Sleep Apnea

Sleep apnea is often overlooked as a significant risk factor related to morbid obesity. When in fact, sleep apnea may be the number three cause of death related to morbid obesity, only after heart disease and diabetes. Sleep apnea is much more serious than just snoring. It is a top cause of:

• Sudden death in your sleep
• Fatal cardiac arrhythmia (irregular heart beats)
• Complications with pregnancy
• Strokes
• Heart attacks
• Pulmonary hypertension

Sleep Apnea Defined:

• Oxygen levels within your blood dropping to dangerously low levels while you are asleep OR
• Significant episodes where 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 related to:

1. Your weight
2. Neck circumference- the most accurate predictor of sleep apnea (16-18 cm leads to a high risk of sleep apnea in most patients)
3. Daytime sleepiness
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. Many patients inquire why these studies are needed if they “sleep fine”.  The answer is that you can have a problem without knowing it’s there. 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 monitored for breathing patterns and oxygen levels. The treatment involves 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’s sleep.”

Weight loss is the most effective way of managing sleep apnea in obese individuals. 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 weight loss surgery.