Bariatric Surgery as a Treatment for Obstructive Sleep Apnoea, Diabetes Mellitus, Hypertension and Asthma–A Case Report

Obstructive Sleep Apnea (OSA) is linked to hypertension, ischemic heart disease, stroke, diabetes and sudden cardiac death. The standard treatment using positive airway pressure (PAP) device may not be tolerated in many patients and therefore alternative options should be explored including bariatric surgery, which have beneficial impacts on other medical co-morbidities as well. OSA is associated with obesity and there is a positive correlation between increasing BMI and sleep apnea. Weight loss by any method is a well-documented treatment for OSA. We report a case of an obese gentleman with poorly controlled asthma and found to have severe obstructive sleep apnea on the background of hypertension and type 2 diabetes. Bariatric surgery cured his OSA and improved the control of all of his other medical comorbidities.

PDF

___

1. Lam JC, Sharma SK, Lam B. Obstructive sleep apnoea: definitions, epidemiology & natural history. Indian J. Med. Res 2010; 131: 165.

2. Liam CK, Pang YK, Shyamala P, Chua KT. Obstructed breathing during sleep and obstructive sleep apnoea syndrome--assessment and treatment. Med J. Malaysia 2007; 62: 268- 273.

3. Clinical Issues Committee, American Society for Metabolic and Bariatric Surgery, Peri- operative Management of Obstructive Sleep Apnea, Published 3/2012.

4. Qaseem A, Holty JC, Owens DK, Dallas P, Starkey M, Shekelle P. Clinical Guidelines Committee of the American College of Physicians. Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern. Med 2013; 159: 471-483.

5. enaiges D Ms- , Goday , Ramon M, hillaro n JJ, Pedro-Botet J, Flores-Le Roux JA. . Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? World Journal of Gastroenterology 2015; 21: 11804- 11814.

6. RT Nguyen, S Hassan, R Adrah, S Gu, S Nguyen, M Zaman, 0554 Psg and Cpap Use Before and After Bariatric Surgery: A Five Year Cohort Study, Sleep, Volume 40, Issue suppl_1, 28 April 2017, Page A206, https://doi.org/10.1093/sleepj/zsx050.553

7. Purnell JQ. Definitions, Classification, and Epidemiology of Obesity. [Updated 2018 Apr 12]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279 167/

8. Acquafresca PA, Palermo M, Rogula T, Duza GE, Serra E. Early surgical complications after gastric by-pass: a literature review. Arq Bras Cir Dig 2015; 28: 74‐80.

9. Lim R, Beekley A, Johnson DC, et al. Early and late complications of bariatric operation Trauma Surgery & Acute Care Open 2018; 3: e000219.

10. Cherian PT , Goussous G , Ashori F , Sigurdsso n A . Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years. Surg Endosc 2010; 24: 2031-2038.

11. Nguyen NT , Longoria M , Chalifoux S , Wilson SE. Gastrointestinal hemorrhage after laparoscopic gastric bypass. Obes Surg 2004; 14: 1308-1312.

12. Manning S, Pucci A, Carter NC, Elkalaawy M, Querci G, Magno S, et al. Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass. Surg Endosc 2015; 29: 1484-1491.