Assessment of the effect of bariatric surgery on severe obstructive sleep apnea patients not tolerating CPAP therapy

Obstructive sleep apnea (OSA) is increasingly prevalent worldwide and is associated with morbidity and mortality, the main line of treatment is CPAP but the compliance is doubtful, as obesity is highly linked to OSA weight loss can help in treatment. The aim of the present study: was to assess the effect of bariatric surgery on severe obstructive sleep apnea patients not tolerating CPAP therapy. Patients and methods: the study was done on 22 patients documented to have morbid obesity (BMI > 40) and severe OSA with Apnea Hypopnea Index (AHI) >30/h and not tolerating CPAP therapy, patients were offered sleeve gastrectomy then were followed up for 12 months before another polysomnography was done to assess the presence of OSA and need for CPAP. Results: 22 patients completed the study. The mean age of the patients was 37.2 ± 17.3 years, 13 males and 9 females. After sleeve gastrectomy and follow up for 12 months the body weight decreased from 135.6 ± 17.8 to 101.3 ± 7.6 kg m (p = 0.001), BMI dropped from 48.2 ± 7.3 to 35.9 ± 4.8 kg m/m2 (p = 0.001), mean AHI decreased from 55.8 ± 8.3 to 12.8 ± 11.3 attacks/hour of sleep (p = 0.001) and CPAP pressure needed to control OSA was decreased from 13.2 ± 2.3 to 8.2 ± 3.9 cm H2O (p = 0.001). Conclusion: sleeve gastrectomy can be an alternate option of treatment for severe OSA patients who are not tolerating CPAP and surgery may cure the disease or at least improve compliance to CPAP by decreasing the needed pressure to control OSA.