Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery
Open accessAbstract
The aim of this study was to evaluate prevalence of obstructive sleep apnea among patients undergoing bariatric surgery and the predictive value of various clinical parameters: body mass index (BMI), neck circumference (NC) and the Epworth Sleepiness Scale (ESS). We performed a prospective, multidisciplinary, single-center observational study including all patients on the waiting list for bariatric surgery between June 2009 and June 2010, irrespective of history or clinical findings. Patients visited our ENT outpatient clinic for patient history, ENT and general examination and underwent a full night polysomnography, unless performed previously. As much as 69.9% of the patients fulfilled the criteria for OSA (mean BMI 44.2 ± SD 6.4 kg/m(2)); 40.4% of the patients met the criteria for severe OSA. The regression models found BMI to be the best clinical predictor, while the ROC curve found the NC to be the most accurate predictor of the presence of OSA. The discrepancy of the results and the poor statistical power suggest that all three clinical parameters are inadequate predictors of OSA. In conclusion, in this large patient series, 69.9% of patients undergoing BS meet the criteria for OSA. More than 40% of these patients have severe OSA. A mere 13.3% of the patients were diagnosed with OSA before being placed on the waiting list for BS. On statistical analysis, increased neck circumference, BMI and the ESS were found to be insufficient predictors of the presence of OSA. Polysomnography is an essential component of the preoperative workup of patients undergoing BS. When OSA is found, specific perioperative measures are indicated.
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In patients being evaluated for bariatric surgery, the prevalence of OSA is estimated to be 70% to 80%.
“In some populations, the prevalence of OSA is substantially higher than this estimate, for example, in patients being evaluated for bariatric surgery (estimated range of 70% to 80%)11”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [11]
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Self-citation
- Authors
- Ravesloot, M. J. L., van Maanen, J. P., Hilgevoord, A. A. J., van Wagensveld, B. A., & de Vries, N.
- Affiliations
- Sint Lucas Andreas Hospital (NL)
- Corresponding author
- Ravesloot, M. J. L.
- ORCID
- Ravesloot, M. J. L.
- Venue
- European Archives of Oto-Rhino-Laryngology
- Published
- 2012-02-05
- Volume
- 269
- Issue
- 7
- Pages
- 1865-1871
- ISSN
- 0937-4477 (ISSN-L)
- 1434-4726
- PMC
- PMC3365234
- OpenAlex
- W1978388061
- Cited by
- 168
- References
- 3
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 14 · 2023: 7 · 2022: 10 · 2021: 14 · 2020: 18 · 2019: 14 · 2018: 13 · 2017: 13 · 2016: 17 · 2015: 10 · 2014: 8 · 2013: 8 · 2012: 3
- FWCI
- 5.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- European Archives of Oto-Rhino-Laryngology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- obstructive sleep apnea, bariatric surgery, underdiagnosis, prevalence, body mass index, neck circumference, Epworth Sleepiness Scale, clinical predictors, polysomnography, preoperative assessment, severe sleep apnea
- MeSH terms
- Adult, Anthropometry, Female, Humans, Male, Middle Aged, Obesity, Predictive Value of Tests, Preoperative Care, Risk Factors, ROC Curve, Body Mass Index, Prevalence, Polysomnography, Sleep Apnea, Obstructive, Bariatric Surgery
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