Information For Patients Undergoing Sleep Apnea Screening Prior to Bariatric Surgery
Why might your bariatric surgeon recommend that you undergo sleep testing before your surgery?
The vast majority of patients with morbid obesity suffer from sleep apnea: a potentially dangerous condition that can cause serious complications following their bariatric surgery. It is safest to ensure effective treatment for sleep apnea prior to undergoing any operation with general anesthesia.
What is sleep apnea?
Repeated pauses in breathing (apneas) lasting at least 10 seconds. In severe cases, hundreds of apneas occur every night. Sleep apnea can result either from collapse of throat (often with irregular snores and/or gasps) or lack of breathing effort—both of which are worsened by being overweight. Also, some overweight patients never stop breathing. Instead, they do not breathe deeply enough when asleep to maintain adequate oxygen levels.
What factors other than obesity increase the risk of sleep apnea?
- Nasal congestion or obstruction, “sinus trouble”, or allergies.
- Large tonsils and/or adenoids, having a “crowded throat”, large tongue or small jaw.
- Lung disease, atrial fibrillation and heart failure.
- Scoliosis, muscle weakness, sedating medications, alcohol and a family history of sleep apnea.
What symptoms and complications can result from sleep apnea?
- Hypertension, heart failure, heart attack, strokes, cardiac arrest, convulsions, and accelerated coronary disease.
- Increased risk of post-operative respiratory arrests and deaths following surgeries if sleep apnea is not under treatment.
- Irritability, personality change and memory problems.
- Daytime sleepiness, often unrecognized by the patient, with a greatly increased risk of highway crashes.
- Restless sleep, night sweats, headaches and dry throat on awakening, arousals with choking, chest pain or shortness of breath.
- No symptoms at all! Studies have shown that the majority of patients with sleep apnea awaiting bariatric surgery have no symptoms–and many have no snoring history!
Wouldn’t I know it if I stopped breathing in my sleep?
Not necessarily. Some patients never awaken with any distress, even if they stop breathing over 100 times per hour! Also, many bariatrics patients with even potentially life-threatening sleep apnea surprisingly have no symptoms. They have no snoring history, are not sleepy during the day and feel that their sleep is refreshing.
Is regular snoring without apneas OK?
Not necessarily. Some patients must struggle to get every breath, to the point that the resulting swings in pressure within their chest can even cause collapse of the left side of the heart! This condition (called Upper Airway Resistance Syndrome) can cause severe sleepiness and may eventually lead to sleep apnea.
Can breathing problems during sleep usually be effectively treated?
Yes! Treatment, which must be tailored to the individual’s needs, is highly successful. The leading treatment in adults is nasal CPAP, a small “blower” device that immediately prevents throat collapse. Treatment can prevent serious health problems and protect patients from potentially devastating complications following bariatric surgery.
Why wouldn’t oxygen following my surgery suffice to protect me against complications from sleep apnea?
If you suffer from obstructive sleep apnea with repeated throat collapse, simply delivering oxygen to your nasal airway would be like putting premium gas in a car with a plugged fuel line–oxygen cannot reach your lungs or bloodstream.
Will having to undergo a sleep evaluation delay my bariatric surgery?
Not at our sleep center. We schedule patients promptly for their initial appointments and sleep studies, perform their overnight sleep recordings on consecutive nights, order any treatments on the day following completion of testing and ensure rapid provision of results to your bariatric surgeon. In most cases, we feel that it is safe to proceed with bariatric surgery following a week or two of successful treatment for sleep apnea.
Will weight loss following bariatric surgery eliminate sleep apnea?
Sometimes, but not always. Some very slender patients suffer from severe sleep apnea. Repeat sleep studies after weight loss are advisable to protect your health.
What if I have additional questions on sleep apnea or sleep testing?
Simply call us at (614) 854-0300 or visit our Contact Page to leave us a message.