Bariatric surgery

OSA is more prevalent in the obese. Bariatric surgery is an effective method to reduce and maintain longer-term weight loss. The additional benefits of weight loss on comorbidities associated with obesity, such as cardiovascular risk factors and cancer, as well as relative reduction in death has resulted in the increased popularity of bariatric surgery in the obese population. Many trials demonstrate a greater beneficial effect of bariatric surgery over lifestyle modification for weight loss, as well as for OSA severity and metabolic outcomes. However, this is not a universal finding. Despite significant reductions in OSA severity, very few patients are cured of OSA following bariatric surgery hence post-operative polysomnography may be necessary prior to cessation of CPAP. Furthermore, ongoing diet and behavioural modification is necessary to maintain the significant weight loss achieved with bariatric surgery.