Impact of Bariatric Surgery on Control of Obstructive Sleep Apnea and Hypopnea Syndrome: Comparison Between Gastric Bypass and Sleeve Gastrectomy

Introduction : Bariatric surgery is well-established treatment for grade 2 and 3 obesity refractory to clinical measures. Obstructive Sleep and Apnea Hypopnea Syndrome is among the comorbidities controlled by bariatric surgery. Patients undergoing bariatric surgery show global improvement in respiratory function. However, there is no formal indication of a specific surgical technique for better control of apnea. Objective : To evaluate the evolution of apnea/hypopnea indices, associated with weight loss, in individuals undergoing two bariatric surgery techniques: Sleeve Gastrectomy and Gastric Bypass. Methods : Prospective cohort carried out at Hospital Santa Joana Recife – Pernambuco - Brazil, including obese patients with Sleep Apnea and Hypopnea Syndrome undergoing bariatric surgery, for pre- and postoperative evaluation through polysomnography. Body mass and apnea/hypopnea indexes were measured pre- and postoperatively. Results : 30 participants were selected, 18 of whom underwent Sleeve Gastrectomy and 12 underwent Gastric Bypass, 73.3% of whom were female, with a mean age of 40.2 years (range 24-63). Mean preoperative body mass and apnea/hypopnea indexes of ​​sleeve gastrectomy and gastric bypass were respectively 39.9 and 42.8 kg/m2, and 33.7 and 27.7 events/hour. After surgery, mean postoperative body mass and apnea/hypopnea indexes for sleeve gastrectomy and gastric bypass were 28.8 and 30.3 kg/m2, and 7.4 and 9.5 events/hour (0.3-27.3), respectively. Reduction in body mass and apnea/hypopnea indexes in the sleeve gastrectomy group was 27.8% and 74.4%, while in the gastric bypass group it was 29.5% and 62.4%, respectively. There was no statistical difference between the groups regarding sleep apnea control. Conclusion: Both surgical techniques are effective in controlling sleep apnea, with no clear preponderance between them. Participants with higher preoperative BMI were the main beneficiaries. A larger number of patients and studies may corroborate these findings.