Trending Weight Loss Between Usual Care and Bariatric Surgery Among Higher Weight Persons With Obstructive Sleep Apnea

Abstract

BackgroundThis study aimed to investigate the actual weight change documented as a goal of treatment after patients were newly diagnosed with obstructive sleep apnea (OSA). We hypothesized that patients with OSA and classified as overweight and obese based on BMI would fail to achieve significant weight loss over a two-to five-year period. MethodologyThis retrospective review included adults aged 18 years or older who were newly diagnosed with OSA in 2015, as indicated by a full nocturnal polysomnogram and using the 4% rule for the definition of hypopnea. Data collected were between January 01, 2015, and December 31, 2020. Patients received either usual care for weight reduction or bariatric surgery to assess the overall weight loss and identify barriers. Statistical analysis included independent t-tests, Mann-Whitney U tests and related samples McNemar change statistics, Cox proportional hazards regression, and Kaplan-Meier curves to analyze age, gender, ethnicity, and weight differences between usual care and bariatric surgery groups. ResultsThe number of participants included for usual care and bariatric surgery was 100 and 24, respectively. Over five years, 87% of the usual care patients remained in the same BMI classification, 7% lowered their classification, and 6% raised theirs. For usual care patients, the average net weight per individual of 2.19 kg gained represented a 1.96% weight change. Bariatric patients lost an average net weight of 30.40 kg (22.39%). Cox proportional hazards regression showed that the overall model fit was statistically significant (χ 2 = 55.40, degrees of freedom [df] = 9, and P-value < 0.001). The significant variables were time-dependent weight change and ethnicity. The Kaplan-Meier curve revealed that weight loss reduced over time in treatment. ConclusionsThis study confirmed that despite the direction to lose weight, only 7% of OSA patients lowered their BMI classification. Patient instruction and provider-driven weight loss strategies seem equally ineffective to achieve sustained weight reduction among high-risk groups. More research is needed to investigate optimal strategies that include interprofessional collaborative practices for sustained weight loss.