title: Weight loss through adjustable gastric banding and improvement in daytime sleepiness: 2 year interim results of APEX study.
abstract: OBJECTIVE
  Obesity is one factor associated with an increased risk of obstructive sleep apnea (OSA). This study reports the investigator-reported resolution or improvement of OSA and improvements in sleep-related quality of life (QOL) 2 years after surgical placement of the LAP-BAND AP * (LBAP) system.
  
  
  METHODS
  The LBAP Experience (APEX) study is an ongoing 5 year, prospective, observational study assessing change in weight, comorbidities, and QOL after LBAP implantation. This is an interim analysis of patients with evaluable data at 24 months who had OSA at baseline.
  
  
  BACKGROUND
  NCT00501085.
  
  
  RESULTS
  At baseline, 117 of 395 patients (29.6%; mean body mass index [BMI], 45.0 kg/m2) reported OSA; of these, 57 had evaluable patient-reported outcome data at 2 years. Investigator-reported resolution or improvement of OSA was 69% and 86% at post-operative years 1 and 2, respectively. Patients reporting resolution, improvement, or no change in OSA experienced mean changes in BMI and percentage of weight loss of -9.7 kg/m(2)/-21.7%, -8.3 kg/m(2)/-18.7%, and -5.7 kg/m(2)/-13.2%, respectively (n = 54). Mean 2 year BMI was not statistically different between the groups (p = not significant). Mean scores for all Epworth Sleepiness Scale responses for the OSA population improved by -0.43 from baseline (p < 0.0001; n = 78) compared with -0.29 for patients without OSA at baseline (n = 177; p = 0.037 between groups). In addition, the overall study population experienced resolution and/or improvement in other obesity-related comorbidities, such as type 2 diabetes (96%) and hypertension (91%).
  
  
  CONCLUSIONS
  These data support that surgically facilitated weight loss can improve sleep-related QOL and may result in resolution or improvement of OSA; the degree of weight loss may be related to these changes.
authors: Health First Medical Group , Melbourne, FL , USA.
authors: Mark
authors: M
authors: Fusco
authors: Steven
authors: S
authors: James
authors: Christopher
authors: C
authors: Cornell
authors: Ted
authors: T
authors: Okerson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006970:Disorders of Excessive Somnolence / Q000209:etiology / Q000601:surgery*; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D015431:Weight Loss; D055815:Young Adult