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There is a strong relationship between obesity and the development of obstructive sleep apnea (OSA). Respectively, bariatric surgery is often touted as the most effective option for treating obesity and its comorbidities, including OSA. Nevertheless, there remains paucity of data in the literature of the comparison of all the specific types of bariatric surgery themselves. In an effort to answer this question, a systematic review was performed, to determine, of the available bariatric procedures [Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, or biliopancreatic diversion (BPD)], which procedures were the most efficacious in the treatment of OSA. A total of 69 studies with 13,900 patients were included. All the procedures achieved profound effects on OSA, as over 75 % of patients saw at least an improvement in their sleep apnea. BPD was the most successful procedure in improving or resolving OSA, with laparoscopic adjustable gastric banding being the least. In conclusion, bariatric surgery is a definitive treatment for obstructive sleep apnea, regardless of the specific type.

Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric surgical procedure associated with an acceptable weight loss and a relatively low morbidity. There is existing evidence suggesting bariatric surgery resolves or improves hypertension. The purpose of this study is to systematically review the effect of LSG on hypertension. An electronic search method was primarily used for identification of the studies. We performed a comprehensive search of all electronic databases (MEDLINE, PubMed, Embase, Scopus, Dare, Clinical Evidence, BIOSIS, Previews, TRIP, Web of Science, Health Technology Database, Conference abstracts, clinical trials, and the Cochrane Library database) using broad search terms. All human studies from August 2000 to September 2011 were included. After an initial screening, a total of 326 studies were identified. After assessment of these studies based on our exclusion criteria, 222 studies were considered for the abstract review. A total of 33 studies were identified after a careful screening, involving a total of 3,997 patients. The mean pre-operative body mass index (BMI) was 49.1 ± 7.5 kg/m(2) (range 37-68). The average follow-up time was 16.9 ± 9.8 months (range 12-48). The mean post-operative BMI was 36 ± 7.0 kg/m(2) (range 25.6-54). LSG resulted in resolution of hypertension in 58% of patients. On average, 75% of patients experienced resolution or improvement of their hypertension. Based on our systematic review, LSG has a significant effect on hypertension, inducing resolution or improvement in the majority of cases. Therefore, LSG remains a viable surgical option in obese patients with hypertension.