Assessment of the effect of bariatric surgery on severe obstructive sleep apnea patients not tolerating CPAP therapy

Shaarawy, Hany; Sarhan, Abd-Elrahman; Hawary, Amr El

doi:10.1016/j.ejcdt.2016.04.007

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…Then, we used the trim-and-fill method and the leave-one study-out method. When we excluded the study of Shaarawy et al (2016), I² was reduced to 13.6%, suggesting that this study was the main driving source for the heterogeneity. Of note, is that the type of surgery-LSG was also a significant factor contributing to the heterogeneity.…”

Section: V) T-90mentioning

confidence: 95%

“…Then, we used the trim-and-fill method and the leave-one study-out method. When we excluded the study of Shaarawy et al (2016), I² resolved suggesting that this study was the main driving source for the heterogeneity. iv) Mean SpO 2…”

Section: I) Bmimentioning

confidence: 99%

“…All the non-randomized controlled trials except two studies [one case-control (Busetto et al, 2005) and one cross-sectional (Lage-Hansen et al, 2018)] were observational (i.e., 26 studies). Out of these 26 observational studies, 19 were prospective (Pillar et al, 1994;Valencia-Flores et al, 2004;Pallayova et al, 2011;Krieger et al, 2012;Bakker et al, 2013Bakker et al, , 2014Fredheim et al, 2013;Bae et al, 2014;Karaköse et al, 2014;Zou et al, 2015;Del Genio et al, 2016;Jiao et al, 2016;Shaarawy et al, 2016;Xu et al, 2016;Peromaa-Haavisto et al, 2017;Tirado et al, 2017;Al-Jumaily et al, 2018;Chierakul et al, 2020;Yilmaz Kara et al, 2021) and 7 retrospective (Peiser et al, 1984;Fritscher et al, 2007;Morong et al, 2014;Obeidat et al, 2020;Song et al, 2021;Wu et al, 2022;Yanari et al, 2022) in study design. Figure 1, the PRISMA flow diagram, demonstrates the flow of records from the initial search through the selection process, the number of records included, and the reasons for exclusion.…”

Section: Included Studiesmentioning

confidence: 99%

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The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis

et al. 2023

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IntroductionWe conducted this systematic review and meta-analysis (SRMA) to evaluate the impact of bariatric surgery on obstructive sleep apnea (OSA) as represented by the following polysomnography (PSG) parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen desaturation (mean SpO2), total sleep time spent with SpO2 < 90% (T-90), and the nadir of oxygen saturation (L SpO2).MethodsA comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, and Scopus databases from inception to March 31, 2023. Only articles written in English were reviewed. The analysis of all outcomes was performed using a random-effects model. We included 30 studies (two randomized controlled trials and 28 observational studies) in the final quantitative synthesis with a total of 1,369 patients.ResultsWe concluded that bariatric surgery (regardless of the type) was associated with reduction in AHI [MD 23.2 events/h (95%CI 19.7, 26.8)], ODI [MD 26.8 events/h (95%CI 21.6, 32.1)], mean SpO2 [MD−1.94% (95%CI −2.5, −1.4)], T-90 [MD 7.5min (95%CI 5.0, 10.0)], and L SpO2 [MD 9.0% (95%CI −11.8, −6.3)].ConclusionOur SRMA results are updates to previously published results and continue to support the positive impact of bariatric surgery on OSA and sleep-related hypoxia.

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Section: V) T-90mentioning

confidence: 95%

Section: I) Bmimentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

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The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis

et al. 2023

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“…OSA is a condition characterized by recurrent loss of tone of the upper airway resulting in hypopnoea (partial obstruction) and apnoea (complete obstruction) causing hypoxia and subsequent waking from sleep [ 6 ]. It is a significant contributor to motor vehicle accidents when not treated [ 7 ], and has been shown to exacerbate long-term diabetes complications such as cardiovascular disease (CVD), neuropathy, retinopathy and nephropathy [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program

et al. 2021

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Background Although there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a multidisciplinary weight management program was to assess the relationship between OSA and CPAP usage, and 12-month weight change. Methods A retrospective cohort study of all patients commencing an intensive multidisciplinary publicly funded weight management program in Sydney, Australia, between March 2018 and March 2019. OSA was diagnosed using laboratory overnight sleep studies. Demographic and clinical data, and use of CPAP therapy was collected at baseline and 12 months. CPAP use was confirmed if used ≥4 h on average per night on download. Results Of the 178 patients who joined the program, 111 (62.4 %) completed 12 months in the program. At baseline, 63.1 % (n=70) of patients had OSA, of whom 54.3 % (n=38) were using CPAP. The non-OSA group had more females compared to the OSA with CPAP group and OSA without CPAP group (90.2 % vs. 57.9 % and 62.5 %, respectively; p=0.003), but there were no significant baseline differences in BMI (50.4±9.3 vs. 52.1±8.7 and 50.3±9.5 kg/m2, respectively; p=0.636). There was significant weight loss across all three groups at 12 months. However, there were no statistically significant differences across groups in the percentage of body weight loss (OSA with CPAP: 6.3±5.6 %, OSA without CPAP: 6.8±6.9 %, non-OSA: 7.2±6.5 %; p=0.844), or the proportion of patients who achieved ≥5 % body weight loss (OSA with CPAP: 57.9 %, OSA without CPAP: 59.4 %, non-OSA: 65.9 %; p=0.743). In patients with T2DM, there was a significant reduction in HbA1c from baseline to 12 months (7.8±1.7 % to 7.3±1.4 %, p=0.03), with no difference between groups (p=0.997). Conclusions This multidisciplinary weight management program resulted in significant weight loss at 12 months, regardless of OSA diagnosis or CPAP use in adults with class 3 obesity. Larger studies are needed to further investigate the effects of severity of OSA status and CPAP use in weight management programs. Until completed, this study suggests that the focus should remain on implementing lifestyle changes and weight management regardless of OSA status.

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Improvement in Nocturnal Hypoxemia in Obese Patients with Obstructive Sleep Apnea after Bariatric Surgery: a Meta-Analysis

et al. 2018

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Assessment of the effect of bariatric surgery on severe obstructive sleep apnea patients not tolerating CPAP therapy

Cited by 8 publications

References 24 publications

The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis

The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis

Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program

Improvement in Nocturnal Hypoxemia in Obese Patients with Obstructive Sleep Apnea after Bariatric Surgery: a Meta-Analysis

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