Long-term Effects of Gastric Bypass Surgery in Patients with Obstructive Sleep Apnea

2020 ◽  
Vol 16 (1) ◽  
pp. 34-38
Author(s):  
Nathir Obeidat ◽  
Saif Aldeen AlRyalat ◽  
Khaled Al Oweidat ◽  
Mahmoud Abu-Khalaf ◽  
Asma Btoush ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Background: Obstructive sleep apnea is a common disorder involving, intermittent mechanical obstruction of the upper airway during sleep. Obesity is the most powerful risk factor for obstructive sleep apnea. Objective: This study aimed to investigate the long-term effect of Roux-en-Y gastric bypass bariatric surgery on patients with obstructive sleep apnea. Methods: This study included patients were referred for bariatric surgery (Roux-en-Y gastric bypass) to control symptoms and complications of obesity during a 5-year period. An overnight sleep study was performed for each patient before and after the bariatric surgery, to study its effect on different obstructive sleep apnea-related variables. Results: This study included 179 patients (mean age 35.9 ± 10.7 years). The mean duration from preoperative assessment to postoperative assessment was 2.4 ± 2.2 years. The mean change in body mass index and weight showed a decrease of 16.0 ± 16.0 kg/m2 and48.7 ± 25.9 kg, respectively. The apnea hypopnea index decreased by a mean of 22.6 ± 26.3 events/hour. Conclusion: We concluded that a decrease in the body mass index by 1 kg/m2 could predict a decrease in the apnea hypopnea index by 0.46 events/hour. Moreover, after mean follow-up duration of 2.4 years, 84.3% of mild and 83.3% of moderate obstructive sleep apnea patients became normal postoperatively.

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Seda Beyhan Sagmen ◽  
Sevda Cömert
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Severe Disease ◽  
Upper Airway ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

Expansion Sphincter Pharyngoplasty: A New Technique for the Treatment of Obstructive Sleep Apnea

2007 ◽  
Vol 137 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Kenny P. Pang ◽  
B. Tucker Woodson
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Pharyngeal Wall ◽  
Obstructive Sleep ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

OBJECTIVE: In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea. STUDY DESIGN: We conducted a prospective, randomized controlled trial. METHODS: Forty-five adults with small tonsils, body mass index less than 30 kg/m 2 , of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study. RESULTS: The mean body mass index was 28.7 kg/m 2 . The apnea-hypopnea index improved from 44.2 ± 10.2 to 12.0 ± 6.6 ( P < 0.005) following ESP and from 38.1 ± 6.46 to 19.6 ± 7.9 in the uvulopalatopharyngoplasty group ( P < 0.005). Lowest oxygen saturation improved from 78.4 ± 8.52% to 85.2 ± 5.1% in the ESP group ( P = 0.003) and from 75.1 ± 5.9% to 86.6 ± 2.2% in the uvulopalatopharyngoplasty group ( P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty ( P < 0.05). CONCLUSION/SIGNIFICANCE: The ESP may offer benefits in a selected group of OSA patients.

scholarly journals Collar Size as Predictor of Obstructive Sleep Apnea

2008 ◽  
Vol 23 (2) ◽  
pp. 14-16
Author(s):  
Lyra V. Veloro ◽  
Michael Alexius A. Sarte ◽  
Samantha S. Castañeda
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Neck Circumference ◽  
Normal Group ◽  
Physical Measurements ◽  
Obstructive Sleep ◽  
Male Patients ◽  
The Mean

