Sleep apnea is a common sleep disorder in which people experience difficulty in
breathing while they are lying or sleeping. In obstructive sleep apnea (OSA), the
most common type of sleep apnea, occurs because of a narrow or blocked airway,
which is similar to the breathing from a straw.

Not only can excess weight causes OSA, but it can worsen the symptoms and can
cause health effects. Lack of sleep may also lead to weight gain. It is proven many
times, weight loss results improves sleep apnea.
Several health conditions increase the chances of developing OSA, but it is most
common in people who are overweight or obese. Overweight creates fat deposits
in an individual’s neck called pharyngeal fat which can block one’s upper airway
during sleep, when the airway is already relaxed which is why snoring is one of
the most common OSA symptom.

Additionally, increased abdominal girth from excess fat can compress one’s chest
wall, decreasing lung volume which further reduces the lung capacity decreases
the airflow, making the upper airway more likely to collapse during sleep. OSA risk
continues to increase with weight gain. Less common causes of sleep apnea
includes:- enlarged tonsils that blocks the airway, anatomical features such as a
large neck or narrow throat, endocrine disorders (including diabetes and thyroid
disease), acid reflux, lung diseases, and cardiac problems. However, roughly 60%
– 90% of adults with OSA are overweight or obese.

Can Bariatric Surgery resolve Sleep Apnea?

Most of the patients lose between 50 and 80 percent of their excess body weight
12 to 18 months following the bariatric surgery. When obese patients lose weight,
the fatty tissue around the upper airway is decreased which can decrease the
upper airway collapse that occurs with sleep apnea. The weight loss you achieve
can only be sustained when one sticks to the dietary changes and regular physical
activity. After the surgery, patients typically notice a significant improvement in
their sleep apnea symptoms – less snoring if or when not using CPAP machine)
and less daytime sleepiness – within the first three months post bariatric surgery.
By one year after surgery, about 80 to 85 percent of patients experience
remission of sleep apnea and can stop using CPAP. It is difficult for the patients to
maintain their weight loss, as regaining certain amount of weight will likely to
cause sleep apnea. Bariatric surgery also helps resolve related health conditions in
more than 75 percent of cases. Patients also experience a 30% – 40 % reduced
chance of sleep apnea. Effects of bariatric surgery on airway obstruction in obese
patients have a larger amount of fatty tissue around their upper airways. When
the obese people go to sleep, the muscles of the body, including the throat,
relaxes and the surrounding weight of the soft tissue partially or completely
collapses the upper airways. After the surgery, reduction of surrounding fat allows
the airway to open which corrects sleep apnea.

Dt. Mahima Bansal

Clinical Therapeutic & Bariatric Dietitian