The effect of surgical weight loss on obstructive sleep apnoea: A systematic review and meta-analysis

2018 ◽  
Vol 42 ◽  
pp. 85-99 ◽  
Author(s):  
Ai-Ming Wong ◽  
Hayley N. Barnes ◽  
Simon A. Joosten ◽  
Shane A. Landry ◽  
Eli Dabscheck ◽  
...  
BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020876 ◽  
Author(s):  
Zhiyong Dong ◽  
Brian Y Hong ◽  
Ashley M Yu ◽  
John Cathey ◽  
Sheikh Mohammed Shariful Islam ◽  
...  

IntroductionObstructive sleep apnoea (OSA) is caused by complete or partial obstruction of the upper airway resulting in repeated episodes of interrupted or shallow breaths. OSA is associated with significant morbidity and mortality. The prevalence is estimated to range from 3% to 7% in the general population but may be much higher. Several studies show that weight loss or bariatric surgery may have a role in treating OSA. The aim of this systematic review is to assess the safety and efficacy of randomised controlled trials (RCTs) of weight loss surgery for adults with OSA and comorbid obesity.Methods and analysisA search of the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and two major Chinese biomedical databases will be performed to identify related trials published as of October 2018. This study will include RCTs, comparing different types of weight loss surgery for OSA with obesity or weight loss surgery for OSA with obesity with other upper airway surgeries. The primary outcomes that will be measured are apnoea–hypopnoea index, excess weight loss and in-hospital mortality. The secondary outcomes will include duration of hospital stay, neck circumference, reoperation, waist circumference, body mass index, Epworth Sleepiness Scale score, overt complications (eg, gastric fistula, bleeding, delayed gastric emptying, wound infection), quality of life, quality of sleep and/or functionality. The systematic review will be conducted according to the recommendations as outlined by the Cochrane collaboration.Ethics and disseminationThe systematic review and meta-analysis will include published data available online and thus ethics approval will not be required. The findings will be disseminated and published in a peer-reviewed journal. Review updates will be conducted if there is new evidence that may cause any change in review conclusions. Any changes to the study protocol will be updated in the PROSPERO trial registry accordingly.PROSPERO registration numberCRD42017081743.


2019 ◽  
Vol 20 (5) ◽  
pp. 750-762 ◽  
Author(s):  
Almudena Carneiro‐Barrera ◽  
Amparo Díaz‐Román ◽  
Alejandro Guillén‐Riquelme ◽  
Gualberto Buela‐Casal

2014 ◽  
Vol 25 (7) ◽  
pp. 1239-1250 ◽  
Author(s):  
Hutan Ashrafian ◽  
Tania Toma ◽  
Simon P. Rowland ◽  
Leanne Harling ◽  
Alan Tan ◽  
...  

2019 ◽  
Vol 133 (03) ◽  
pp. 168-176 ◽  
Author(s):  
S Sharma ◽  
J C R Wormald ◽  
J M Fishman ◽  
P Andrews ◽  
B T Kotecha

AbstractObjectivesObstructive sleep apnoea is a common chronic sleep disorder characterised by collapse of the upper airway during sleep. The nasal airway forms a significant part of the upper airway and any obstruction is thought to have an impact on obstructive sleep apnoea. A systematic review was performed to determine the role of rhinological surgical interventions in the management of obstructive sleep apnoea.MethodsA systematic review of current literature was undertaken; studies were included if they involved comparison of a non-surgical and/or non-rhinological surgical intervention with a rhinological surgical intervention for treatment of obstructive sleep apnoea.ResultsSixteen studies met the selection criteria. The pooled data suggest that there are reductions in the apnoea/hypopnea index and respiratory disturbance index following nasal surgery. However, the current body of studies is too heterogeneous for statistically significant meta-analysis to be conducted.ConclusionNasal surgery may have limited benefit for a subset of patients based on current evidence.


2019 ◽  
Vol 6 (1) ◽  
pp. e000402 ◽  
Author(s):  
Maria Giralt-Hernando ◽  
Adaia Valls-Ontañón ◽  
Raquel Guijarro-Martínez ◽  
Jorge Masià-Gridilla ◽  
Federico Hernández-Alfaro

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.


2019 ◽  
Vol 30 (2) ◽  
pp. 156-170 ◽  
Author(s):  
Shih‐Ying Lin ◽  
Yu‐Xuan Su ◽  
Yi‐Cheng Wu ◽  
Jenny Zwei‐Chieng Chang ◽  
Yu‐Kang Tu

2015 ◽  
Vol 33 (2) ◽  
pp. 158-168 ◽  
Author(s):  
W. B. Leong ◽  
F. Jadhakhan ◽  
S. Taheri ◽  
Y. F. Chen ◽  
P. Adab ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028242 ◽  
Author(s):  
Anne-Sophie Prévost ◽  
Mathieu Hylands ◽  
Mireille Gervais ◽  
Jean-Paul Praud ◽  
Marie-Claude Battista ◽  
...  

IntroductionObstructive sleep apnoea affects up to 6% of children worldwide. Although current guidelines recommend systematic tonsillectomy and adenoidectomy, many children do not benefit from these interventions. Drug-induced sleep endoscopy (DISE) allows the dynamic evaluation of patients’ airways to identify the specific anatomic sites of obstruction. This intervention can potentially guide subsequent invasive procedures to optimise outcomes and minimise the number of children exposed to unnecessary operations.Methods and analysisWe will identify randomised controlled trials and controlled observational studies comparing DISE-directed interventions to systematic tonsillectomy and adenoidectomy in paediatric populations. We will search MEDLINE, EMBASE, CINAHL, CENTRAL as well as clinical trial registries and conference proceedings (initial electronic search date 9 October 2018). Screening, data extraction and risk of bias assessments will be performed in duplicate by independent reviewers. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the overall quality of evidence and present our results.Ethics and disseminationEthics approval is not required for this systematic review of published data. This review will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will present our findings at otorhinolaryngology conferences and publish a report in a peer-reviewed journal.PROSPERO registration numberCRD42018085370.


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