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A Surgeon’s Perspective: Sleep Apnea in People with Morbid Obesity

By Carl A. Weiss, III, MD PhD FACS

 

A very common condition associated with morbid obesity is sleep apnea. This has been estimated to occur in as many as 90% of people who are struggling with their weight. Common complaints include fatigue and headaches. Those with sleep apnea will even fall asleep while speaking with us during their office visits. Sleep apnea is also thought to directly contribute to worsening metabolic problems such high blood pressure and diabetes.

 

One of the frequent beneficial effects of successful weight loss surgery is that patients notice improved energy. They sleep better and wake up feeling rested and refreshed. This may be related directly to an improvement in sleep quality. One way to think about sleep is to consider whether or not we achieve high quality or low-quality rest. Low quality sleep tends to occur during frequent episodes of low oxygen saturation which leads to wakefulness. Lack of rest then leads to daytime fatigue. High quality sleep seems to be much more common after weight loss surgery during which patient's experience restful sleep and awaken with new-found energy. Patients who are able to invest this newly found energy into exercise in conjunction with good eating habits clearly are those who have the best chance for significant and long-standing weight loss success.

 

In simple terms, the difference between low and high-quality rest is directly impacted by weight loss surgery. After surgery, many patients need to have their sleep apnea machines titrated or readjusted downwards or even discontinued after weight loss surgery since supplemental oxygen needs diminish over time.