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Sleeping easy

Surgery does not significantly improve sleep apnoea

Obstructive sleep apnoea affects most obese patients.
Study finds no significant difference in obstructive sleep apnoea levels between gastric band and weight loss therapy patients

Laparoscopic adjustable gastric banding does not lead to better resolution of obstructive sleep apnoea than conventional weight-loss treatment, despite better overall weight loss, according to research published in the Journal of the American Medical Association.

"Our research confirmed that weight loss is associated with reduction in obstructive sleep apnoea, but it's a complex relationship” Associate Professor John Dixon

The research, carried out at Monash University by Associate Professor John Dixon, and Professor Matthew Naughton, a sleep specialist, and colleagues, compared 30 gastric banding patients with 30 patients who underwent conventional weight loss therapy. After two years, they found that the gastric banding patients did not have a statistically significant reduction in the number of nightly apnoea-hypopnoea events they experienced.

"Our research confirmed that weight loss is associated with reduction in obstructive sleep apnoea, but it's a complex relationship,” said Dixon. “The effects vary greatly between individuals. It seems that the largest improvement in obstructive sleep apnoea, is associated with mild to moderate, rather than extreme weight loss."

Patients selected for the trial had BMIs between 35 and 55, with a diagnosis of obstructive sleep apnoea within the last six months, and an apnoea-hypopnoea index of 20 events/hour or more. They were randomised into either the gastric band or the weight-loss therapy group, and were followed up every four to six weeks for two years.

While the gastric band patients lost significantly more weight than the therapy patients on average – 27.8kg vs. 5.1kg – their apnoea-hpopnoea indexes did not decrease significantly. The therapy patients experienced 14.0 fewer events/hour (95% confidence interval, -3.3 to -24.6 events/hour), while the banding patients experienced 25.5 fewer events/hour (95% CI, -5.3 to to -28.3 events/hour; p=0.18).

All patients had been prescribed continuous positive airway pressure therapy to manage their sleep apnoea. Adherence to therapy did not differ between the groups.

Dixon said the study suggested that medical professionals should be cautious about recommending bariatric surgery as a remedy for sleep apnoea.

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