All of you that read my blog know that I believe that obesity surgery cures (yes, he said that, cures!) a variety of medical conditions. I believe that certain conditions like diabetes, high blood pressure and acid reflux are cured with obesity surgery. Many internal medicine and family practice specialists will howl in protest, but the science is very good and truly drowns the debate.
We can now add sleep apnea to the list of conditions that obesity surgery can cure.
For those of you who might not know what sleep apnea is, it is a condition that causes a person to stop breathing when they fall asleep. This is scary and it is a major health problem. If you have ever slept next to a noisy night time breather, someone who snores and rattles the windows, or in the midst of the hurricane like cacophony you hear ½ to 1 minute of silence, followed by the return of the noisy symphony, that person likely has sleep apnea.
While this seems like the fodder for jokes and marital banter, it is a serious condition. When a person with sleep apnea stops breathing, carbon dioxide builds up. The brain recognizes this and forces the person to “wake up”, except they really do not awaken to consciousness, they just stir enough to take a few breaths, until they fall back to deep sleep. Then the cycle of not breathing and gasping starts all over.
This is serious for your health. Long term untreated sleep apnea leads to high blood pressure, fatigue realted to disturbed sleep, migraines, heart conditions, lung conditions, stroke and heart attack. Is this serious enough for you. That story about snoring so loud the neighbors dog barks at you, isn’t so funny anymore.
Obstructive Sleep Apnea (OSA) can be treated.
The first line of treatment is masks (CPAP) that are placed over a persons face that pressurize air and blow air in to the lungs, this was confimred by a recent review in the journal Annals of Internal Medicine (Ann. Int. Med. 2013;159:471-83). As you can imagine, this is not an easy or comfortable thing. Most patients hate their masks, find them uncomfortable and just don’t wear them.
Another treatment is to have an ENT specialist perform a surgery on the back of your nose and throat to remove excess tissue that block your airways. How nice does that sound?
But all of you know Dr. Dirk. I am going to bring science and common sense in to this. Science – The journal Obesity Surgery (Obes Surg. 2013 Mar;23(3):414-23) published a review of 69 different studies involving 13,900 patients. This study included patients that has the Lap Band®, the Sleeve, the Bypass and the Duodenal Switch. This remarkable review showed that at the very least 75% of patients had significant improvement and even resolution of their sleep apnea. The average weight loss in this review was 75 pounds and the average reduction in BMI (body mass index) was 17 points. The authors concluded that “bariatric surgery is the definitive treatment of choice for sleep apnea”. My personal surgical experience has shown that over 90% of patients with sleep apnea, cure their sleep apnea after obesity surgery. Meaning they do not need a breathing mask, they do not snore and they do not suffer from migraines, fatigue or other conditions related to sleep apnea. Common Sense – if you have the condition of obesity AND sleep apnea what you need is obesity surgery.
The take home message is that is you have the medical condition of obesity AND you have sleep apnea the best treatment to cure both is obesity surgery.