Routine Polysomnography before Bariatric Surgery: Is it Necessary or Optional?

Abstract

Obstructive sleep apnea (OSA) is a condition characterized by episodes of apnea or hypopnea during sleep that result in excessive daytime sleepiness and a range of metabolic disturbances, which adversely affect cardiovascular, metabolic, and psychologic health. The common underlying mechanism for the same is periodic airway closure, which worsens with loss of pharyngeal muscle tone during sleep that results in significant obstruction and episodic apnea. Obesity is one comorbidity that commonly precipitates OSA and also worsens the long-term metabolic sequelae of OSA. With the ever increasing epidemic of obesity that is now starting to affect more developing countries such as India, more patients are undergoing bariatric surgery than before for a range of indications. This population provides a unique set of management issues that shall be the subject of this review.