Feasibility of at-home continuous overnight pulse oximetry for obstructive sleep apnea screening in bariatric surgery candidates

Abstract

Screening for obstructive sleep apnea (OSA) is recommended in patients scheduled for bariatric surgery because continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA reduces postoperative complications. However, cardiorespiratory polygraphy (CRP) and polysomnography (PSG) are expensive and time-consuming. The present study aimed to assess whether at-home continuous overnight pulse oximetry can be used to diagnose moderate-to-severe OSA in patients scheduled for bariatric surgery. In this prospective observational study, we enrolled consecutive patients scheduled for bariatric surgery. Patients with no prior OSA diagnosis were evaluated using the ESS, SBQ, and preoperative at-home CRP. Correlations were calculated between AHI and oximetry parameters. For each oximetry parameter, a receiver-operating characteristic (ROC) curve was generated to identify optimal cut-off values for diagnosing moderate-to-severe OSA. In total, 117 patients were included. The oxygen desaturation index was the most correlated oximetry parameter; the optimal cut-off value for diagnosing moderate-to-severe OSA was 23.9. The sensitivity and specificity were 80 and 92%, respectively. The area under the ROC curve was 0.935. At-home continuous overnight pulse oximetry could be used to screen moderate-to-severe OSA in patients scheduled for bariatric surgery because it would allow clinicians to implement early CPAP therapy and avoid preoperative PSG or CRP.