Obstructive sleep apnea remission following bariatric surgery: a national registry cohort study

Abstract Background Obstructive sleep apnoea(OSA) is strongly associated with metabolic syndrome. Bariatric surgery is an effective available treatment for OSA; however, limited research predicts which patients undergoing bariatric surgery will undergo OSA resolution. Objectives To determine perioperative predictors for OSA resolution following bariatric surgery using a national database. Setting United Kingdom national bariatric surgery database. Methods The UK National Bariatric Surgery Registry(NBSR) was interrogated to identify all patients with OSA that underwent primary bariatric surgery between January 2009 and June 2017. Those with at least one follow-up recording post-operative OSA status were selected for further analysis. Demographic, pre- and post-operative outcomes were collected and analysed. Poisson multivariate regression was conducted to identify predictors of OSA remission. Results A total of 4015 bariatric cases were eligible for inclusion: 2,482(61.8%) patients underwent laparoscopic Roux-en-Y gastric bypass(LRYGB), 1,196(29.8%) sleeve gastrectomy(LSG) and 337(8.4%) adjustable gastric-banding(LAGB). Overall, the mean excess weight loss(EWL) % for the whole group was 61.2(SD±27.2). OSA resolution was recorded in 2,377(59.2%) patients. Following Poisson regression, LRYGB (RR 1.49 (confidence interval (CI) 1.25-1.78)) and LSG (1.46(CI 1.22-1.75) were associated with approximately 50% increased likelihood of OSA remission compared to LAGB. Greater weight loss following intervention was associated with greater likelihood of OSA remission, while both greater age and greater preoperative BMI were associated with reduced likelihood of OSA remission (p Conclusion This study demonstrated that metabolic surgery results in OSA remission in the majority of patients with obesity. Younger age, lower BMI pre-procedure, greater %EWL and the use of LSG or LRYGB positively predicted OSA remission.