The study, which compared the effects of laparoscopic adjustable gastric banding (LABG) and a conventional diet-plus-exercise weight loss program on OSA and apnea-hypoapnea index (AHI), found that while bariatric surgery produced significantly greater weight loss than conventional therapy, the increased weight loss did not appear to translate into a significant reduction in the AHI in obese patients. Specifically, the LABG group lost a mean of 27.8 kg compared to a loss of 5.1 kg in the conventional treatment group (p<0.001). While the surgery group showed a greater decrease in AHI compared to the conventional group (25.5 fewer events per hour versus 14 fewer events per hour), the difference between the two groups was not statistically significant (p=0.18).
The study also found that adherence to continuous positive airway pressure treatment was similar in both groups, with 14 patients in the LABG group (mean pressure 11.6 cm H2O for 5.2 hours/night) and 18 patients in the conventional group (11.5 cm H2O for 5.6 hours/night) at two years. Patients in the LABG group showed significantly better scores on the Short Form-36 for physical role, general health, vitality and physical component summary (p=0.04). Both groups showed similar reductions in daytime sleepiness and symptoms of depression with improvements in the six-minute walk test. "While there is a clear overall response to weight loss, the individual effects are variable, incomplete and appear to be related to modest weight loss," noted John Dixon, MBBS, PhD, Obesity Research Unit, Monash University, Melbourne, Australia, and leader author of the study. Moving forward, Dixon suggests that caution be used in counseling patients about the expected benefits of weight loss for OSA. |
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