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Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

Nitipatana Chierakul, MD¹, Phasawee Thangdechahirun, MD¹, Voraboot Taweerutchana, MD², Auamporn Kodchalai, MSc³, Tawatchai Panuchawan, MSc³, Kusuma Mamanee, BSc³

Affiliation : ¹ Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Division of Minimally Invasive Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ³ Siriraj Sleep Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases.
Objective: To provide objective evidence that BS can improve OSA severity.
Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months.
Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively.
Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients.
Received 23 Sep 2019 | Revised 11 Jun 2020 | Accepted 12 Jun 2020

doi.org/10.35755/jmedassocthai.2020.08.10650

Keywords : Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)


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