Objective: This study focuses on evaluating the relationship between physical findings, particularly collar size and Body Mass Index (BMI), and polysomnographic parameters in male patients seen at a Sleep Disorders Laboratory, suspected to have Obstructive Sleep Apnea (OSA).    Methods: Design: Cross-sectional study Setting: Academic tertiary private hospital Participants:  Charts of 149 adult male patients referred for polysomnography between July 1, 2005 and June 30, 2006 were reviewed.  Height, weight, and external neck circumference measurements were obtained.  The data from polysomnography results were noted and correlated with the physical measurements.    Results: The mean collar size for the OSA group was 42.03 cm with a mean BMI of 29.14 while the mean collar size for the normal group was 39.05 cm with a mean BMI of 25.36.  A significant difference was noted in both the collar size and body mass index (BMI) between the OSA group and the normal group (p<0.005).  Results showed a significant correlation between collar size and BMI.  Collar size and BMI measurements were also correlated with increasing severity of sleep apnea in the OSA group.  The ³40 cm collar size among male adults with symptoms of OSA was 80% sensitive and 67% specific with a positive predictive value of 94% in predicting true OSA.   Conclusion: This study suggests that the external neck circumference and the degree of obesity determined through BMI measurement may be important predictors of sleep apnea in adult Filipino males suspected to have OSA.  Given the high probability of having true OSA in symptomatic male adults with a collar size ³ 40 cm, outright definitive management may be opted for in these patients, while those with a collar size < 40 cm may need to undergo further confirmatory tests.     Keywords: obstructive sleep apnea, external neck circumference, collar size, body mass index, polysomnography, obesity  

scholarly journals Explorating the Involvement of Plasma Sestrin2 in Obstructive Sleep Apnea

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Rong Jiang ◽  
Qiru Wang ◽  
Huifen Zhai ◽  
Xiaohua Du ◽  
Shibo Sun ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Obstructive Sleep Apnea ◽  
Heart Disease ◽  
Sleep Apnea ◽  
Body Mass ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) can lead to serious complications such as coronary heart disease and hypertension due to oxidative stress. Sestrin2 expression is upregulated under conditions of oxidative stress. This study aimed to explore whether Sestrin2 was involved in OSA. OSA and healthy control subjects were recruited and matched with age, gender, and body mass index (BMI). Plasma Sestrin2 levels were measured and compared. A multivariate stepwise regression model was used to detect the relationship between Sestrin2 and other variable factors. The Sestrin2 levels were compared between before and after four weeks treatment by nasal continuous positive airway pressure (nCPAP) in severe OSA patients. Fifty-seven subjects were divided into two groups: control group (39.33 ± 9.40 years, n = 21) and OSA group (38.81 ± 7.84 years, n = 36). Plasma Sestrin2 levels increased in the OSA group (control group 2.06 ± 1.76 ng/mL, OSA group 4.16 ± 2.37 ng/mL; P=0.001). Sestrin2 levels decreased after four-week nCPAP treatment (pre-nCPAP 5.21 ± 2.32 ng/mL, post-nCPAP 4.01 ± 1.54 ng/mL; P=0.004). Sestrin2 was positively correlated with apnea/hypopnea index (AHI) oxygen desaturation index, while negatively correlated with mean oxygen saturation. Moreover, these correlations remained unchanged after adjusting for gender, age, waist-to-hip ratio, and body mass index. Multiple regression analysis showed that there was an association between Sestrin2 and AHI. Our findings suggest that Sestrin2 is involved in OSA. The increase of plasma Sestrin2 is directly related to the severity of OSA. To some extent, Sestrin2 may be useful for determining the severity of OSA and monitoring the effect of CPAP. In addition, since some complications of OSA such as coronary heart disease and diabetes are usually related with oxidative stress, the role of Sestrin2 in those OSA complications needs further study.

scholarly journals Decreased serum betatrophin may correlate with the improvement of obstructive sleep apnea after Roux-en-Y Gastric Bypass surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhiyuan Song ◽  
Kaifeng Guo ◽  
Weijun Huang ◽  
Huajun Xu ◽  
Yupu Liu ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Sleep Apnea ◽  
Subcutaneous Fat ◽  
Magnetic Resonance Images ◽  
Apnea Hypopnea Index ◽  
Contributing Factors ◽  
Visceral Fat Area ◽  
Obstructive Sleep

