slide 1: Overcome Snoring and Sleep Apnea
In general reliable and substantial Slim Down Sleep Review weight loss usually not achieved by
dietary means can be accomplished by bariatric surgery with accompanying major reductions in
associated co-morbidities. Two operative approaches are commonly performed: vertical-banded
gastroplasty VBG and Roux-en-Y gastric bypass. The loss of weight may be as much as 100 to
150 pounds within a year. The mechanism of this weight loss is twofold: decreased food intake
coupled with its malabsorption. This is because of the reduction in the size of the stomach as well as
the rerouting of food to the small intestine which reduces the calories and nutrients absorbed by the
body. In general mean weight loss is greater after gastric bypass than after VBG.
Weight loss achieved by bariatric surgery has been reported to be associated with significant long-
term improvements in obstructive respiratory events oxygenation and resolution of daytime
somnolence. Bariatric surgery may significantly reduce breathing interruptions during sleep and
reduce snoring. A possible mechanism for amelioration of symptoms is that weight loss is
associated with a reduction in upper airway collapsibility and that resolution of sleep apnea depends
on the absolute value to which the upper airway critical pressure falls.
To clinically diagnose OSA and define its severity though sleep medicine doctors use the "apnea-
hypoxia index" and those with mild OSA have 5-14 episodes of apnea-hypoxia an hour while OSA
is said to be severe if the number of apnea-hypoxic episodes per hour exceeds 30. There are no clear
cut guidelines for determining which patients of OSA are ideal candidates for bariatric surgery.
Sleep apnea is one of the criteria used to support the medical necessity of bariatric surgeries even
those with moderate obesity BMI≥35 could be a candidate if their surgeon is convinced that they
have a "serious obesity-related morbidity such as obstructive sleep apnea." Therefore if surgery is
considered the patient should be evaluated by a multidisciplinary team that incorporates medical
nutritional and psychological care and proper counseling regarding its risk benefit ratio.
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