title: Treatment Discontinuation Following Bariatric Surgery in Obstructive Sleep Apnea: a Controlled Cohort Study.
abstract: Uncontrolled studies looking at the discontinuation of obstructive sleep apnea (OSA) treatment after bariatric surgery (BS) have suggested that surgery improves OSA. However, this discontinuation of OSA treatment by BS patients has never been compared to a matched population without BS. The objectives of this study are to evaluate whether BS increases OSA treatment discontinuation compared to that in matched patients without BS and to identify predictive factors of OSA treatment discontinuation in BS patients. The study took place in an ambulatory, tertiary hospital.
  
  
  
  We included 61 OSA patients who underwent BS in a retrospective controlled cohort study. The computerized matching procedure included age, sex, body mass index, year of starting OSA treatment, treatment type, and duration selected 59 controls matched to 28 patients with BS. The main outcome was OSA treatment discontinuation within 2 years after BS.
  
  
  
  Patients with BS stopped OSA treatment more often than controls, usually between 6 months and 1 year after BS: hazards ratio (HR (95 %, CI)) 15.93 (3.29, 77.00). Before 6 months or beyond 1 year after BS, treatment discontinuation was not different between BS patients and controls. In univariate analyses, female gender, absence of co-morbidities, greater weight loss, and lower baseline OSA severity were associated with stopping OSA treatment after BS. No factor remained independently associated in multivariate analysis.
  
  
  
  Apneic patients having BS stop OSA treatment more than matched controls. Treatment discontinuation may be attributed to recovery or to abandonment. The effect of BS on OSA may have been overestimated in uncontrolled BS studies that ignored basal OSA treatment discontinuation in routine clinical practice.
authors.affiliation: Pole DIGIDUNE, Endocrinology Department, Grenoble University Hospital, Grenoble, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Agosta
authors.affiliation: "ICàdom", Agiràdom, Meylan, France.|HP2 laboratory, INSERM U1042, Grenoble Alpes University, Grenoble, France.
authors.forename: Jean-Christian
authors.initials: JC
authors.lastname: Borel
authors.affiliation: Pole DIGIDUNE, Digestive Surgery Department, Grenoble University Hospital, Grenoble, France.
authors.forename: Fabian
authors.initials: F
authors.lastname: Reche
authors.affiliation: Pole DIGIDUNE, Digestive Surgery Department, Grenoble University Hospital, Grenoble, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arvieux
authors.affiliation: "ICàdom", Agiràdom, Meylan, France.
authors.forename: Nelly
authors.initials: N
authors.lastname: Wion
authors.affiliation: Anaesthesiology and Intensive Care, Anaesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, INSERM U1046, Montpellier 1 University, Montpellier University Hospital, Montpellier, 34295, France.
authors.forename: Samir
authors.initials: S
authors.lastname: Jaber
authors.affiliation: Pulmonary Disorders and Respiratory Sleep Disorders Unit, Polyclinic Saint-Privat, 34760, Boujan sur Libron, France.
authors.forename: Dany
authors.initials: D
authors.lastname: Jaffuel
authors.affiliation: HP2 laboratory, INSERM U1042, Grenoble Alpes University, Grenoble, France.|Pole Thorax et vaisseaux, Clinique Physiologie, Sommeil et Exercice, Grenoble University Hospital, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pépin
authors.affiliation: Pole DIGIDUNE, Endocrinology Department, Grenoble University Hospital, Grenoble, France. alborel@chu-grenoble.fr.|HP2 laboratory, INSERM U1042, Grenoble Alpes University, Grenoble, France. alborel@chu-grenoble.fr.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Borel
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010349:Patient Compliance; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*
keywords: Bariatric surgery; Cohort; Continuous positive airway pressure; Controlled; Sleep apnea syndrome