Bariatric surgery is an effective strategy to decrease long-term obstructive sleep apnea (OSA) severity in patients with grade 1 and grade 2 obesity, according to results from a subanalysis of the Gastric Bypass to Treat obese Patients With steAdy hYpertension study (GATEWAY; ClinicalTrials.gov identifier: NCT01784848) presented at the 33rd Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held June 8 to 12, in San Antonio, Texas.
A significant amount of previous research has established OSA as a known risk factor for obesity and has identified weight loss as a possible mechanism to improve the severity of OSA symptoms. Although bariatric surgery is an effective therapy for obesity, few studies have assessed the long-term effect of bariatric surgery on OSA severity. Consequently, the researchers investigated the long-term effect of Roux-en-Y gastric bypass (RYGB) surgery on OSA severity in patients with obesity grades of 1 or 2.
In this randomized, controlled, subanalysis of the GATEWAY study, patients were randomly assigned to receive either RYGB plus optimized clinical treatment or optimized clinical treatment alone. A subsample of the cohort agreed to perform portable sleep monitoring before and after 3-year follow-ups. Researchers categorized OSA as mild (apnea-hypopnea-index [AHI] 5-14.9 events/h), moderate (15-29.9 events/h) or severe (≥30 events/h). Epworth Sleepiness Scale was used to access excessive daytime sleepiness.
Overall, 37 patients (24 in the RYGB group and 13 in the optimized clinical treatment group) were included in the analysis.
Researchers discovered that RYGB led to a significant decrease in body mass index, waist circumference, neck circumference, and AHI compared with in those in the optimized clinical treatment group. In addition, the occurrence of moderate to severe OSA (AHI (≥15 events/h) at baseline was 62.5% in the RYGB group vs 46.2% in the optimized clinical treatment group (P =.175). Moreover, post-procedure, moderate OSA was present in only 8.3% of the patients in the RYGB group vs 69.3% in the optimized clinical treatment group (P <.001).
Researchers concluded that bariatric surgery demonstrates long-term beneficial effects on OSA severity in patients with obesity grades of 1 or 2.
Disclosure: The authors declared affiliations with Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Ethicon, Inc.
Furlan SF, Drager LF, Martins FC, et al. Long-term effects of bariatric surgery on obstructive sleep apnea in patients with grade 1 and grade 2 obesity: a sub analysis from Gateway study. Poster presented at: 33rd Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society (SLEEP 2019); June 8-12, 2019; San Antonio, TX. Poster 277.