Sleep Study Recommended Prior to Bariatric Surgery, Experts Say

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Many candidates for bariatric surgery suffer from the obesity-related disorder obstructive sleep apnea. Los Angeles LAP-BAND surgeon Dr. Shahram Salimitari recommends that bariatric surgery candidates get a sleep study to check for the condition to avoid complications.

We know that obesity is at epidemic levels and that OSA is probably under-diagnosed in the general population

A growing body of research has highlighted the necessity of a sleep study for bariatric surgery candidates to check for the obesity-related condition obstructive sleep apnea (OSA). Bariatric patients with OSA are at a higher risk for complications during surgery because of their sleep apnea being worsened by lying on their backs, as well as an adverse reaction with the anesthesia. Sedation from anesthesia causes the throat muscles to relax which can block breathing for an OSA patient. Los Angeles weight loss surgeon Dr. Shahram Salimitari said sleep studies should be standard for bariatric surgery candidates.

“Although there isn’t a standard protocol for screening bariatric surgery candidates for sleep disorders, we recommend it to our patients so they get the appropriate care during surgery,” said Dr. Salimitari.

OSA is a sleep disorder where a person stops breathing multiple times at night and wakes up repeatedly in order to resume breathing. Often, those who suffer from OSA are unaware they have the condition, but experience symptoms such as chronic daytime sleepiness and poor memory. Left untreated, OSA can lead to serious problems, including depression, sexual dysfunction and heart disease.

To diagnose OSA, a sleep specialist hooks up equipment to monitor heart, lung and brain activity, said sleep expert Dr. Dan Naim of the Los Angeles Sleep Study Institute. These devices detect abnormalities and measure breathing patterns, body movement and blood oxygen saturation levels.

“The reason obesity can lead to OSA is due to the added weight in the torso and neck area,” said Dr. Naim. “This raises the risk of sleep-disordered breathing and compromised breathing function.”

Nearly two-thirds of the bariatric surgery candidates are undiagnosed with OSA prior to being evaluated for bariatric surgery, according to a study published in April.

“In light of the negative consequences of OSA, both for general health and post-operative outcomes, bariatric providers should be aware of the high prevalence of clinically significant OSA among patients who do not report significant impairment in daily functioning from sleepiness,” wrote lead researcher Dr. Katherine Sharkey, a sleep medicine specialist at Brown University.

Dr. Sharkey said people with severe obesity should be tested for OSA, even if they present no symptoms.

“We know that obesity is at epidemic levels and that OSA is probably under-diagnosed in the general population,” said Dr. Sharkey. “Our data show that patients with obesity severe enough to consider surgery nearly always have significant OSA, but they either do not experience symptoms or they underreport them or they attribute their symptoms to something other than sleep problems.”

Due to the risks associated with any surgery, experts recommend taking all necessary precautions to ensure the best possible outcome.

For more information about obesity and sleep disorders, visit the National Sleep Foundation website at

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