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Obesity Surgery
Erschienen in: Obesity Surgery 7/2015

01.07.2015 | Original Contributions

Bariatric Surgery or Non-Surgical Weight Loss for Obstructive Sleep Apnoea? A Systematic Review and Comparison of Meta-analyses

verfasst von: Hutan Ashrafian, Tania Toma, Simon P. Rowland, Leanne Harling, Alan Tan, Evangelos Efthimiou, Ara Darzi, Thanos Athanasiou

Erschienen in: Obesity Surgery | Ausgabe 7/2015

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Abstract

Background

Obstructive sleep apnoea (OSA) is a well-recognised complication of obesity. Non-surgical weight loss (medical, behavioural and lifestyle interventions) may improve OSA outcomes, although long-term weight control remains challenging. Bariatric surgery offers a successful strategy for long-term weight loss and symptom resolution.

Objectives

To comparatively appraise bariatric surgery vs. non-surgical weight loss interventions in OSA treatment utilising body mass index (BMI) and apnoea-hypopnoea index (AHI) as objective measures of weight loss and apnoea severity.

Methods

A systematic literature review revealed 19 surgical (n = 525) and 20 non-surgical (n = 825) studies reporting the primary endpoints of BMI and AHI before and after intervention. Data were meta-analysed using random effects modelling. Subgroup analysis, quality scoring and risk of bias were assessed.

Results

Surgical patients had a mean pre-intervention BMI of 51.3 and achieved a significant 14 kg/m2 weighted decrease in BMI (95%CI [11.91, 16.44]), with a 29/h weighted decrease in AHI (95%CI [22.41, 36.74]). Non-surgical patients had a mean pre-intervention BMI of 38.3 and achieved a significant weighted decrease in BMI of 3.1 kg/m2 (95%CI [2.42, 3.79]), with a weighted decrease in AHI of 11/h (95%CI [7.81, 14.98]). Heterogeneity was high across all outcomes.

