Bariatric surgery for treatment of sleep apnea syndrome in 15 morbidly obese patients: Long-term results

OBJECTIVE: To evaluate the long-term outcomes of bariatric surgery with respect to respiratory disturbance index (RDI) in sleep apnea syndrome (SAS). DESIGN. Case series with long-term follow-up (I to 12 years). SETTING: Private clinic in an academic tertiary referral center. PATIENTS: Fifteen morbidly obese patients (10 men 5 women) who were referred for the treatment of severe SAS. INTERVENTION, For all 15 patients who presented with severe SAS, nasal positive airway pressure breathing was either not available or was not tolerated by the patient; therefore, bariatric, surgery was performed as a means of treatment for SAS. MAIN OUTCOME MEASURES., RDIs and minimum oxygen saturation were measured both preoperatively and postoperatively (1 to 12 years after surgery). RESULTS: Weight loss ranged from 60 to 220 pounds (27 to 100 kg). RDI decreased by at least 55% in each patient, and all patients with tracheostomies (8 of TS) had their tracheostomy tubes removed. Average RDI preoperatively was 96.9 and average RDI postoperatively was 11.3. Results were similar for all 15 patients in that minimum oxygen saturation increased during sleep from an average preoperative minimum oxygen saturation of 58.7% to an average postoperative minimum oxygen saturation of 85.2%. CONCLUSIONS: Bariatric surgery as a means of treating SAS in the morbidly obese provides effecfive long-term reduction in RDI. Bariatric surgery also significantly improves minimum oxygen saturation in morbidly obese patients with SAS. Biliopancreatic bypass is more effective in reducing RDI to normal values than vertical banded gastroplasty.