title: Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity.
abstract: OBJECTIVE
  To evaluate the effect of bariatric surgery on sleep apnea symptoms and obesity-associated morbidity in patients with severe obesity.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospitals and community centers in Sweden.
  
  
  METHODS
  We investigated the influence of weight loss surgery (n=1729) on sleep apnea symptoms and obesity-related morbidity using a conservatively treated group (n=1748) as a control.
  
  
  RESULTS
  Baseline BMI in surgical group (42.2+/-4.4 kg/m(2)) and control group (40.1+/-4.6 kg/m(2)) changed -9.7+/-5 kg/m(2) and 0+/-3 kg/m(2), respectively, at 2-year follow-up. In the surgery group, there was a marked improvement in all obstructive sleep apnea (OSA) symptoms compared with the control group (P <0.001). Persistence of snoring (21.6 vs 65.5%, adjusted OR 0.14, 95% CI 0.10-0.19) and apnea (27.9 vs 71.3%, adjusted OR 0.16, 95% I 0.10-0.23) were much less in the surgery group compared with controls. Compared with subjects with no observed apnea at follow-up (n=2453), subjects who continued to have or developed observed apnea (n=404) had a higher incidence of diabetes (adjusted OR 2.03, 95% CI 1.19-3.47) and hypertriglyceridemia (adjusted OR 1.86, 95% CI 1.07-3.25) but not hypertension (adjusted OR 1.09, 95% CI 0.65-1.83) or hypercholesterolemia (adjusted OR 0.91, 95% CI 0.53-1.58).
  
  
  CONCLUSIONS
  Bariatric surgery results in a marked improvement in sleep apnea symptoms at 2 years. Despite adjustment for weight change and baseline central obesity, subjects reporting loss of OSA symptoms had a lower 2-year incidence of diabetes and hypertriglyceridemia. Improvement in OSA in patients losing weight may provide health benefits in addition to weight loss alone.
authors.affiliation: Department of Puhnlmonary and Sleep Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. rrg@med.usyd.edu.au
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Grunstein
authors.forename: Kaj
authors.initials: K
authors.lastname: Stenlöf
authors.forename: Jan A
authors.initials: JA
authors.lastname: Hedner
authors.forename: Markku
authors.initials: M
authors.lastname: Peltonen
authors.forename: Kristjan
authors.initials: K
authors.lastname: Karason
authors.forename: Lars
authors.initials: L
authors.lastname: Sjöström
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D015431:Weight Loss