Obstructive sleep apnea in the morbidly obese. An indication for gastric bypass
D. W. Victor Jr, C. F. Sarmiento, M. Yanta and J. D. Halverson
Two morbidly obese patients were described as having severe obstructive
sleep apnea syndrome with several apneic periods occurring during sleep
that produced substantial oxygen desaturation and, in one patient, cardiac
arrhythmias. These patients, by dieting, had noted specific "trigger"
weights at which they would manifest symptoms of lethargy, hypersomnolence,
and snoring. Both were treated with tracheostomy, and after several days
without apnea their cardiac and respiratory status stabilized and they
underwent loop gastric bypass. Successful weight loss ensued and repeated
sleep studies disclosed no further apneic periods (with the tracheostomies
occluded), and so their tracheostomies were removed. We consider sleep
apnea syndrome to be an indication for bariatric surgery.
