Obstructive sleep apnea (OSA) is common among people who are obese and many of these people turn to bariatric surgery to achieve a healthier weight.  Many bariatric surgery patients say their OSA goes away or becomes more bearable after bariatric surgery and many post-surgery bariatric patients choose to discontinue treatment for OSA.

Discontinuing treatment may be a risky decision, according to the results of a study conducted by investigators at the Walter Reed Army Medical Center.  The relief from OSA may not be as great as many patients report and, left untreated, OSA can severely limit the quality of one’s life.

OSA is thought to affect between 55% to 90% of the population of obese Americans.  The sleep disorder itself is thought to promote excessive weight gains by working on several mechanisms, including impairment of glucose metabolism, imbalance of proteins that regulate appetite and fat metabolism, and ineffective quality of sleep.

Christopher J. Lettieri, MD, Chief of Sleep Medicine at the army medical center, evaluated 24 patients complaining of excessive daytime somnolence (EDS) when reporting to the Pulmonary Critical Care and Sleep Medicine Service for evaluation before bariatric surgery.  Average patient age was 47.9 years and 75% of them were female.  All study participants had an overnight polysomnography before the bariatric surgery and again one year after it.

One year after surgery, only one study participant, representing 4% of the study group, proved to be free of OSA.  Most of them (71%) had lingering OSA at the moderate to severe level.

Only seven study participants, representing 29%, complained of snoring, a symptom of OSA, after surgery.  All but one of them (96%) still snored, according to their post-surgery polysomnography.

The research team cautions doctors and patients alike to the need to continue OSA treatments, including continuous positive airway pressure (CPAP) therapy, until the absence of OSA has been clinically proven.

Further details of the Walter Reed sleep study have been published in the Journal of Clinical Sleep Medicine.

Source: American Academy of Sleep Medicine