According to the most recent International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Worldwide Survey, there were 685,874 bariatric operations performed in 2016. 1 As the prevalence of obesity increases, the number of patients who undergo bariatric surgery will also continue to rise. Surgeons, anesthesiologists, and other perioperative providers need to be aware of important comorbidities associated with obesity, particularly obstructive sleep apnea (OSA), in order to decrease morbidity and mortality in patients undergoing bariatric surgery.Based on recent studies, the prevalence of OSA worldwide is nearing one billion persons. 2 The prevalence of OSA in the bariatric surgery population has been reported to be anywhere between 35% and 94%. 3 One study that performed polysomnography (PSG) on all patients before bariatric surgery found an OSA rate of 47%. 4 Thus, the actual prevalence of OSA may be higher than some estimates due to patients with undiagnosed OSA.Sleep-disordered breathing (SDB), which leads to a higher rate of pulmonary and cardiovascular complications in the postoperative period, is common in patients with obesity. 5 Examining the significance of OSA as a comorbidity in patients undergoing bariatric surgical procedures is of special interest due to the strong association between OSA and obesity. The majority of weight loss surgeries are performed using a minimally invasive laparoscopic approach, which has a lower complication rate compared with open procedures. 6 To minimize morbidity and mortality and optimize resource utilization, it is appropriate to determine the ideal preoperative screening tests, intraoperative management, and postoperative monitoring techniques for patients with OSA undergoing bariatric surgery.

The prevalence of patients with obesity continues to rise worldwide and has reached epidemic proportions. There is a strong correlation between obesity and sleep-disordered breathing (SDB), and, in particular, obstructive sleep apnea (OSA). OSA is often undiagnosed in the surgical population. Bariatric surgery has been recognized as an effective treatment option for both obesity and OSA. Laparoscopic bariatric procedures, particularly laparoscopic sleeve gastrectomy (LSG), have become the most frequently performed procedures. OSA has been identified as an independent risk factor for perioperative complications and failure to recognize and prepare for patients with OSA is a major cause of postoperative adverse events, suggesting that all patients undergoing bariatric surgery should be screened preoperatively for OSA. These patients should be treated with an opioid-sparing analgesic plan and continuous positive airway pressure (CPAP) perioperatively to minimize respiratory complications. With the number of bariatric surgical patients with SDB likely to continue rising, it is critical to understand the best practices to manage this patient population.