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Background <p>The frequent co-occurrence of obstructive sleep apnea (OSA) and obesity is driven by shared pathophysiological pathways that significantly amplify cardiometabolic risk. Bariatric and metabolic surgery (BMS) is recognized as the most effective modality for achieving substantial and durable weight loss. This review synthesizes current evidence regarding its impact on sleep-disordered breathing, metabolic parameters, and cardiovascular outcomes.</p> Methods <p>This narrative review is based on a comprehensive analysis of the supplied literature set, prioritizing high-level evidence from systematic reviews, meta-analyses, clinical guidelines, and key original studies published between 2021 and 2025.</p> Results <p>Evidence consistently demonstrates that BMS, primarily sleeve gastrectomy and Roux-en-Y gastric bypass, leads to clinically significant improvements in the apnea-hypopnea index (AHI) and nocturnal oxygenation. However, complete resolution of OSA is not universal, with persistent disease observed in approximately 20–40% of patients postoperatively.BMS also confers substantial benefits for glycemic control, hypertension, dyslipidemia, and non-alcoholic fatty liver disease.Optimal perioperative care for this patient population mandates systematic OSA screening, preoperative CPAP optimization where indicated, opioid-sparing anesthetic techniques, and enhanced postoperative monitoring. Emerging strategies, including novel pharmacotherapies (e.g., GLP-1/GIP receptor agonists) and combination approaches, show promise in augmenting OSA remission but require further validation through rigorous prospective studies.</p> Conclusions <p>BMS is a pivotal therapeutic intervention for patients with obesity and OSA, offering major respiratory and metabolic advantages.Nonetheless, the persistence of OSA in a considerable proportion of patients underscores the necessity for multidisciplinary, long-term management. Future research should focus on identifying predictive biomarkers for treatment response, conducting randomized trials of combined surgical and medical therapies, and standardizing long-term outcome reporting.</p>

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The role of bariatric and metabolic surgery in the management of obstructive sleep apnea and obesity: a narrative review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月2日

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  • Qing Zhou,
  • Yong-fa Zhi,
  • Jin-ke Kang,
  • Huai-yun Zheng,
  • Ming-jie Ma,
  • Xiao-de Ren,
  • Jie Niu,
  • Xingyuan - Yang,
  • Ting Xiang

摘要

Background

The frequent co-occurrence of obstructive sleep apnea (OSA) and obesity is driven by shared pathophysiological pathways that significantly amplify cardiometabolic risk. Bariatric and metabolic surgery (BMS) is recognized as the most effective modality for achieving substantial and durable weight loss. This review synthesizes current evidence regarding its impact on sleep-disordered breathing, metabolic parameters, and cardiovascular outcomes.

Methods

This narrative review is based on a comprehensive analysis of the supplied literature set, prioritizing high-level evidence from systematic reviews, meta-analyses, clinical guidelines, and key original studies published between 2021 and 2025.

Results

Evidence consistently demonstrates that BMS, primarily sleeve gastrectomy and Roux-en-Y gastric bypass, leads to clinically significant improvements in the apnea-hypopnea index (AHI) and nocturnal oxygenation. However, complete resolution of OSA is not universal, with persistent disease observed in approximately 20–40% of patients postoperatively.BMS also confers substantial benefits for glycemic control, hypertension, dyslipidemia, and non-alcoholic fatty liver disease.Optimal perioperative care for this patient population mandates systematic OSA screening, preoperative CPAP optimization where indicated, opioid-sparing anesthetic techniques, and enhanced postoperative monitoring. Emerging strategies, including novel pharmacotherapies (e.g., GLP-1/GIP receptor agonists) and combination approaches, show promise in augmenting OSA remission but require further validation through rigorous prospective studies.

Conclusions

BMS is a pivotal therapeutic intervention for patients with obesity and OSA, offering major respiratory and metabolic advantages.Nonetheless, the persistence of OSA in a considerable proportion of patients underscores the necessity for multidisciplinary, long-term management. Future research should focus on identifying predictive biomarkers for treatment response, conducting randomized trials of combined surgical and medical therapies, and standardizing long-term outcome reporting.