Asymptomatic sleep-disordered breathing in premenopausal women awaiting bariatric surgery

There is a strong association between sleep-disordered breathing (SDB) and obesity. However, there are no studies addressed to determining the prevalence of SDB in morbidly obese premenopausal women, the most frequent group of patients requiring bariatric surgery. To evaluate the prevalence and characteristics of sleep apnea-hypopnea syndrome (SAHS) and obesity hypoventilation syndrome (OHS) in morbidly obese pre-menopausal women included in a program of bariatric surgery.

A total of 88 consecutive morbidly obese pre-menopausal women (38.3 +/- 8.1 years, body mass index (BMI) 48.0 +/- 6.7 kg/m(2)) being evaluated for bariatric surgery at the outpatient obesity unit of a university hospital were prospectively recruited. SDB examinations included a non-attended respiratory polygraphy, pulmonary function testing, and an awake arterial gasometry. SAHS was defined as an apnea-hypopnea index (AHI) >or=10 events per hour and patients were divided in non-SAHS (AHI <10), mild (AHI: 10-20), moderate (AHI: 21-30), and severe (AHI >30). OHS was defined as the presence of hypercapnia (PaCO(2) > 45). Somnolence was evaluated using the Epworth sleepiness scale.

A total of 66 (75.0%) obese patients had SAHS: 25 (28.4%) mild, 14 (15.9%) moderate, and 27 (30.6%) severe. Seven (7.9%) obese patients presented OHS. Excessive daily somnolence was recorded in only 11 (16.6%) of the obese women with SAHS. In multiple regression analysis, BMI was the only variable independently associated with SAHS severity.

Due to its high prevalence and severity, it should be recommended to investigate SDB in all morbidly obese pre-menopausal women awaiting bariatric surgery even in the absence of excessive daytime sleepiness.