Conclusions

Both bariatric surgery and non-surgical weight loss may have significant beneficial effects on OSA through BMI and AHI reduction. However, bariatric surgery may offer markedly greater improvement in BMI and AHI than non-surgical alternatives. Future studies must address the lack of randomised controlled and comparative trials in order to confirm the exact relationship between metabolic surgery and non-surgical weight loss interventions in OSA resolution.
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Literatur
1.
2.
3.
Lee W, Nagubadi S, Kryger MH, Mokhlesi B. Epidemiology of obstructive sleep apnea: a population-based perspective. Expert Rev Respir Med. 2008;2(3):349–64.PubMedCentralPubMedCrossRef
4.
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217–39.PubMedCrossRef
5.
Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol. 2005;99(4):1592–9.PubMedCrossRef
6.
Collop NA. Advances in treatment of obstructive sleep apnea syndrome. Curr Treat Options Neurol. 2009;11(5):340–8.PubMedCrossRef
7.
Araghi MH, Chen YF, Jagielski A, Choudhury S, Banerjee D, Hussain S, et al. Effectiveness of lifestyle interventions on obstructive sleep apnea (OSA): systematic review and meta-analysis. Sleep. 2013;36(10):1553–62. 62A-62E.PubMedCentralPubMed
8.
Anandam A, Akinnusi M, Kufel T, Porhomayon J, El-Solh AA. Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath Schlaf Atmung. 2013;17(1):227–34.CrossRef
9.
Ashrafian H, Darzi A, Athanasiou T. Bariatric surgery - can we afford to do it or deny doing it? Front Gastroenterol. 2011;2(2):82–9.CrossRef
10.
Sarkhosh K, Switzer NJ, El-Hadi M, Birch DW, Shi X, Karmali S. The impact of bariatric surgery on obstructive sleep apnea: a systematic review. Obes Surg. 2013;23(3):414–23.PubMedCrossRef
11.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.PubMedCrossRef
12.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.PubMedCentralPubMedCrossRef
13.
Busetto L, Enzi G, Inelmen EM, Costa G, Negrin V, Sergi G, et al. Obstructive sleep apnea syndrome in morbid obesity: effects of intragastric balloon. Chest. 2005;128(2):618–23.PubMedCrossRef
14.
Dixon JB, Schachter LM, O'Brien PE. Polysomnography before and after weight loss in obese patients with severe sleep apnea. Int J Obes (Lond). 2005;29(9):1048–54.CrossRef
15.
Haines KL, Nelson LG, Gonzalez R, Torrella T, Martin T, Kandil A, et al. Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea. Surgery. 2007;141(3):354–8.PubMedCrossRef
16.
Lettieri CJ, Eliasson AH, Greenburg DL. Persistence of obstructive sleep apnea after surgical weight loss. J Clin Sleep Med. 2008;4(4):333–8.PubMedCentralPubMed
17.
Fredheim JM, Rollheim J, Sandbu R, Hofso D, Omland T, Roislien J, et al. Obstructive sleep apnea after weight loss: a clinical trial comparing gastric bypass and intensive lifestyle intervention. J Clin Sleep Med. 2013;9(5):427–32.PubMedCentralPubMed
18.
Pallayova M, Steele KE, Magnuson TH, Schweitzer MA, Smith PL, Patil SP, et al. Sleep apnea determines soluble TNF-alpha receptor 2 response to massive weight loss. Obes Surg. 2011 Feb 6.
19.
Pillar G, Peled R, Lavie P. Recurrence of sleep apnea without concomitant weight increase 7.5 years after weight reduction surgery. Chest. 1994;106(6):1702–4.PubMedCrossRef
20.
Poitou C, Coupaye M, Laaban JP, Coussieu C, Bedel JF, Bouillot JL, et al. Serum amyloid A and obstructive sleep apnea syndrome before and after surgically-induced weight loss in morbidly obese subjects. Obes Surg. 2006;16(11):1475–81.PubMedCrossRef
21.
Rajala R, Partinen M, Sane T, Pelkonen R, Huikuri K, Seppalainen AM. Obstructive sleep apnoea syndrome in morbidly obese patients. J Intern Med. 1991;230(2):125–9.PubMedCrossRef
22.
Rasheid S, Banasiak M, Gallagher SF, Lipska A, Kaba S, Ventimiglia D, et al. Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity. Obes Surg. 2003;13(1):58–61.PubMedCrossRef
23.
Valencia-Flores M, Orea A, Herrera M, Santiago V, Rebollar V, Castano VA, et al. Effect of bariatric surgery on obstructive sleep apnea and hypopnea syndrome, electrocardiogram, and pulmonary arterial pressure. Obes Surg. 2004;14(6):755–62.PubMedCrossRef
24.
Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM. Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr. 1992;55(2 Suppl):597S–601.PubMed
25.
Guardiano SA, Scott JA, Ware JC, Schechner SA. The long-term results of gastric bypass on indexes of sleep apnea. Chest. 2003;124(4):1615–9.PubMedCrossRef
26.
Dixon JB, Schachter LM, O'Brien PE, Jones K, Grima M, Lambert G, et al. Surgical vs conventional therapy for weight loss treatment of obstructive sleep apnea: a randomized controlled trial. JAMA. 2012;308(11):1142–9.PubMedCrossRef
27.
Tuomilehto H, Gylling H, Peltonen M, Martikainen T, Sahlman J, Kokkarinen J, et al. Sustained improvement in mild obstructive sleep apnea after a diet- and physical activity-based lifestyle intervention: postinterventional follow-up. Am J Clin Nutr. 2010;92(4):688–96.PubMedCrossRef
28.