AbstractObesity is strongly correlated with obstructive sleep apnea (OSA), and bariatric surgery can effectively treat obesity and alleviate OSA. However, the contributing factors are still unclear. We aimed to explore the relationship between betatrophin and OSA in patients undergoing Roux-en-Y gastric bypass (RYGB) surgery. Our study consisted of thirty-seven individuals with OSA and type 2 diabetes (16 males, 21 females) undergoing RYGB surgery. The polysomnography test, anthropometric results, serum betatrophin, and abdominal magnetic resonance images were evaluated both before and 1 year after RYGB surgery. Factors that may correlate with the alleviation of OSA were investigated. In our study, RYGB surgery significantly decreased apnea hypopnea index (AHI) and serum betatrophin concentration (p < 0.001). The abdominal visceral fat area, subcutaneous fat area and HOMA-IR were also significantly decreased (p < 0.001). The preoperative AHI, postoperative AHI and the change in AHI were significantly correlated with the preoperative betatrophin, postoperative betatrophin and the change in betatrophin, respectively (p < 0.05). These correlations were still significant after adjustment for other risk factors. The change in betatrophin was also independently associated with the change in minimum oxygen saturation (p < 0.001). Our data might indicate that serum betatrophin was significantly independently correlated with the improvement of OSA after bariatric surgery.

scholarly journals Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1485
Author(s):  
Marta Stelmach-Mardas ◽  
Beata Brajer-Luftmann ◽  
Marta Kuśnierczak ◽  
Halina Batura-Gabryel ◽  
Tomasz Piorunek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Meta Analysis ◽  
Apnea Hypopnea Index ◽  
Metabolic Risk ◽  
Index Reduction ◽  
Obstructive Sleep

Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea–hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea–hypopnea index (−2.83/h; 95% CI: −4.24, −1.41), total cholesterol (−0.12 mmol/L; 95% CI: −0.22, −0.01), triglycerides (−0.24 mmol/L; 95% CI: −0.46, −0.02), fasting insulin (−7.3 pmol/L; 95% CI: −11.5, −3.1), systolic (−1.86 mmHg; 95% CI: −3.57, −0.15) and diastolic blood pressure (−2.07 mmHg; 95% CI: −3.79, −0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.

Glottic and cervical tracheal narrowing in patients with obstructive sleep apnea

1989 ◽  
Vol 67 (6) ◽  
pp. 2427-2431 ◽  
Author(s):  
I. Rubinstein ◽  
T. D. Bradley ◽  
N. Zamel ◽  
V. Hoffstein
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Structural Abnormality ◽  
Pathophysiological Mechanism ◽  
Obstructive Sleep

There are several studies showing that patients with idiopathic obstructive sleep apnea (OSA) have a narrow and collapsible pharynx that may predispose them to repeated upper airway occlusions during sleep. We hypothesized that this structural abnormality may also extend to the glottic and tracheal region. Consequently, we measured pharyngeal (Aph), glottic (Agl), cervical tracheal (Atr1), midtracheal (Atr2), and distal (Atr3) tracheal areas during tidal breathing in 66 patients with OSA (16 nonobese and 50 obese) and 8 nonapneic controls. We found that Aph, Agl, and Atr1, but not Atr2 or Atr3, were significantly smaller in the OSA group than in the control group. Obese patients with OSA had the smallest upper airway area, although the nonapneic controls had the largest areas. Multiple linear regression analysis revealed that the pharyngeal area, cervical tracheal area, and body mass index were all independent determinants of the apnea-hypopnea index, accounting for 31% of the variability in apnea-hypopnea index. Aph, Agl, and Atr showed significant correlation with the body mass index. We conclude that sleep-disordered breathing is associated with diffuse upper airway narrowing and that obesity contributes to this narrowing. Furthermore, we speculate that a common pathophysiological mechanism may be responsible for this reduction in upper airway area extending from the pharynx to the proximal trachea.

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