CHICAGO — Gastric bypass surgery relieved the need for nighttime treatment of severe obstructive sleep apnea, according to a review of 53 morbidly obese patients.
Most patients with obstructive sleep apnea (OSA) who required nighttime treatment with continuous positive airway pressure (CPAP) no longer needed CPAP by 1 month after gastric bypass surgery, Dr. Esteban Varela reported at the annual clinical congress of the American College of Surgeons.
The patients underwent laparoscopic Roux-en-Y gastric bypass at the University of California, Irvine, when Dr. Varela was at that center. Their mean age was 46, and their mean body mass index was 48 kg/m2.
All patients were assessed by polysomnography prior to surgery. Based on the results, 11 were diagnosed with mild OSA, 15 with moderate OSA, and 27 with severe OSA that required nighttime CPAP treatment.
At 1 month after surgery, about 75% of the patients who had originally required CPAP no longer needed treatment. At 3 months after gastric bypass, about 90% no longer needed treatment, and by 6 months all 27 patients who began with severe OSA no longer needed CPAP treatment.
By 1 year after surgery, the 53 patients had lost an average of 73% of their baseline weight, said Dr. Varela, currently a surgeon at the University of Texas Southwestern Medical Center at Dallas.
On the basis of this finding, Dr. Varela and his associates now routinely use polysomnography to assess patients who are considering gastric bypass for treating morbid obesity prior to surgery to determine if they have OSA.
Documentation showing that OSA resolves after patients undergo gastric bypass may incline insurers to cover this type of surgery, Dr. Varela said.