Barnes M, Goldsworthy UR, Cary BA, Hill CJ. A diet and exercise program to improve clinical outcomes in patients with obstructive sleep apnea–a feasibility study. J Clin Sleep Med. 2009;5(5):409–15.PubMedCentralPubMed
29.
Ferland A, Poirier P, Series F. Sibutramine versus continuous positive airway pressure in obese obstructive sleep apnoea patients. Eur Respir J. 2009;34(3):694–701.PubMedCrossRef
30.
Kansanen M, Vanninen E, Tuunainen A, Pesonen P, Tuononen V, Hartikainen J, et al. The effect of a very low-calorie diet-induced weight loss on the severity of obstructive sleep apnoea and autonomic nervous function in obese patients with obstructive sleep apnoea syndrome. Clin Physiol. 1998;18(4):377–85.PubMedCrossRef
31.
Nerfeldt P, Nilsson BY, Mayor L, Udden J, Friberg D. A two-year weight reduction program in obese sleep apnea patients. J Clin Sleep Med. 2010;6(5):479–86.PubMedCentralPubMed
32.
Pasquali R, Colella P, Cirignotta F, Mondini S, Gerardi R, Buratti P, et al. Treatment of obese patients with obstructive sleep apnea syndrome (OSAS): effect of weight loss and interference of otorhinolaryngoiatric pathology. Int J Obes. 1990;14(3):207–17.PubMed
33.
Phillips CL, Yee BJ, Trenell MI, Magnussen JS, Wang D, Banerjee D, et al. Changes in regional adiposity and cardio-metabolic function following a weight loss program with sibutramine in obese men with obstructive sleep apnea. J Clin Sleep Med. 2009;5(5):416–21.PubMedCentralPubMed
34.
Rubinstein I, Colapinto N, Rotstein LE, Brown IG, Hoffstein V. Improvement in upper airway function after weight loss in patients with obstructive sleep apnea. Am Rev Respir Dis. 1988;138(5):1192–5.PubMedCrossRef
35.
Sampol G, Munoz X, Sagales MT, Marti S, Roca A, Dolors de la Calzada M, et al. Long-term efficacy of dietary weight loss in sleep apnoea/hypopnoea syndrome. Eur Respir J. 1998;12(5):1156–9.PubMedCrossRef
36.
Suratt PM, McTier RF, Findley LJ, Pohl SL, Wilhoit SC. Changes in breathing and the pharynx after weight loss in obstructive sleep apnea. Chest. 1987;92(4):631–7.PubMedCrossRef
37.
Suratt PM, McTier RF, Findley LJ, Pohl SL, Wilhoit SC. Effect of very-low-calorie diets with weight loss on obstructive sleep apnea. Am J Clin Nutr. 1992;56(1 Suppl):182S–4.PubMed
38.
Foster GD, Borradaile KE, Sanders MH, Millman R, Zammit G, Newman AB, et al. A randomized study on the effect of weight loss on obstructive sleep apnea among obese patients with type 2 diabetes: the Sleep AHEAD study. Arch Intern Med. 2009;169(17):1619–26.PubMedCentralPubMedCrossRef
39.
Johansson K, Neovius M, Lagerros YT, Harlid R, Rossner S, Granath F, et al. Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ. 2009;339:b4609.PubMedCentralPubMedCrossRef
40.
Yee BJ, Phillips CL, Banerjee D, Caterson I, Hedner JA, Grunstein RR. The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea. Int J Obes (Lond). 2007;31(1):161–8.CrossRef
41.
Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis. 1991;144(3 Pt 1):494–8.PubMedCrossRef
42.
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.PubMedCrossRef
43.
Ashrafian H, le Roux CW, Rowland SP, Ali M, Cummin AR, Darzi A, et al. Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012;67(5):442–9.PubMedCrossRef
44.
Simpson L, Mukherjee S, Cooper MN, Ward KL, Lee JD, Fedson AC, et al. Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea. Sleep. 2010;33(4):467–74.PubMedCentralPubMed
45.
Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25(9):735–41.PubMedCrossRef
46.
Meslier N, Gagnadoux F, Giraud P, Person C, Ouksel H, Urban T, et al. Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome. Eur Respir J. 2003;22(1):156–60.PubMedCrossRef
47.
Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med. 2002;165(5):677–82.PubMedCrossRef
48.
Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, Chrousos GP. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. 1997;82(5):1313–6.PubMedCrossRef
49.
Punjabi NM, Beamer BA. C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep. 2007;30(1):29–34.PubMed
50.
Kopp HP, Kopp CW, Festa A, Krzyzanowska K, Kriwanek S, Minar E, et al. Impact of weight loss on inflammatory proteins and their association with the insulin resistance syndrome in morbidly obese patients. Arterioscler Thromb Vasc Biol. 2003;23(6):1042–7.PubMedCrossRef
51.
Calvin AD, Albuquerque FN, Lopez-Jimenez F, Somers VK. Obstructive sleep apnea, inflammation, and the metabolic syndrome. Metab Syndr Relat Disord. 2009;7(4):271–8.PubMedCentralPubMedCrossRef
52.
Ip MS, Lam KS, Ho C, Tsang KW, Lam W. Serum leptin and vascular risk factors in obstructive sleep apnea. Chest. 2000;118(3):580–6.PubMedCrossRef
53.
Eun YG, Kim MG, Kwon KH, Shin SY, Cho JS, Kim SW. Short-term effect of multilevel surgery on adipokines and pro-inflammatory cytokines in patients with obstructive sleep apnea. Acta Otolaryngol. 2010;130(12):1394–8.PubMedCrossRef
54.
Birkmeyer JD, Finks JF, O'Reilly A, Oerline M, Carlin AM, Nunn AR, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369(15):1434–42.PubMedCrossRef
