What question did this study set out to answer?

This research aims to investigate the long-term effects of bariatric surgery on obstructive sleep apnea (OSA) over 20 years.

February 27, 2026

Obstructive Sleep Apnea Following Bariatric Surgery: 20 Year Outcomes From the Swedish Obese Subjects Study.

Key Result

Bariatric surgery reduced OSA prevalence by 32.1 percentage points and new-onset OSA by 5.8 percentage points over 20 years versus usual care.

Key Points

This research aims to investigate the long-term effects of bariatric surgery on obstructive sleep apnea (OSA) over 20 years.
Evaluated participants from the Swedish Obese Subjects (SOS) study over 20 years.
Included 4047 individuals: 2010 underwent bariatric surgery, 2037 received usual obesity care.
OSA status assessed via questionnaires at multiple time points from baseline to 20 years.
Compared remission and new onset of OSA between surgery and non-surgery groups.
Bariatric surgery linked to a 32.1 percentage points lower prevalence of OSA in participants with baseline OSA.
Surgery associated with a 5.8 percentage points lower prevalence of new-onset OSA among those without OSA at baseline.

Structured PICO

Does bariatric surgery improve remission and prevent new onset of obstructive sleep apnea in individuals with obesity compared to usual obesity care?

Population

4,047 individuals with obesity from the Swedish Obese Subjects (SOS) study

Intervention

Bariatric surgery

Comparator

Usual obesity care

Outcome

Remission and new onset of obstructive sleep apnea (OSA) over 20 years, assessed via questionnairespatient reported

Bariatric surgery is associated with durable long-term improvements in obstructive sleep apnea, including higher remission and lower new-onset rates over 20 years compared to usual care.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

OBJECTIVE: Bariatric surgery has been suggested to improve obstructive sleep apnea (OSA) in short-term studies, but long-term evidence is limited. We evaluated remission and new onset of OSA over 20 years in participants from the Swedish Obese Subjects (SOS) study, comparing bariatric surgery with usual obesity care. METHODS: The SOS study is a nonrandomized, controlled intervention study including 4047 individuals who received bariatric surgery (n = 2010) or usual obesity care (n = 2037). OSA status was assessed via questionnaires at baseline and at 1, 2, 3, 4, 6, 8, 10, 15, and 20 years. We examined remission and new onset of OSA among participants with or without the condition at baseline, comparing surgery to usual care. RESULTS: On average over 20 years, bariatric surgery was associated with a 32.1 percentage points lower prevalence of OSA in participants with baseline OSA (95% CI: -36.9 to -27.2; p < 0.001) compared to usual care. Among those without baseline OSA, surgery patients had a 5.8 percentage points lower prevalence of new-onset OSA (95% CI: -7.1 to -4.6; p < 0.001). CONCLUSIONS: Bariatric surgery was associated with durable OSA benefits, including higher remission and lower long-term new onset of OSA compared to usual obesity care. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01479452.

Bookmark