Introduction:
Studies have demonstrated that the incidence of obstructive sleep apnoea (OSA) is increasing within the general population. Obstructive sleep apnoea has been shown to be associated with increased incidence of stroke, hypertension and coronary artery disease. Research has additionally suggested that OSA in more prevalent with increasing age and obesity. Alarmingly, a large number of patients with OSA deny experiencing common diagnostic symptoms including daytime sleepiness. The purpose of this study was to investigate the incidence of undiagnosed OSA within a bariatric population undergoing laparoscopic sleeve gastrectomy and to compare this with the general public.
Method:
A retrospective analysis was undertaken incorporating 235 patients with a BMI>30 who had undergone a laparoscopic sleeve gastrectomy at the Mater Hospital Pimlico between 2014-2016. All patients underwent a sleep study as part of the pre operative workup. Patients with no previous diagnosis of OSA who had findings suggestive of OSA on sleep study were included in the study. Patients with known OSA were excluded from the study.
Results:
Of the 235 patients who underwent laparoscopic sleeve gastrectomy, 12 (5.1%) had known OSA and hence were excluded from the study. 158 (67.2%) had no known OSA with positive sleep studies. Of these patients, 54 (34.1%) had mild OSA, 17 (10.8%) had mild/moderate OSA, 27 (17.1%) had moderate OSA, 12 (7.6%) had moderate/severe OSA, 39 (24.7%) had severe OSA and 9 (5.7%) had very severe OSA.
Conclusion:
Of concern, 67.2% of bariatric patients in the study had undiagnosed OSA. This is higher than the general population average which studies have suggested as being between 37-50%. Furthermore, of the patients with undiagnosed OSA, only 34.1% had mild disease while 30.4% had severe and very severe OSA with urgent continuous positive airway pressure (CPAP) therapy recommended.