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Prevalence of obstructive sleep apnea in obese patients evaluated for bariatric surgery
Obesity has reached epidemic levels globally and is a strong predictor of overall mortality and directly associated with the presence of comorbidities such as diabetes, dyslipidemia and obstructive sleep apnea (OSA). Bariatric surgery should be provided as an option to patients with morbid obesity for whom the procedure induces weight loss and improves weight-related comorbidities. As untreated OSA seems to increase the overall surgery-associated risk, screening for OSA prior to bariatric surgery has been recommended.
The aim of this study is to determine the prevalence and severity of undiagnosed OSA in a population of patients evaluated for bariatric surgery.
Consecutive obese patients evaluated for bariatric surgery from August 2018 to August 2019 underwent a standard overnight polysomnography (PSG) at a sleep study center. Each sleep study included supervised electroencephalography, electrooculography, electrocardiography, oxygen saturation, oral and nasal airflow, respiratory effort monitoring, and submental and tibial electromyography. Evaluation and interpretation of the PSG followed the American Society of Sleep Medicine criteria (version 2.5). Inclusion criteria included age > 18 years and a body mass index (BMI) > 30 kg/m2. Exclusion criteria included a previous diagnosis of OSA and incomplete data.
The analysis sample included 112 patients (83% female) with an average age of 36.1 ± 9.4 (range = 18–63) and an average BMI of 36.7 ± 2.3 (range = 32–42.3). More than two-thirds of the sample (77.7%) had OSA and nearly half had severe OSA (40.2%). Among female patients, average age was 35.8 ± 9.2 (range=18-63), average BMI was 36.5 ± 2.1 (range=32-42.3) and 74.2% had OSA and 33.3% had moderate to severe OSA. Among male patients, average age was 37.5 ± 10.3 (range=20-58), average BMI was 37.7 ± 2.5 (range=33-42.1) and 94.7% had OSA and 73.7% had moderate to severe OSA. Male gender was associated a higher prevalence of moderate to severe OSA(p=0.001).
OSA is highly prevalent in obese patients evaluated for bariatric surgery, particularly in male subjects.
Obstructive sleep apnea; Bariatric Surgery; Obesity
Centro de Tratamento de Obesidade Dr.Bruno Mota - Alagoas - Brasil, Faculdade de Medicina da Universidade Federal de Alagoas - Alagoas - Brasil, Ssonoclin - Clínica de Medicina do Sono - Alagoas - Brasil
Michele Ferreira Lino Rocha, Wellisson Rodrigues Silva, Letícia Góes Gitaí Fernandes, Victor Cardoso Rocha, Paulo Victor Lima, Jorge Artur Peçanha de Miranda Coelho, Bruno Rocha Mota, Lívia Leite Góes Gitaí