Is bariatric surgery a good treatment option for an obese person who has obstructive sleep apnea?
A recent study in the Journal of Clinical Sleep Medicine provides caution. The study involved 24 men and women with sleep apnea.
Before surgery they had an average body mass index (BMI) of 51. A BMI of 30 or higher is considered “obese.”
Their sleep apnea also was severe. They had an average apnea-hypopnea index (AHI) of 47.9.
This means that they stopped breathing about 48 times per hour of sleep. In general an AHI of more than 30 is considered “severe.”
Bariatric surgery did provide some benefits. But it wasn’t a cure.
One year after surgery the participants were still obese; but they had a much lower average BMI of 32.
Their average AHI also dropped to 24.5. But only one person no longer had sleep apnea.
The majority of the group still had moderate to severe sleep apnea. All but one of them also continued to snore. They still needed to use CPAP therapy to restore normal breathing during sleep.
The AASM recommends bariatric surgery as an optional treatment for severe obesity and sleep apnea. But it should only be used along with a first-line treatment such as CPAP.
The NIDDK warns that complications can occur with bariatric surgery. These include blood clots and hernias.
There also is a 10 percent chance of unsatisfactory weight loss. Some people also regain much of the weight they lose after surgery.
Bariatric surgery also is costly. The NIDDK estimates that the price for surgery is about $20,000 to $25,000.
Medicare only covers bariatric surgery if you are “morbidly obese” with a BMI of at least 35. You also must have a serious health condition related to obesity. Sleep apnea is listed by Medicare as one of the obesity-related problems that is covered.
Contact an AASM –accredited sleep center to discuss all treatment options for sleep apnea.
Tuesday, February 24, 2009
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