Obesity Surgery Does Not Cure SLeep Apnoea [Study]

[James @ Intus]

I hope this doesn't ring true for our buddy Puffin but research has shown that obesity surgery such as bariatric operations do not / may not cure obstructive sleep apnoea.

MedHeadlines reports:

One year after surgery, only one study participant, representing 4% of the study group, proved to be free of OSA. Most of them (71%) had lingering OSA at the moderate to severe level.

Only seven study participants, representing 29%, complained of snoring, a symptom of OSA, after surgery. All but one of them (96%) still snored, according to their post-surgery polysomnography.

The research team cautions doctors and patients alike to the need to continue OSA treatments, including continuous positive airway pressure (CPAP) therapy, until the absence of OSA has been clinically proven.

WebMD says:

Don't count on weight loss surgery to end your obstructive sleep apnea if you're obese.

A new study shows that obstructive sleep apnea often persists after weight loss surgery, but most patients don't realize that and wind up taking risks with their health.

This last part seems like a sound bit of advice:

The study was small, and the findings may not apply to all obstructive sleep apnea patients.

Still, Lettieri's team wants obese obstructive sleep apnea patients to know two things:

* You're likely to still need sleep apnea treatment after weight loss surgery.
* No matter what, don't quit your CPAP machine without your doctor's approval and a sleep test to check that your sleep apnea really is gone.

[puffin]

That interesting James, one lad I've been in touch with lad lost 6 stone in 12 weeks post surgery. He had OSA pre-op. He had a sleep test a few weeks ago. He is now off his CPAP because he no longer needs it.

However as the study says it was a small sample (20 odd individuals), and they looked at the individuals after 12 months. I suspect that a lot would depend on starting weight/BMI of each individual and as everyone loses weight at different rates. After 12 months, which is approximately the half way mark after weight loss surgery, a number of those individual may still be over weight with a BMI well in excess of 25 which is seen as the ideal. The break even point is about two years post-op. when you will stop losing weight. So a more valid check point would be 2 years rather than 1 year.

But as the report says, don't change your CPAP habit until you Doctor says you can. Quote.
"The research team cautions doctors and patients alike to the need to continue OSA treatments, including continuous positive airway pressure (CPAP) therapy, until the absence of OSA has been clinically pr oven. "

[James @ Intus]

I suspect that a lot would depend on starting weight/BMI of each individual and as everyone loses weight at different rates.

Totally agree with that and as we know, not all OSA is due to being overweight so if someone was obese AND they had narrow windpipes to begin with, loosing the weight obviously won't make much of a difference (as far as the OSA is concerned).

[puffin]

I posted the link on the weight loss surgery forum late last night. So far at least 6 people of both sexes have been told that they no longer need CPAP.

One person was told that weight loss can result in loose baggy tissue around the airways, also overall muscle tone can be effected with major weight loss in the first 6 to 12 months after WLS.

As I said its such a small sample that data can be distorted, so take it with a pinch of salt.

[James @ Intus]

Sounds ecouraging.

As I said its such a small sample that data can be distorted, so take it with a pinch of salt.

Which is why I put [Study] in brackets behind the title What's the chance this study was funded by one of the big boy CPAP manufacturers

[puffin]

one of the big boy CPAP manufacturers

Is that atempt at a joke, James.

[Andysee]

I was 14st 4lb in January when I started CPAP treatment. Not exactly obese just a bit outside my recommended BMI index figure. I'm now 11st 9lb and according to my Resmed stats I'm still getting AI's between 0 and .9. I suspect my weight has nothing to do with my OSA. I would be interested to know if there are any other males of simular weight (or less) who have OSA. James, maybe you are aware of one or two?
Best regards
Andy

[James @ Intus]

We have been thinking about a 'survey' of sorts on those stats Andy but off the top of my head, no.

A better indication would be AHI without CPAP but you would need something other than the CPAP to test that with so that's harder. We have people who arrange a follow-up study with their hospital or who rent the pulse oximetry test from us who then record one night on CPAP and one night without to compare.

OSA can be down to a recessed lower jaw, narrow windpipes, nasal problems and a few more obscure reasons but predominantly it's overweight.

[Andysee]

Thank you James for your reply. When I'm next summoned to the sleep clinic (December I think) I will ask a few questions. I hope they don't just ask me to send the data from my machine on a card in the post. I think I may have the narrow passage problem as I have snored since early teens.

Thanks again
Andy

[James @ Intus]

If that is the case there's little that can be done, CPAP would be the only thing I know of. They may be able to confirm this is the cause, if you really want to know, with a naso-endoscopy where they stick a camera op your nose into the throat so they can see what happens where. Possibly even a 'sleep naso-endoscopy' where they put you to artificial sleep to get an even better picture. You'd need a visit to a well-equipped (technology wise ) ENT for that.