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

Area of Science:

• Metabolic and Bariatric Surgery
• Sleep Medicine
• Obesity Research

Background:

• Long-term evidence on bariatric surgery's impact on obstructive sleep apnea (OSA) is limited.
• The Swedish Obese Subjects (SOS) study provides a unique dataset for evaluating long-term outcomes.
• Obesity is a major risk factor for OSA, necessitating effective long-term management strategies.

Purpose of the Study:

• To evaluate the long-term effects of bariatric surgery on obstructive sleep apnea (OSA) remission and new onset.
• To compare the outcomes of bariatric surgery with usual obesity care over a 20-year period.
• To assess the durability of OSA benefits following bariatric intervention.

Main Methods:

• The Swedish Obese Subjects (SOS) study is a nonrandomized, controlled intervention trial.
• 4047 participants were included: 2010 received bariatric surgery and 2037 received usual obesity care.
• OSA status was assessed via questionnaires at multiple time points up to 20 years post-intervention.

Main Results:

• Over 20 years, bariatric surgery was associated with a 32.1 percentage point lower prevalence of OSA in participants with baseline OSA compared to usual care.
• For participants without baseline OSA, bariatric surgery led to a 5.8 percentage point lower prevalence of new-onset OSA.
• These findings indicate significant and durable benefits of bariatric surgery for OSA management.

Conclusions:

• Bariatric surgery offers durable benefits for managing obstructive sleep apnea (OSA).
• The study demonstrates higher rates of OSA remission and lower rates of new-onset OSA with bariatric surgery compared to usual obesity care.
• These results support bariatric surgery as an effective long-term treatment strategy for individuals with obesity and OSA.