Estudo da função pulmonar, força muscular ventilatória, sono e qualidade de vida em pacientes obesos mórbidos submetidos a cirurgia bariátrica

Abstract

Introduction: The increase in the prevalence of obesity in both developed and developing countries is one of the most serious public health problems and has led to a global epidemic. Objective: The aim of the present study was to assess sleep structure and lung function and quality of life in subjects with morbid obesity before and after bariatric surgery. Methods: The patients were randomly divided into a bariatric surgery group and control group. The clinical evaluation of the subjects was performed at the Sleep Laboratory of the Universidade Nove de Julho (Sao Paulo, Brazil) and consisted of the collection of personal data, heart rate, respiratory rate, peripheral blood pressure, weight, height, body mass index (BMI), measurements of neck and waist circumference, spirometry, manovacuometry, basal nocturnal polysomnography and the administration of the Berlin Questionnaire and Epworth Sleepiness Scale and BAROS questionnaire. Results: Fifty-two patients participated in the present study, 16 of whom underwent PSG before and after bariatric surgery. BMI diminished from 48.15±8.58 to 36.91±6.67 Kg/m2 following surgery. Moreover, significant differences were found between the preoperative and postoperative periods regarding neck and abdominal circumference (p˂0.001and p˂0.001), maximum inspiratory pressure (p=0.002 and p=0.004) and maximum expiratory pressure (p=0.001 and p=0.002) for women and men, respectively, as well as stage 3 of non-REM sleep (p˂0.001), REM sleep (p=0.049) and the apnea-hypopnea index (p=0.008). Conclusion: Bariatric surgery effectively reduces neck and waist circumference, increases maximum respiratory pressures, enhances sleep architecture and quality of life and reduces and/or eliminated obstructive sleep apnea in patients with morbid obesity.