Predictive Factors for Obstructive Sleep Apnea Diagnosis in Bariatric Surgery Candidates with or Without Chronic Insomnia Complaints

• Published in: Obesity surgery 2022, Vol.32 (1), p.33-41
• Main Authors: Duarte, Ricardo L. M., Magalhães-da-Silveira, Flavio J., Gozal, David
• Format: Article
• Language: English
• Subjects: Bariatric Surgery; Body mass index; Cross-Sectional Studies; Disorders of Excessive Somnolence - diagnosis; Disorders of Excessive Somnolence - epidemiology; Disorders of Excessive Somnolence - etiology; Gastrointestinal surgery; Humans; Insomnia; Male; Medicine; Medicine & Public Health; Obesity, Morbid - surgery; Original Contributions; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep Initiation and Maintenance Disorders - diagnosis; Sleep Initiation and Maintenance Disorders - epidemiology; Surgery
• ISSN: 0960-8923; 1708-0428; 1708-0428
• DOI: 10.1007/s11695-021-05748-5

Objective This study aims to evaluate the frequency of insomnia complaints in bariatric patients and to assess obstructive sleep apnea (OSA) predictors according to the presence or absence of chronic insomnia. Methods Insomnia was defined as the presence of at least one specific symptom: difficulty falling asleep, difficulty maintaining sleep, and/or waking up earlier than expected. Diagnosis of OSA was objectively obtained from in-laboratory polysomnography. Multivariate logistic regression analysis was used to assess OSA predictors. Results This cross-sectional study contains 1,737 bariatric surgery candidates: 59.6% without insomnia and 40.4% with insomnia. OSA prevalence was similar among participants with or without insomnia either for any OSA ( p  = 0.168) or for moderate-to-severe OSA ( p  = 0.185). Patients without insomnia showed a higher prevalence of severe OSA than those with insomnia ( p  = 0.005). In both cohorts, five parameters were independent OSA predictors: sex, age, body mass index (BMI), neck circumference (NC), and excessive daytime sleepiness (EDS). Male sex was the most important predictor, whether in individuals without insomnia (adjusted odds ratio [OR] ranging from 4.874 to 8.369) or in those with insomnia (adjusted OR ranging from 5.672 to 12.441). Conclusions A considerable proportion of bariatric patients report insomnia complaints. The probability of suffering from OSA was similar among bariatric candidates with or without insomnia, except for severe OSA diagnosis. Sex, age, BMI, NC, and EDS were independent predictors for OSA diagnosis irrespective of insomnia symptoms, and male sex was the main predictor for OSA in bariatric individuals with or without insomnia. Graphical abstract