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Obesity and sleep apnea

How are obesity and sleep apnea connected? Research suggests that sleep apnea:

  • Is highly prevalent in morbidly obese patients and is associated with increased risk of cardiac arrhythmias1
  • Has been found to affect as many as 77% of bariatric surgery candidates2
  • Increases the occurrence of major post-operative complications in bariatric surgery patients3 and increases hospital costs in this patient group4
  • Must be considered as part of perioperative care for bariatric surgery5
  • Air pressure treatment required may fluctuate post-operatively because bariatric patients undergo dramatic physical changes (e.g., weight loss). Automatic positive airway pressure (APAP) devices should be considered as a treatment choice during this time.6
  • Is improved by weight loss. Surgery does not necessarily eliminate sleep apnea in obese patients, necessitating long-term follow-up and monitoring.7
  • Can reappear with post-operative weight gain in bariatric patients.8
  • Development and severity may be increased by weight gain.9

References

1

Valencia-Flores M, Orea A, Castano VA, Resendiz M, Rosales M, Rebollar V, Santiago V, Gallegos J, Campos RM, Gonzalez J, Oseguera J, Garcia-Ramos G, Bliwise DL. Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients. Obesity Research 2000;8(3):262-9.

2

O’Keeffe T, Patterson E. Evidence supporting routine polysomnography before bariatric surgery.   Obesity Surgery 2004;14(1):23-6.

3

Perugini RA, Mason R, Czerniach DR, Novitsky YW, Baker S, Litwin DE, Kelly JJ.  Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass: a series of 188 patients. Archives of Surgery 2003;138(5):541-5; discussion 545-6.

4

Cooney RN, Haluck RS, Ku J, Bass T, MacLeod J, Brunner H, Miller CA. Analysis of cost outliers after gastric bypass surgery: what can we learn? Obesity Surgery 2003;13(1):29-36.

5

Schumann R, Jones SB, Ortiz VE, Connor K, Pulai I, Ozawa ET, Harvey AM, Carr DB. Best practice recommendations for anesthetic perioperative care and pain management in weight loss surgery. Obes Res. 2005;13(2):254-66.Continuous positive airway pressure (CPAP) changes in bariatric surgery patients undergoing rapid weight loss.

6

Lankford DA, Proctor CD, Richard R. Continuous positive airway pressure (CPAP) changes in bariatric surgery patients undergoing rapid weight loss. Obes Surg 2005;15(3):336-41.

7

Guardiano SA, Scott JA, Ware JC, Schechner SA. The long-term results of gastric bypass on indexes of sleep apnea. Chest 2003;124(4):1615-9.

8

Charuzi I, Lavie P, Peiser J, Peled R. Bariatric surgery in morbidly obese sleep-apnea patients: short- and long-term follow-up.

9

Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000;284(23):3015-21.