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Prevalence and Prediction of Obstructive Sleep Apnea Prior to Bariatric Surgery—Gender-Specific Performance of Four Sleep Questionnaires

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Abstract

Purpose

Bariatric surgery (BS) is a treatment option for morbid obesity leading to substantial and sustained weight loss in adults. As obstructive sleep apnea (OSA) is highly prevalent in obese subjects and may increase the perioperative risk, screening for OSA is recommended prior to BS. In clinical routine, BS is performed more frequently in women. Therefore, we sought to assess the gender-specific performance of four sleep questionnaires (Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOPBang, and NoSAS) to predict moderate to severe OSA in the morbidly obese population.

Material and Methods

We applied all four questionnaires to patients scheduled for BS with polygraphic OSA screening at our institution between 2012 and 2015 and performed gender-specific sensitivity analyses.

Results

We included 251 bariatric patients (76% female, median age 39 years, median BMI 42.0 kg/m2). OSA (AHI > 5/h; AHI > 15/h) was present in 43% (females 35%, males 68%; p < 0.001) and 21% (females 13%, males 45%; p < 0.001). STOPBang and NoSAS performed markedly better than ESS and FSS. With the exception of the ESS, all sleep questionnaires allowed better OSA prediction in women than in men.

Conclusion

In obese patients scheduled for BS, a gender-specific difference was observed in the performance of the evaluated OSA screening questionnaires. This needs to be considered when these questionnaires are used. Our results underline the need for better gender-specific OSA screening algorithms in morbidly obese patients.

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Authors and Affiliations

  1. Department of Pulmonary Medicine, Inselspital, University Hospital and University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland

    Christian M. Horvath, Juri Jossen, Anne-Kathrin Brill & Sebastian R. Ott

  2. Department of Pneumology and Sleep Medicine, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9000, St. Gallen, Switzerland

    Christian M. Horvath & Florent Baty

  3. Department of Visceral Surgery and Medicine, Inselspital, University Hospital and University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland

    Dino Kröll & Philipp C. Nett

Authors
  1. Christian M. Horvath
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  2. Juri Jossen
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  3. Dino Kröll
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  4. Philipp C. Nett
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  6. Anne-Kathrin Brill
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Corresponding author

Correspondence to Christian M. Horvath.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the local ethics committee (KEK 2017-00772).

Informed Consent

Due to the retrospective nature of the study, informed patient consent was waived.

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Horvath, C.M., Jossen, J., Kröll, D. et al. Prevalence and Prediction of Obstructive Sleep Apnea Prior to Bariatric Surgery—Gender-Specific Performance of Four Sleep Questionnaires. OBES SURG 28, 2720–2726 (2018). https://doi.org/10.1007/s11695-018-3222-z

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  • DOI: https://doi.org/10.1007/s11695-018-3222-z

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