[The obstructive sleep apnea in bariatric surgery].
BACKGROUND
Obesity is a well known risk factor for obstructive sleep apnea (OSA). Medical therapy is not effective for morbid obesity. Bariatric surgery is therefore a reasonable option for weight reduction for patients with clinically severe obesity.


METHODS
283 obese patients were operated on from 1999 until 2005 in our Institution and they were examined with a history, physical examination and the Epworth Sleepiness Scale (ESS). Obese patients with a ESS score > or = than 10 were evaluated with a Polysomnography (PSG).


RESULTS
61 patients (21.5%) resulted with a ESS > or = than 10. An obstructive sleep apnoea syndrome was identified in 52 patients (85.2%). These patients were treated by continuous positive airway pressure (CPAP) for 3 months before the surgical treatment. After 1 year follow-up (100% of patients) we observed a reduction in OSAS patients: ESS < 10 in 77.5% and PSG negative in 80.3%.


CONCLUSIONS
This study considered the value of ESS to select obese patients with a high risk of OSA. We did not observe any association between grade of obesity and risk of OSA. Bariatric surgery reduced the prevalence of OSA already after 1 year of follow-up and the preoperative treatment of OSA (3 months CPAP) reduced the post-operative morbidity.
Mittempergher
Franceso
F
Cattedra di Chirurgia Generale, Università degli Studi di Brescia, I Divisione Chirurgia, Spedali Civili di Brescia. fmitt@libero.it
Di Betta
Ernesto
E
Pata
Giacomo
G
Nascimbeni
Riccardo
R
D000328:Adult; D050110:Bariatric Surgery; D045422:Continuous Positive Airway Pressure / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D017286:Polysomnography; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000209:etiology* / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome