Sleeping Problems and Weight Loss Surgery
Sleeping Problems and Weight Loss Surgery are directly correlated. Sleep apnea is often overlooked as a significant risk factor related to morbid obesity. In fact, sleep apnea may be the number three cause of death which is secondary to morbid obesity, only after coronary artery disease and diabetes. Sleep apnea is worse than just snoring in that it is a top cause of:
- Sudden death in your sleep
- Fatal cardiac arrhythmias (irregular heart beats)
- Pregnancy related complications
- Heart attacks
- Pulmonary Hypertension
Sleep Apnea Defined:
- oxygen levels within your blood dropping to dangerously low levels while you are asleep, or
- significant episodes were breathing actually stops in the middle of the night.
The number of times these occurrences or events are observed defines the degree of sleep apnea that you have. The risk of sleep apnea is usually based upon;
1. your weight,
2. neck circumference- the most accurate predictors of sleep apnea (16 to 18 cm has been accepted as a high risk for sleep apnea in most patients),
3. daytime sleepiness, and
4. degree of snoring.
Given the severe risks of sleep apnea, all patients seen by Texas Bariatric Specialists will fill out a sleep apnea survey or evaluation prior to weight loss surgery in order to be able to improve their preoperative risk. Many patients inquire why these studies are needed if they “sleep fine”. The answer is that just because you don’t know you have a problem, does not mean that you don’t have a problem. It is our belief that it is important to define all co-morbidities prior to weight loss surgery. This will help us improve your overall health prior to surgery and help keep you safer around the time of surgery. Left untreated or undiagnosed, the risks listed above may be even further increased by the stress of surgery.
Sleep apnea is diagnosed by undergoing a sleep study. This test is conducted as an overnight study at a sleep lab where you are videoed and monitored for breathing patterns and oxygen levels. The treatment is using a sleep apnea machine (BIPAP or CPAP machine). Those who need a sleep apnea machine come to be addicted to it as it restores a “good night sleep.”
Recently, some data has suggested that weight loss surgery may not be as effective for the treatment of sleep apnea as originally felt. Texas Bariatric Specialists still holds loyal to the fact that the most effective means of managing sleep apnea in obese individuals is weight loss. Given that weight loss surgery is the most effective way to achieve and sustain significant weight loss, it is felt that weight loss surgery remains the ideal treatment for candidates with sleep apnea. The largest study to date evaluating this topic (by Dr. Buchwald) demonstrates up to a 87% improvement or resolution rate for sleep apnea following the lap band or the gastric bypass.