Sleep Changes Through Weight Loss 2 Years after Adjustable Gastric Banding
July 20, 2012
Dr. Mark A. Fusco, founder of LifeShape Advanced Bariatric Center of Florida, has been published in the Journal of Sleep and Sleep Disorders* regarding sleep changes through weight loss two years after Adjustable Gastric Banding surgery. The paper was presented at the 26th Annual meeting of the Associated Professional Sleep Societies (APSS) in Boston. Ted Okerson MD, FACP, and Christopher Cornell PhD coauthored the study with Dr. Fusco.
"The study mirrored other studies that similarly showed improvement in sleep apnea after Lap-Band surgery. Interestingly, the study also showed that even patients that were not identified as having sleep apnea preoperatively experienced a significant improvement in their sleep related quality of life,” stated Dr. Fusco.
Obesity is one of several factors associated with an increased risk of obstructive sleep apnea (OSA) and several studies have reported that weight loss through laparoscopic adjustable gastric banding (LAGB) can effectively resolve this condition and improve patient quality of life (QOL). This study reports the resolution/improvement of OSA and improvements in sleep-related QOL after surgical placement of the LAP-BAND® AP (LBAP; Allergan).
The APEX study is an ongoing 5-year, prospective, observational study assessing weight reduction, co-morbidity changes and QOL after LBAP implantation. This is an interim analysis of subjects with evaluable data at 24 months who had OSA prior to LAGB surgery (all data being last observation carried forward).
At baseline, 117/395 (29.6%) of subjects [mean body mass index (BMI) of 44.9 kg/m2] reported OSA; of these, 57 had evaluable patient reported outcome data at 2 years. At 1 year, 36% of subjects had resolution or improvement of OSA; at 2 years, this proportion increased to 86%, with 14% reporting no change. The mean BMI at 2 years for those that resolved or improved was 35.7 kg/m2, representing a 20.2% loss of body weight. Subject populations reporting resolution, improvement, or no change in OSA experienced mean changes in BMI and % weight loss of -9.7/-21.7, -8.3/-18.7 and -5.7/-13.2, respectively (n=54). Mean 2 year BMI was not statistically significantly different between the resolved, improved and no change groups (p=NS; one-way ANOVA). Compared to baseline, mean scores for all Epworth Sleepiness Scale (ESS) responses for the OSA population improved, ranging from -0.10 (sitting and talking to someone) to -0.65 (being a passenger in a motor vehicle for an hour or more without a break). The overall mean change in score across all questions in the ESS for the OSA group was -0.43 (p<0.0001; n=78) compared to -0.29 for subjects who did not have OSA at baseline (n=177), with the difference between the two groups being statistically significant (p=0.037). In addition to OSA benefits, the overall study population experienced resolution and/or improvement in other obesity-related co-morbidities such as type 2 diabetes (96%) and hypertension (91%).
These data support that surgically-facilitated weight loss can affect the resolution or improvement of OSA and sleep-related QOL; the degree of weight loss may be related to these changes.
"LifeShape has an ongoing commitment to clinical research. Obesity continues to be such a significant issue, it is important to continue to increase our understanding of this disease and its treatments. We also feel that our involvement in research helps us to keep track of our results so we can continually improve our program," explained Dr. Fusco.
As Founder of LifeShape Advanced Bariatric Center of Florida located in Melbourne, Dr. Mark A. Fusco specializes in Laparoscopic Gastric Band surgery. LifeShape Advanced Bariatric Center of Florida is a full service multidisciplinary weight loss center offering physician supervised medical weight loss programs, personalized fitness training in private state-of-the-art gym, and surgical treatment. With a highly trained team of surgeons, internal medicine doctors, nurses, nutritionists, personal trainers, and psychologists, LifeShape is able to provide patients with a safe and effective weight-loss surgery, comprehensive pre- and post-operative education and ongoing aftercare. LifeShape is located at 1223 Gateway Drive, Suite 2B, Melbourne, FL 32901. 321-728-7553
*Journal of Sleep and Sleep Disorders Research Volume 35, 2012