body mass index by 1 kg/m2 could predict a decrease in the apnea hypopnea index by 0.46 events/hour. Moreover, after mean follow-up duration of 2.4 years, 84.3% of mild and 83.3% of moderate obstructive sleep apnea patients became normal postoperatively.

Keywords: Bariatric surgery, Jordan, obstructive sleep apnea, roux-en-Y gastric bypass, sleep-disordered breathing, postoperative assessment.

[1]
Ioachimescu OC, Collop NA. Sleep-disordered breathing. Neurol Clin 2012; 30(4): 1095-136.
[http://dx.doi.org/10.1016/j.ncl.2012.08.003] [PMID: 23099131]
[2]
Ruehland WR, Rochford PD, O’Donoghue FJ, Pierce RJ, Singh P, Thornton AT. The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep 2009; 32(2): 150-7.
[http://dx.doi.org/10.1093/sleep/32.2.150] [PMID: 19238801]
[3]
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165(9): 1217-39.
[http://dx.doi.org/10.1164/rccm.2109080] [PMID: 11991871]
[4]
Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet 2014; 384(9945): 766-81.
[http://dx.doi.org/10.1016/S0140-6736(14)60460-8] [PMID: 24880830]
[5]
Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am 2003; 32(4): 869-94.
[http://dx.doi.org/10.1016/S0889-8529(03)00069-0] [PMID: 14711066]
[6]
Encinosa WE, Bernard DM, Du D, Steiner CA. Recent improvements in bariatric surgery outcomes. Med Care 2009; 47(5): 531-5.
[http://dx.doi.org/10.1097/MLR.0b013e31819434c6] [PMID: 19318997]
[7]
Ashrafian H, Toma T, Rowland SP, et al. Bariatric surgery or non-surgical weight loss for obstructive sleep apnoea? a systematic review and comparison of meta-analyses. Obes Surg 2015; 25(7): 1239-50.
[http://dx.doi.org/10.1007/s11695-014-1533-2] [PMID: 25537297]
[8]
Sarkhosh K, Switzer NJ, El-Hadi M, Birch DW, Shi X, Karmali S. The impact of bariatric surgery on obstructive sleep apnea: a systematic review. Obes Surg 2013; 23(3): 414-23.
[http://dx.doi.org/10.1007/s11695-012-0862-2] [PMID: 23299507]
[9]
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292(14): 1724-37.
[http://dx.doi.org/10.1001/jama.292.14.1724] [PMID: 15479938]
[10]
Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg 2013; 257(5): 791-7.
[http://dx.doi.org/10.1097/SLA.0b013e3182879ded] [PMID: 23470577]
[11]
Hamed O, Kerlakian G, Engel A, Bollmer C. Outcome of hand-assisted laparoscopic gastric bypass in super obese patients. Surg Obes Relat Dis 2008; 4(5): 618-24.
[http://dx.doi.org/10.1016/j.soard.2007.11.001] [PMID: 18226979]
[12]
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up. Obes Surg 2000; 10(3): 233-9.
[http://dx.doi.org/10.1381/096089200321643511] [PMID: 10929154]
[13]
Higa K, Ho T, Tercero F, Yunus T, Boone KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis 2011; 7(4): 516-25.
[http://dx.doi.org/10.1016/j.soard.2010.10.019] [PMID: 21333610]
[14]
Nelson LG, Lopez PP, Haines K, et al. Outcomes of bariatric surgery in patients > or =65 years. Surg Obes Relat Dis 2006; 2(3): 384-8.
[http://dx.doi.org/10.1016/j.soard.2006.02.012] [PMID: 16925358]
[15]
Villaneuva AT, Buchanan PR, Yee BJ, Grunstein RR. Ethnicity and obstructive sleep apnoea. Sleep Med Rev 2005; 9(6): 419-36.
[http://dx.doi.org/10.1016/j.smrv.2005.04.005] [PMID: 16183307]
[16]
Vats MG, Mahboub BH, Al Hariri H, Al Zaabi A, Vats D. Obesity and sleep-related breathing disorders in Middle East and UAE. Canadian resp J 2016; 2016.
[http://dx.doi.org/10.1155/2016/9673054]
[17]
Obeidat F, Shanti H, Mismar A, Albsoul N, Al-Qudah M. The magnitude of antral resection in laparoscopic sleeve gastrectomy and its relationship to excess weight loss. Obes Surg 2015; 25(10): 1928-32.
[http://dx.doi.org/10.1007/s11695-015-1642-6] [PMID: 25744305]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 1
Year: 2020
Published on: 15 September, 2020
Page: [34 - 38]
Pages: 5
DOI: 10.2174/1573398X16666200206151624
Price: $65

Article Metrics

PDF: 14
HTML: 1