Feasibility of at-home continuous overnight pulse oximetry for obstructive sleep apnea screening in bariatric surgery candidates.

ABSTRACT

PURPOSE: Screening for obstructive sleep apnea (OSA) is recommended in patients scheduled for bariatric surgery because continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA reduces postoperative complications. However, cardiorespiratory polygraphy (CRP) and polysomnography (PSG) are expensive and time-consuming. The present study aimed to assess whether at-home continuous overnight pulse oximetry can be used to diagnose moderate-to-severe OSA in patients scheduled for bariatric surgery. METHODS: In this prospective observational study, we enrolled consecutive patients scheduled for bariatric surgery. Patients with no prior OSA diagnosis were evaluated using the ESS, SBQ, and preoperative at-home CRP. Correlations were calculated between AHI and oximetry parameters. For each oximetry parameter, a receiver-operating characteristic (ROC) curve was generated to identify optimal cut-off values for diagnosing moderate-to-severe OSA. RESULTS: In total, 117 patients were included. The oxygen desaturation index was the most correlated oximetry parameter; the optimal cut-off value for diagnosing moderate-to-severe OSA was 23.9. The sensitivity and specificity were 80 and 92%, respectively. The area under the ROC curve was 0.935. CONCLUSIONS: At-home continuous overnight pulse oximetry could be used to screen moderate-to-severe OSA in patients scheduled for bariatric surgery because it would allow clinicians to implement early CPAP therapy and avoid preoperative PSG or CRP.