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August 1984

Obstructive Sleep Apnea in the Morbidly Obese: An Indication for Gastric Bypass

Author Affiliations

From Departments of Surgery (Drs Victor and Sarmiento) and Pulmonary Medicine (Dr Yanta), Scott AFB Medical Center, Scott AFB, Ill, and Department of Surgery, Washington University, St Louis (Dr Halverson). Dr Victor is now with Proudfoot and Associates, Cave Run Clinic, Morehead, Ky.

Arch Surg. 1984;119(8):970-972. doi:10.1001/archsurg.1984.01390200086020

• Two morbidly obese patients were described as having severe obstructive sleep apnea syndrome with several apneic periods occurring during sleep that produced substantial oxygen desaturation and, in one patient, cardiac arrhythmias. These patients, by dieting, had noted specific "trigger" weights at which they would manifest symptoms of lethargy, hypersomnolence, and snoring. Both were treated with tracheostomy, and after several days without apnea their cardiac and respiratory status stabilized and they underwent loop gastric bypass. Successful weight loss ensued and repeated sleep studies disclosed no further apneic periods (with the tracheostomies occluded), and so their tracheostomies were removed. We consider sleep apnea syndrome to be an indication for bariatric surgery.

(Arch Surg 1984;119:970-972)

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