title: Assessment of obstructive sleep apnea in adults undergoing bariatric surgery in the longitudinal assessment of bariatric surgery-2 (LABS-2) study.
abstract: OBJECTIVE
  Evaluate frequency of diagnostic testing for obstructive sleep apnea (OSA), prevalence of OSA, and factors independently associated with OSA status in adults undergoing bariatric surgery. DESIGN, SETTINGS AND INTERVENTIONS: Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) is an observational cohort of 2,458 adults undergoing bariatric surgery at 10 U.S. hospitals. Within 30 days prior to surgery, researchers determined if participants had a diagnostic polysomnography (PSG) in the previous 12 months. When available, apnea-hypopnea index (AHI) was recorded. Based on medical records and participant report, research clinicians recorded OSA status and positive airway pressure (PAP) use. Participants completed the Berlin Questionnaire (BQ). Multivariable logistic regression was used to determine factors independently associated with AHI-confirmed OSA status.
  
  
  RESULTS
  28.7% (n = 693) of participants had a PSG within 12 months before surgery. Of subjects with AHI available (n = 509), 80.7% (n = 411) had OSA (AHI ≥ 5); 83.0% (n = 341) reported PAP use. In participants without a known AHI (n = 1,949), 45.4% (n = 884) had self-reported OSA; 81.2% (n = 718) reported PAP use. Self-reported history of snoring and pauses in breathing (odds ratio [OR] = 10.0; 95%, confidence interval [CI] = 4.8-20.6), male sex (OR = 5.1; 95% CI = 1.7-15.3), older age (OR = 1.4; 95% CI = 1.2-1.6 per 5 years), and larger sagittal abdominal diameter (OR = 1.8; 95% CI = 1.2-2.5 per 5 cm) were independently associated with a greater odds of confirmed OSA.
  
  
  CONCLUSIONS
  Preoperative diagnostic testing for OSA was infrequent. Prevalence estimates of OSA differed greatly between those with and without a past-year AHI (81% vs. 46%, respectively). Most BQ responses did not differentiate OSA status, but endorsement of snoring and pauses in breathing was independently associated with presence of OSA.
authors: Oregon Health and Science University, Portland, OR 97239-3098, USA. khana@ohsu.edu
authors: Akram
authors: A
authors: Khan
authors: Wendy C
authors: WC
authors: King
authors: Emma J
authors: EJ
authors: Patterson
authors: Jamie
authors: J
authors: Laut
authors: William
authors: W
authors: Raum
authors: Anita P
authors: AP
authors: Courcoulas
authors: Charles
authors: C
authors: Atwood
authors: Bruce M
authors: BM
authors: Wolfe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult