Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;280(5):2435-2443.
doi: 10.1007/s00405-023-07821-4. Epub 2023 Jan 16.

Bariatric surgery reduces sleep apnea in obese patients with obstructive sleep apnea by increasing pharyngeal cross-sectional area during the early postoperative period

Yuliang Zhao  1 , Tao Li  2 , Guangyuan Zhang  1 , Xiaorong Liang  1 , Yanxia Wang  1 , Jiansheng Kang  2 , Jiangang Ma  3
Affiliations

Bariatric surgery reduces sleep apnea in obese patients with obstructive sleep apnea by increasing pharyngeal cross-sectional area during the early postoperative period

Yuliang Zhao et al. Eur Arch Otorhinolaryngol. 2023 May.

Abstract

Objective: Bariatric surgery (BS) is considered one of the most effective treatments for obese individuals with Obstructive Sleep Apnea (OSA). However, otolaryngologists have raised concerns about the structural alterations caused by BS on the upper respiratory tract, especially, on the pharyngeal cavity.

Methods: In this study, we recruited 42 individuals who underwent BS at our hospital. They were divided into two groups based on apnea-hypopnea index (AHI): mild group (5 ≤ AHI < 15) and moderate-severe group (AHI ≥ 15). The participants were followed up for 12 months and several indicators, including body mass index (BMI), polysomnography (PSG), and acoustic pharyngometry (APh), were assessed repeatedly before surgery and at 3, 6, and 12 months (m) after surgery.

Results: Participants exhibited significant decreases in BMI (F = 128.1, P = 0.001) and total weight loss (F = 176.7, P < 0.001) after BS. The AHI value among obese patients with mild OSA decreased significantly within three months after surgery (0 day vs. 3 months, P < 0.01), and decreased significantly more than 12 months with moderate-to-severe patients (0 day vs. 3 months, 3 months vs. 6 months, 6 months vs. 12 months, P < 0.01). The therapeutic effect of OSA of the mild group was significantly better compared with that of the moderate-severe group at 6 months (mean rank = 28.13 vs. 14.21, P < 0.001) and 12 m (mean rank = 26.75 vs. 15.52, P = 0.001). The APh results revealed that the pharyngeal volume of the two groups increased significantly between 0 day and 6 months after surgery (P < 0.01). The oropharyngeal junction (OPJ) area and the glottal area were increased significantly between 0 day and 6 m after surgery (P < 0.01).

Conclusion: BS can relieve apnea and OSA symptoms among obese patients with OSA, especially in the early postoperative period. Moreover, OSA severity was closely associated with OPJ and glottal areas, rather than pharyngeal cavity volume.

Keywords: Bariatric surgery; Obstructive sleep apnea; Pharyngeal cross-sectional area.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Acoustic pharyngometry (APh) curve(s)
Fig. 2
Fig. 2
A schematic representation of acoustic pharyngometry (modified from Molfenter [17])
Fig. 3
Fig. 3
A flow chart illustrating the participants selection process
Fig. 4
Fig. 4
Variations in body mass index (BMI) and total weight loss (TWL) between the two groups of participants (mild and moderate-severe groups) at different time points. The black solid line represents the mild group while the red dashed line represents the moderate-severe group
Fig. 5
Fig. 5
Variations in apnea–hypopnea index (AHI) in the two groups of participants (mild and moderate-severe groups) at various time points, and comparison of effectiveness. The black solid line represents the mild group while the red dashed line represents the moderate-severe group
Fig. 6
Fig. 6
Variations in pharyngeal volumes, and the area of oropharyngeal junction and glottal of the two groups of participants at different time points. The black solid line represents the mild group while the red dashed line represents the moderate-severe group
See this image and copyright information in PMC

References

    1. Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC (2016) Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 34:70–81. 10.1016/j.smrv.2016.07.002 - PubMed
    1. Senaratna CV, Perret JL, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev. 2017;34:70–81. doi: 10.1016/j.smrv.2016.07.002. - DOI - PubMed
    1. Belyavskiy E, Pieske-Kraigher E, Tadic M. Obstructive sleep apnea, hypertension, and obesity: a dangerous triad. J Clin Hypertens. 2019;21(10):1591–1593. doi: 10.1111/jch.13688. - DOI - PMC - PubMed
    1. Xie C, Zhu R, Tian Y, et al. Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis. BMJ Open. 2017;7(12):e013983. doi: 10.1136/bmjopen-2016-013983. - DOI - PMC - PubMed
    1. Szymanski FM, Filipiak KJ, Platek AE, et al. Presence and severity of obstructive sleep apnea and remote outcomes of atrial fibrillation ablations—a long-term prospective, cross-sectional cohort study. Sleep Breath. 2015;19(3):1–8. doi: 10.1007/s11325-014-1102-x. - DOI - PMC - PubMed

MeSH terms