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Adventures in Sleep

Bariatric Patients in the Sleep Lab

Published January 27, 2010 2:05 PM by Amy Reavis

We have several new doctors performing bariatric surgery in our area. As a result, we're seeing an increase in the number of super obese patients in the sleep lab. By and large, this is not a problem. The only real difference in care is they tend to need a fan and many more pillows in order to get comfortable and go to sleep.

However, I've noticed an unsettling trend in their attitude. Many bariatric patients believe they don't need to treat their sleep apnea. They also think they're having a PSG simply for the OSA diagnosis so they can get their surgery. No one has explained to them they really need to treat their apnea and there is no guarantee that once they lose the weight they will be able to come off CPAP.

This is very frustrating. We do our best to provide care and education, but it appears they think bariatric surgery will cure everything.

I should disclose that I personally have considered this surgery and even have chatted with the surgeon. Fortunately, for me and his other patients, he thoroughly explained what to expect and what he expected of me. He described the need for testing and treatment of other conditions before the surgery, including sleep apnea. The surgeon also said this procedure won't be easy and won't cure every heath issue.

What has been your experience with bariatric patients?

1 comments

You're absolutely right...many issues are not resolved with bariatric surgery (been there, done that).  Loss of muscle tone, lingering extra skin etc. will mandate the continued use of cpap.  Many physicians do not delve into these areas as they are not well-versed in the long-range effects of the surgery other than the weight loss and benefits related to HTN, Diabetes etc.  Without the benefit of knowing that the need for cpap may not go away, unrealistic expectations will continue in this patient population and compliance with the need to modify behaviors may suffer.

Brandy, Respiratory Care - Mgr. RCS, ACMC February 2, 2010 6:34 PM
Oakland CA

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    Adventures in Sleep
    Occupation: Sleep technicians
    Setting: Various sleep facilities
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