Three-year effects of bariatric surgery on obstructive sleep apnea in patients with obesity grade 1 and 2: a sub-analysis of the GATEWAY trial

Abstract

Background Most of the evidence on bariatric surgery on obstructive sleep apnea (OSA) is based on observational studies and/or short-term follow-up in patients with obesity grade 3. Subjects/Methods This randomized study compared the effects of roux-en-Y gastric bypass (RYGB) or usual care (UC) on OSA severity in patients with obesity grade 1–2. Mild, moderate, and severe OSA was defined by the apnea-hypopnoea index (AHI): 5–14.9; 15–29.9, and ≥30 events/h, respectively. OSA remission was defined by converting any form of OSA into normal AHI (2, respectively. The AHI increased by 5 (−4.2; 12.7) in the UC group while reduced in the RYGB group to −13.2 (−22.7; −7) events/h. UC significantly increase the frequency of moderate OSA (from 15.4 to 46.2%). In contrast, RYGB had a huge impact on reaching no OSA status (from 4.2 to 70.8%) in parallel to a decrease of moderate (from 41.7 to 8.3%) and severe OSA (from 20.8 to 0%). Conclusions RYGB is an attractive strategy for mid-term OSA remission or decrease moderate-to-severe forms of OSA in patients with obesity grade 1–2.