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Epidemiology and Population Health

Three-year effects of bariatric surgery on obstructive sleep apnea in patients with obesity grade 1 and 2: a sub-analysis of the GATEWAY trial

International Journal of Obesity volume 45, pages 914–917 (2021)Cite this article

Subjects

Abstract

Background

Most of the evidence on bariatric surgery on obstructive sleep apnea (OSA) is based on observational studies and/or short-term follow-up in patients with obesity grade 3.

Subjects/Methods

This randomized study compared the effects of roux-en-Y gastric bypass (RYGB) or usual care (UC) on OSA severity in patients with obesity grade 1–2. Mild, moderate, and severe OSA was defined by the apnea-hypopnoea index (AHI): 5–14.9; 15–29.9, and ≥30 events/h, respectively. OSA remission was defined by converting any form of OSA into normal AHI (<5 events/h).

Results

After 3-year of follow-up, the body-mass index increased in the UC while decreased in the RYGB group: +1.7 (−1.9; 2.7) versus −10.6 (−12.7; −9.2) kg/m2, respectively. The AHI increased by 5 (−4.2; 12.7) in the UC group while reduced in the RYGB group to −13.2 (−22.7; −7) events/h. UC significantly increase the frequency of moderate OSA (from 15.4 to 46.2%). In contrast, RYGB had a huge impact on reaching no OSA status (from 4.2 to 70.8%) in parallel to a decrease of moderate (from 41.7 to 8.3%) and severe OSA (from 20.8 to 0%).

Conclusions

RYGB is an attractive strategy for mid-term OSA remission or decrease moderate-to-severe forms of OSA in patients with obesity grade 1–2.

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Fig. 1: Main results.

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Acknowledgments

We thank the patients, the surgical center and ward staff, the Surgical Team, and the Research Institute from Heart Hospital for assistance with the GATEWAY trial.

Funding

The research reported in this publication was supported by Ethicon, Inc. and represented in Brazil by Johnson & Johnson do Brasil (Grant no. 100238). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Author notes

  1. These authors contributed equally: Sofia F. Furlan, Luciano F. Drager

Authors and Affiliations

  1. Program in Cardiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

    Sofia F. Furlan

  2. Hypertension Unit, University of São Paulo Medical School, São Paulo, Brazil

    Sofia F. Furlan, Luciano F. Drager & Luiz A. Bortolotto

  3. Renal Division, University of São Paulo Medical School, São Paulo, Brazil

    Luciano F. Drager

  4. Research Institute, Heart Hospital (HCor), São Paulo, Brazil

    Renato Nakagawa Santos, Lucas P. Damiani, Angela Cristine Bersch-Ferreira, Tamiris A. Miranda, Rachel Helena V. Machado, Eliana V. Santucci, Alexandre B. Cavalcanti & Carlos A. Schiavon

  5. Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), São Paulo, Brazil

    Geraldo Lorenzi-Filho

  6. Albert Einstein Hospital, São Paulo, Brazil

    Otavio Berwanger

Authors
  1. Sofia F. Furlan
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  2. Luciano F. Drager
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  3. Renato Nakagawa Santos
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  4. Lucas P. Damiani
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  5. Angela Cristine Bersch-Ferreira
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  6. Tamiris A. Miranda
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  7. Rachel Helena V. Machado
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  8. Eliana V. Santucci
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  9. Luiz A. Bortolotto
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  10. Geraldo Lorenzi-Filho
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  12. Alexandre B. Cavalcanti
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  13. Carlos A. Schiavon
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Corresponding authors

Correspondence to Luciano F. Drager or Carlos A. Schiavon.

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Conflict of interest

Drs. Drager and Schiavon received fees for lectures from Ethicon (modest). The other authors had no relevant conflicts to disclose.

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Furlan, S.F., Drager, L.F., Santos, R.N. et al. Three-year effects of bariatric surgery on obstructive sleep apnea in patients with obesity grade 1 and 2: a sub-analysis of the GATEWAY trial. Int J Obes 45, 914–917 (2021). https://doi.org/10.1038/s41366-021-00752-2

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