Obstructive Sleep Apnoea Screening Preoperatively with the Epworth Questionnaire: Is It Worth It…?

Area of Science:

• Bariatric Surgery
• Sleep Medicine
• Pulmonology

Background:

• Obstructive sleep apnoea (OSA) is highly prevalent in bariatric populations, with reported rates from 60-83%.
• The Epworth Sleepiness Scale (ESS) is a common tool for assessing subjective daytime sleepiness and identifying individuals at high risk for OSA.

Purpose of the Study:

• To determine the prevalence of OSA in patients undergoing bariatric surgery using ESS screening.
• To evaluate the predictive value of the ESS for OSA in this specific patient group.

Main Methods:

• A prospective study included 425 patients undergoing bariatric surgery from 2012-2017.
• Patients were screened using the ESS pre-operatively and categorized into low-risk (ESS < 11) and high-risk (ESS ≥ 11) groups.
• Demographics and ESS scores were recorded; OSA prevalence was assessed.

Main Results:

• The study found an OSA prevalence of 14% in the community and 20% overall in the bariatric cohort.
• The ESS demonstrated a positive predictive value of 60% for OSA.
• Patients with OSA were older and had a lower female ratio; hospital stay was slightly longer for OSA patients, with high-ESS scores correlating with longer stays.

Conclusions:

• The actual prevalence of OSA in this bariatric surgery cohort was lower than previously reported.
• The ESS may have limited predictive value for identifying OSA in patients prior to bariatric surgery.
• OSA might be overemphasized in the pre-bariatric surgery pathway.