Evidence Supporting Routine Polysomnography before Bariatric Surgery

Terence OKeeffe, Emma J. Patterson

Research output: Contribution to journalArticle

176 Citations (Scopus)

Abstract

Background: Obstructive sleep apnea (OSA) is common in morbidly obese patients, with a reported prevalence from 12 to 40%. Preoperative diagnosis of OSA is important for both perioperative airway management and the prevention of postoperative pulmonary complications. BMI has been reported to be an Independent risk factor, and has been used recently in scoring systems to help predict OSA. Our hypothesis was that OSA is highly prevalent in patients presenting for bariatric surgery, and that BMI alone is not a good predictor of the presence or absence of sleep apnea. Methods: A cross-sectional study was undertaken of the last 170 consecutive patients presenting for bariatric surgery in a single surgeon's practice. Clinical and demographic data were available from our prospective database, and polysomnography results were reviewed retrospectively. Sleep apnea was noted as present or absent, and graded from mild to severe. The patient population was stratified by BMI into severely obese (BMI 35-39.9), morbidly obese (BMI 40-49.9), super-obese (BMI 50-59.9), and super-super-obese (BMI ≥ 60). Results: OSA had been diagnosed before surgical consultation in 26 of the 170 patients (15.3%). Sleep studies were not available in 7 patients (4.1%). The remaining 137 patients (80.6%) had sleep data available, and 105 (76.6%) had sleep apnea (based on American Board of Sleep Medicine criteria). There was no correlation of sleep apnea with BMI. The overall prevalence of OSA in this cohort was 77% (131/170) Conclusions: In this large patient cohort, sleep apnea was prevalent (77%) independent of BMI, and most cases were not diagnosed before bariatric surgical consultation. These data support the use of routine screening polysomnography before bariatric surgery.

Original languageEnglish (US)
Pages (from-to)23-26
Number of pages4
JournalObesity Surgery
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2004

Fingerprint

Bariatric Surgery
Polysomnography
Obstructive Sleep Apnea
Sleep Apnea Syndromes
Sleep
Referral and Consultation
Bariatrics
Airway Management
Cross-Sectional Studies
Medicine
Demography
Databases
Lung

Keywords

  • Bariatric surgery
  • Morbid obesity
  • Obstructive sleep apnea
  • Polysomnography

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Evidence Supporting Routine Polysomnography before Bariatric Surgery. / OKeeffe, Terence; Patterson, Emma J.

In: Obesity Surgery, Vol. 14, No. 1, 01.01.2004, p. 23-26.

Research output: Contribution to journalArticle

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abstract = "Background: Obstructive sleep apnea (OSA) is common in morbidly obese patients, with a reported prevalence from 12 to 40{\%}. Preoperative diagnosis of OSA is important for both perioperative airway management and the prevention of postoperative pulmonary complications. BMI has been reported to be an Independent risk factor, and has been used recently in scoring systems to help predict OSA. Our hypothesis was that OSA is highly prevalent in patients presenting for bariatric surgery, and that BMI alone is not a good predictor of the presence or absence of sleep apnea. Methods: A cross-sectional study was undertaken of the last 170 consecutive patients presenting for bariatric surgery in a single surgeon's practice. Clinical and demographic data were available from our prospective database, and polysomnography results were reviewed retrospectively. Sleep apnea was noted as present or absent, and graded from mild to severe. The patient population was stratified by BMI into severely obese (BMI 35-39.9), morbidly obese (BMI 40-49.9), super-obese (BMI 50-59.9), and super-super-obese (BMI ≥ 60). Results: OSA had been diagnosed before surgical consultation in 26 of the 170 patients (15.3{\%}). Sleep studies were not available in 7 patients (4.1{\%}). The remaining 137 patients (80.6{\%}) had sleep data available, and 105 (76.6{\%}) had sleep apnea (based on American Board of Sleep Medicine criteria). There was no correlation of sleep apnea with BMI. The overall prevalence of OSA in this cohort was 77{\%} (131/170) Conclusions: In this large patient cohort, sleep apnea was prevalent (77{\%}) independent of BMI, and most cases were not diagnosed before bariatric surgical consultation. These data support the use of routine screening polysomnography before bariatric surgery.",
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