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Bariatric Surgery Reduces Sleep Apnoea: Presented at ERS

By David Owen

STOCKHOLM, SWEDEN -- September 17, 2007 -- Bariatric surgery can do more than help patients lose weight – it can significantly reduce or even eliminate sleep apnoea, according to studies presented here at the Annual Congress of the European Respiratory Society (ERS).

Ana Maria Fortuna, Department of Respiratory Medicine, Santa Creu i Sant Pau Hospital, Barcelona, Spain, and her colleagues determined the frequency of obstructive sleep apnoea syndrome (OSAS) in 31 morbidly obese patients (mean body mass index [BMI] 47) prior to bariatric surgery, and then, in a post-surgical control study, measured the benefits in terms of reduced sleep apnoea resulting from weight loss linked to the surgery.

Nineteen of the 31 subjects were found to suffer from OSAS pre-surgery (although only 4 had been diagnosed). More men than women had OSAS (9 of the 10 men participating in the study), which is commonly found.

The researchers were struck by the severity of the OSAS among the patients in this study. "Of the 19 patients diagnosed, 14 had an apnoea/hypopnoea index (AHI) of more than 15, which means that they stopped breathing for over 10 seconds at least 15 times per hour. That index was as high as 30 for 11 of the patients," Dr. Fortuna explained.

The BMI of the most severe OSAS cases fell post-surgery to between 25 and 30. The operation helped these patients to shed between 35 and 65 kg.

The study was completed in 16 patients, noted Dr. Fortuna, adding that, "Following surgery, the apnoea/hypopnoea index (AHI) fell from 59 to 9 on average, with only 3 patients presenting an AHI above 15."

A second sleep-apnoea study presented at the ERS was carried out by a team from Salt Lake City, Utah, United States, and was led by James Walker PhD, director, Intermountain Sleep Disorders Centre, LDS Hospital, Salt Lake City.

In Dr. Walker's study, 153 morbidly obese subjects (22 men and 131 women with an average BMI of 47-48) underwent bariatric surgery. Almost all had OSAS (95% of the men, 83% of the women).

"On average, 26 months after surgery, the weight loss was on the order of 55 kg for men and 43 kg for women," said Dr. Walker. "Importantly, this weight loss reduced the number of apneas/hypopneas for men and women, from 40 to 10 per hour and from 20 to 7 per hour, respectively," he added.


[Presentation titles: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS) in Patients Undergoing Bariatric Surgery: Prevalence and Benefits of Weight Reduction. Abstract P2015. The Effect of Bariatric Surgery on Sleep Apnea and Insulin Resistance in Males and Females With Severe Obesity. Abstract E2762]

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