- •Prevalence of obstructive sleep apnea (OSA) in adolescents undergoing metabolic bariatric surgery (MBS) is higher than the general adolescent population with severe obesity.
- •Adolescents whom have remission of OSA post-MBS have lower pre-MBS BMI and obstructive apnea hypopnea index (OAHI) compared to adolescents whom continue with OSA.
Little is known regarding obstructive sleep apnea’s (OSA’s) prevalence or the factors related to OSA remission post–metabolic bariatric surgery (MBS) in adolescents.
To identify the baseline OSA prevalence in adolescents with severe obesity and examine factors associated with post-MBS OSA remission.
Tertiary-care children’s hospital.
We conducted a retrospective chart review of 81 patients pre-MBS with OSA assessments done between June 2017 to September 2020 to collect demographic characteristics; co-morbidities; polysomnography (PSG) results, if indicated; and weight data. Chi-square or Mann-Whitney tests compared baseline characteristics and surgical outcomes by pre-MBS OSA status. McNemar’s test or t tests assessed differences in baseline characteristics, stratified by remission versus no remission of OSA.
The patients were 71% female, had an average age of 16.9 ± 2.0 years, and had a mean body mass index (BMI) of 47.9 ± 7.3 kg/m2. Half (50%) of the patients were Hispanic and 20% had type 2 diabetes. The OSA prevalence, defined as an Obstructive Apnea Hypopnea Index (OAHI) score ≥5, was 54% pre-MBS (n = 44), with 43% having severe OSA (OAHI > 30). Those with OSA were older (17.3 versus 16.4 yr, respectively; P = .05), more likely to be male (79% versus 42%, respectively; P = .022), and had higher baseline weights (142.0 versus 126.4 kg, respectively; P = .001) than those without OSA. Of the 23 patients with a post-MBS PSG result (average 5 mo post MBS), 15 (66%) had remission of OSA. Patients with OSA remission had a lower average pre-MBS BMI (46.0 versus 57.7 kg/m2, respectively; P < .001) and weight (132.9 versus 172.6 kg, respectively; P = .002) but no significant differences in percentage weight loss through 12 months post MBS versus those with continued OSA.
The OSA prevalence in an adolescent MBS population was higher than that in the general adolescent population with severe obesity. Remission of OSA was correlated with lower pre-MBS BMI and weight, but not weight loss within the first year post-MBS.
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Published online: December 16, 2020
Accepted: December 6, 2020
Received: June 11, 2020
© 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.