55.
Flum DR, Belle SH, King WC, Wahed AS, Berk P, et al. Longitudinal Assessment of Bariatric Surgery C. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.PubMedCrossRef
56.
57.
Redline S, Budhiraja R, Kapur V, Marcus CL, Mateika JH, Mehra R, et al. The scoring of respiratory events in sleep: reliability and validity. J Clin Sleep Med. 2007;3(2):169–200.PubMed
58.
Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea?: The rational clinical examination systematic review. JAMA. 2013;310(7):731–41.PubMedCrossRef
59.
Harman EM, Wynne JW, Block AJ. The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obese men. Chest. 1982;82(3):291–4.PubMedCrossRef
60.
Peiser J, Lavie P, Ovnat A, Charuzi I. Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery. Ann Surg. 1984;199(1):112–5.PubMedCentralPubMedCrossRef
61.
Charuzi I, Ovnat A, Peiser J, Saltz H, Weitzman S, Lavie P. The effect of surgical weight reduction on sleep quality in obesity-related sleep apnea syndrome. Surgery. 1985;97(5):535–8.PubMed
62.
Charuzi I, Fraser D, Peiser J, Ovnat A, Lavie P. Sleep apnea syndrome in the morbidly obese undergoing bariatric surgery. Gastroenterol Clin North Am. 1987;16(3):517–9.PubMed
63.
Summers CL, Stradling JR, Baddeley RM. Treatment of sleep apnoea by vertical gastroplasty. Br J Surg. 1990;77(11):1271–2.PubMedCrossRef
64.
Charuzi I, Lavie P, Peiser J, Peled R. Bariatric surgery in morbidly obese sleep-apnea patients: short- and long-term follow-up. Am J Clin Nutr. 1992;55(2 Suppl):594S–6.PubMed
65.
Noseda A, Kempenaers C, Kerkhofs M, Houben JJ, Linkowski P. Sleep apnea after 1 year domiciliary nasal-continuous positive airway pressure and attempted weight reduction. Potential for weaning from continuous positive airway pressure. Chest. 1996;109(1):138–43.PubMedCrossRef
66.
Scheuller M, Weider D. Bariatric surgery for treatment of sleep apnea syndrome in 15 morbidly obese patients: long-term results. Otolaryngol Head Neck Surg. 2001;125(4):299–302.PubMedCrossRef
67.
Lankford DA, Proctor CD, Richard R. Continuous positive airway pressure (CPAP) changes in bariatric surgery patients undergoing rapid weight loss. Obes Surg. 2005;15(3):336–41.PubMedCrossRef
68.
Kalra M, Inge T, Garcia V, Daniels S, Lawson L, Curti R, et al. Obstructive sleep apnea in extremely overweight adolescents undergoing bariatric surgery. Obes Res. 2005;13(7):1175–9.PubMedCrossRef
69.
Grunstein RR, Stenlof K, Hedner JA, Peltonen M, Karason K, Sjostrom L. Two year reduction in sleep apnea symptoms and associated diabetes incidence after weight loss in severe obesity. Sleep. 2007;30(6):703–10.PubMedCentralPubMed
70.
Fritscher LG, Canani S, Mottin CC, Fritscher CC, Berleze D, Chapman K, et al. Bariatric surgery in the treatment of obstructive sleep apnea in morbidly obese patients. Respiration. 2007;74(6):647–52.PubMedCrossRef
71.
Marti-Valeri C, Sabate A, Masdevall C, Dalmau A. Improvement of associated respiratory problems in morbidly obese patients after open Roux-en-Y gastric bypass. Obes Surg. 2007;17(8):1102–10.PubMedCrossRef
72.
Varela JE, Hinojosa MW, Nguyen NT. Resolution of obstructive sleep apnea after laparoscopic gastric bypass. Obes Surg. 2007;17(10):1279–82.PubMedCrossRef
73.
Kuzniar TJ, Morgenthaler TI. A patient with obstructive sleep apnea undergoing bariatric surgery. J Clin Sleep Med. 2008;4(3):279–80.PubMedCentralPubMed
74.
Rao A, Tey BH, Ramalingam G, Poh AG. Obstructive sleep apnoea (OSA) patterns in bariatric surgical practice and response of OSA to weight loss after laparoscopic adjustable gastric banding (LAGB). Ann Acad Med Singapore. 2009;38(7):587–7.PubMed
75.
Smith PL, Gold AR, Meyers DA, Haponik EF, Bleecker ER. Weight loss in mildly to moderately obese patients with obstructive sleep apnea. Ann Intern Med. 1985;103(6 (Pt 1)):850–5.PubMedCrossRef
76.
Kiselak J, Clark M, Pera V, Rosenberg C, Redline S. The association between hypertension and sleep apnea in obese patients. Chest. 1993;104(3):775–80.PubMedCrossRef
77.
Nahmias J, Kirschner M, Karetzky MS. Weight loss and OSA and pulmonary function in obesity. N J Med. 1993;90(1):48–53.PubMed
78.
Martinez D, Basile BR. Sibutramine does not worsen sleep apnea syndrome: a randomized double-blind placebo-controlled study. Sleep Med. 2005;6(5):467–70.PubMedCrossRef
79.
Verhulst SL, Franckx H, Van Gaal L, De Backer W, Desager K. The effect of weight loss on sleep-disordered breathing in obese teenagers. Obesity (Silver Spring). 2009;17(6):1178–83.
Metadaten
Titel
Bariatric Surgery or Non-Surgical Weight Loss for Obstructive Sleep Apnoea? A Systematic Review and Comparison of Meta-analyses
verfasst von
Hutan Ashrafian
Tania Toma
Simon P. Rowland
Leanne Harling
Alan Tan
Evangelos Efthimiou
Ara Darzi
Thanos Athanasiou
Publikationsdatum
01.07.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 7/2015
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1533-2

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