Review
Assessment of bariatric surgery efficacy on Obstructive Sleep Apnea (OSA)
M. Quintas-Nevesa,, , J. Pretoa,b, , M. Drummonda,c,
a Faculty of Medicine, University of Porto, Porto, Portugal
b Surgery Department of São João Medical Center, Porto, Portugal
c Pulmonology Department of São João Medical Center, Porto, Portugal
Received 31 July 2015, Accepted 06 May 2016
Abstract

A worldwide rise in weight and obesity is taking place, associated with an increase in several comorbid conditions, such as Obstructive Sleep Apnea (OSA). Bariatric surgery is an effective treatment approach for obesity, with resultant improvement in obesity-related comorbidities. However, the relationship between this type of treatment and OSA is not well established. This systematic review aims to assess and characterize the impact that different types of bariatric surgery have on obese OSA patients. 22 articles with stated preoperative apnea–hypopnea index (AHI), apnea index (AI) or respiratory disturbance index (RDI) were analyzed in this review. A significant improvement in AHI/AI/RDI occurred after surgery, in addition to the foreseeable reduction in body mass index (BMI). Moreover, almost every study stated a postoperative reduction of the AHI to < 20/h and/or a >50% postoperative reduction of AHI, with few exceptions. The interventions with a combined malabsorptive and restrictive mechanism, like roux-en-Y gastric bypass (RYGB), were more efficacious in resolving and improving OSA than purely restrictive ones, like laparoscopic adjustable gastric banding (LAGB).

In conclusion, bariatric surgery has a significant effect on OSA, leading to its resolution or improvement, in the majority of cases, at least in the short/medium term (1–2 years). However, the different results must be interpreted with caution as there are many potential biases resulting from heterogeneous inclusion criteria, duration of follow-up, diagnostic methodology and assessed variables.

Keywords
Bariatric surgery, Obesity, Sleep apnea, Apnea–hypopnea index, Body mass index

Metrics

  • Impact Factor: 1.357(2015)
  • 5-years Impact Factor: 0,841
  • SCImago Journal Rank (SJR):0,29
  • Source Normalized Impact per Paper (SNIP):0,685