Obstructive sleep apnea in bariatric surgery patients: a population-based study

PurposeA high proportion of obstructive sleep apnea (OSA) remains undiagnosed. The main objectives of this study were to measure the prevalence of diagnosed OSA and determine OSA predictors in patients who underwent bariatric surgery, who are predominantly female and pre-menopausal and represent an understudied population in OSA literature.MethodsThis was a cross-sectional population-based study using the Ontario Bariatric Registry (OBR) from 2010 to 2016, linked to ICES databases which include health administrative data on all encounters within a single public-payer system. Multiple logistic regression was used to measure OSA predictors.ResultsOut of a total of 18,074 patients who underwent bariatric surgery, OSA was diagnosed in 47% (95% confidence interval [CI]: 46 to 47), and OSA was the second most common comorbidity within this population. Only 63% of OSA diagnoses were recorded in the OBR at the time of initial bariatric consultation. Based on interaction, it was found that, in females, OSA predictors included social inequality, diabetes and chronic obstructive pulmonary disease, in addition to the predictors measured in males (age, body mass index and comorbidity burden).ConclusionA significant proportion of patients presenting for initial bariatric surgery consultation have undiagnosed OSA. OSA screening and testing may lead to underdiagnosis of OSA, especially in pre-menopausal females who represent the majority of the population undergoing bariatric surgery.