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January 9, 2021Obesity Surgery39 citationsOpen Access

Obstructive Sleep Apnea in Obese Patients: a UK Population Analysis

SESimon ErridgeOMOsama MoussaCMCaroline McIntyre

Structured PICO

Does bariatric surgery reduce the risk of developing obstructive sleep apnea in obese patients?

P
Population
276,210 obese patients (BMI ≥ 30 kg/m2) from the UK Clinical Practice Research Datalink (CPRD) with at least 5 years of follow-up.
I
Intervention
Bariatric surgery and various clinicopathological risk factors (e.g., male sex, increasing BMI class, smoking, COPD, GERD).
C
Comparator
No bariatric surgery / absence of respective risk factors.
O
Outcome
Diagnosis of Obstructive Sleep Apnea (OSA).

In obese patients, increasing BMI and numerous comorbidities are associated with a higher likelihood of developing OSA, whereas bariatric surgery appears to be strongly protective.

Limitations

  • Reliant on accurate coding of clinical and demographic data in the database
  • OSA diagnosis likely less reliable in a primary care database, leading to underestimation of prevalence
  • CPAP pressures not recorded in the CPRD
  • AHI scores not reliably represented by any medcode within the datalink

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) is an increasingly common disorder associated with increased cardiovascular disease, mortality, reduced productivity, and an increased risk of road traffic accidents. A significant proportion of patients with OSA in the UK are undiagnosed. This study aims to identify risk factors for OSA in an obese cohort. METHOD: ) from the Clinical Practice Research Datalink (CPRD). A logistic regression model was used to calculate odds ratios (ORs) for developing OSA according to other clinicopathological characteristics. Multivariate analysis was conducted of individual factors that affect the propensity to develop OSA. Statistical significance was defined as p < 0.050. RESULTS: From 276,600 obese patients identified during a data extraction of the CPRD in July 2017, the prevalence of OSA was 5.4%. The following risk factors were found to be independently associated with increased likelihood of OSA: male sex (OR = 3.273; p < 0.001), BMI class II (OR = 1.640; p < 0.001), BMI class III (OR = 3.768; p < 0.001), smoking (OR = 1.179; p < 0.001), COPD (OR = 1.722; p < 0.001), GERD (OR = 1.557; p < 0.001), hypothyroidism (OR = 1.311; p < 0.001), acromegaly (OR = 3.543; p < 0.001), and benzodiazepine use (OR = 1.492; p < 0.001). Bariatric surgery was associated with reduced risk of OSA amongst this obese population (OR = 0.260; p < 0.001). CONCLUSIONS: In obese patients, there are numerous comorbidities that are associated with increased likelihood of OSA. These factors can help prompt clinicians to identify undiagnosed OSA. Bariatric surgery appears to be protective against developing OSA.

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Cite This Study

Erridge et al. (2021) studied this question.

synapsesocial.com/papers/6a801fa39b5ec1a88046fe68https://doi.org/10.1007/s11695-020-05196-7
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