Background <p>This study aimed to assess the effectiveness of bariatric surgery in improving symptoms of sleep-related outcomes among obese patients suffering from obstructive sleep apnoea. </p> Methods <p>This retrospective cohort study analysed prospectively collected clinical records of patients with a symptomatic diagnosis of obstructive sleep apnoea (OSA), who later underwent bariatric surgery (sleeve gastrectomy or mini-gastric bypass) at the Department of General Surgery at Jinnah Postgraduate Medical Centre (JPMC), Karachi, between 2018 and 2023. Preoperative and postoperative (6 weeks and 3 months) follow-up records were reviewed to extract information on OSA-related clinical features, including apnoea status (yes/no), loud snoring (yes/no), daytime sleep bouts (yes/no), and the number of nighttime waking events. Data were analysed using SPSS version 23, and paired-sample t-tests and McNemar’s test were applied. A p-value &lt;0.05 was considered statistically significant.</p> Results <p>A total of 150 patients were included with equal gender distribution (50% male, 50% female) and a mean body mass index (BMI) of 47.8 ± 8.5 kg/m². At baseline, all patients (100%) were diagnosed as having obstructive sleep apnoea (OSA) based on symptomology. All patients showed complete clinical improvement of OSA-related symptoms by 6 weeks, which persisted at the 3-month follow-up, as assessed by the study questionnaire. Marked reductions were also noted in loud snoring and daytime sleepiness. Furthermore, the average number of waking up events at night decreased significantly by 0.66 ± 2.12 events at six weeks and by 3.09 ± 1.89 events at three months postoperatively (p &lt; 0.001).</p> Conclusions <p>Bariatric surgery showed significant improvement in sleep quality and led to marked clinical improvement and symptom-based remission of OSA-related manifestations within 3 months of follow-up</p>