Journal ArticleDOI
Evidence supporting routine polysomnography before bariatric surgery.
TLDR
In this large patient cohort, sleep apnea was prevalent (77%) independent of BMI, and most cases were not diagnosed before bariatric surgical consultation, which support the use of routine screening polysomnography beforebariatric surgery.Abstract:
Background: Obstructive sleep apnea (OSA) is common in morbidly obese patients, with a reported prevalence from 12 to 40%. Preoperative diagnosis of OSA is important for both perioperative airway management and the prevention of postoperative pulmonary complications. BMI has been reported to be an independent risk factor, and has been used recently in scoring systems to help predict OSA. Our hypothesis was that OSA is highly prevalent in patients presenting for bariatric surgery, and that BMI alone is not a good predictor of the presence or absence of sleep apnea. Methods: A cross-sectional study was undertaken of the last 170 consecutive patients presenting for bariatric surgery in a single surgeon's practice. Clinical and demographic data were available from our prospective database, and polysomnography results were reviewed retrospectively. Sleep apnea was noted as present or absent, and graded from mild to severe. The patient population was stratified by BMI into severely obese (BMI 35-39.9), morbidly obese (BMI 40-49.9), super-obese (BMI 50-59.9), and super-super-obese (BMI ≥ 60). Results: OSA had been diagnosed before surgical consultation in 26 of the 170 patients (15.3%). Sleep studies were not available in 7 patients (4.1%). The remaining 137 patients (80.6%) had sleep data available, and 105 (76.6%) had sleep apnea (based on American Board of Sleep Medicine criteria).There was no correlation of sleep apnea with BMI. The overall prevalence of OSA in this cohort was 77% (131/170). Conclusions: In this large patient cohort, sleep apnea was prevalent (77%) independent of BMI, and most cases were not diagnosed before bariatric surgical consultation.These data support the use of routine screening polysomnography before bariatric surgery.read more
Citations
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Journal ArticleDOI
Stop questionnaire: a tool to screen patients for obstructive sleep apnea
Frances Chung,Balaji Yegneswaran,Pu Liao,Sharon A. Chung,Santhira Vairavanathan,Sazzadul Islam,Ali Khajehdehi,Colin M. Shapiro +7 more
TL;DR: The STOP questionnaire is a concise and easy-to-use screening tool for OSA that has been developed and validated in surgical patients at preoperative clinics and had a high sensitivity, especially for patients with moderate to severe OSA.
Journal Article
Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine.
Nancy A. Collop,W. McDowell Anderson,Brian Boehlecke,Rochelle Goldberg,Daniel J. Gottlieb,David W. Hudgel,Michael J. Sateia,Richard Schwab,James A. Haley +8 more
TL;DR: PM testing be performed under the auspices of an AASM-accredited comprehensive sleep medicine program with written policies and procedures and must allow for display of raw data with the capability of manual scoring or editing of automated scoring by a qualified sleep technician/technologist.
Journal ArticleDOI
Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery
Martin Fried,Volkan Yumuk,Jean-Michel Oppert,Nicola Scopinaro,Antoni Torres,Rudolf A. Weiner,Yury I Yashkov,Gema Frühbeck +7 more
TL;DR: The 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced was revised and update by focusing in particular on the evidence gathered in relation to the effects on diabetes and the changes in the recommendations of patient eligibility criteria.
Journal ArticleDOI
Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches.
Alan R. Schwartz,Susheel P. Patil,Alison M. Laffan,Vsevolod Y. Polotsky,Hartmut Schneider,Philip L. Smith +5 more
TL;DR: Examining responses to specific weight loss strategies will provide critical insight into mechanisms linking obesity and sleep apnea, and will help to elucidate the humoral and molecular predictors of weight loss responses.
Journal ArticleDOI
Validation of the Berlin questionnaire and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients.
Frances Chung,Balaji Yegneswaran,Pu Liao,Sharon A. Chung,Santhira Vairavanathan,Sazzadul Islam,Ali Khajehdehi,Colin M. Shapiro +7 more
TL;DR: Similar to the STOP questionnaire, the Berlin questionnaire and ASA checklist demonstrated a moderately high level of sensitivity for OSA screening and were able to identify the patients who were likely to develop postoperative complications.
References
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