Effect of Endoscopic Gastric Balloon Insertion on Obstructive Sleep Apnea in Patients With Morbid Obesity
Effect of Endoscopic Gastric Balloon Insertion on Obstructive Sleep Apnea in Patients With Morbid Obesity
To investigate the effect of weight loss by gastric balloon insertion on parameters of
 obstructive sleep apnea.
Most of the patients with obstructive sleep apnea (OSA) are obese. It has been noted that
 significant weight loss could improve the severity of sleep apnea. Significant weight loss is
 difficult to achieve especially in morbidly obese patients. Endoscopic gastric balloon
 insertion is minimally invasive procedure is employed by surgeon for weight reduction for
 morbidly obese patients. This study would assess the parameters of sleep which could be
 affected by weight reduction. If results are positive, this procedure might be considered as
 treatment for obstructive sleep apnea in morbidly obese patients.

 Patient population would be selected from patients who would undergo gastric balloon
 insertion in the surgical department. There would be no sex or age limit. Patient recruited
 would have BMI > 35. Consent would be signed for sleep studies. Baseline sleep study, lung
 function, Epworth Sleepiness Scale (ESS) and quality of life would be assessed in patients
 who have symptoms suggestive of OSA. If a patient is confirmed to have OSA, a continuous
 positive airway pressure (CPAP) titration would be offered if the patient is willing to try
 CPAP. Otherwise patients would be discharged home and wait for balloon insertion. The same
 assessment would be repeated 3 months and 6 months after the surgical procedure. All sleep
 studies would be done as in-patient.

 Leptin and ghrelin are hormones control satiety, which are also related to the degree of
 obesity. Blood for plasma leptin and ghrelin would be taken before and 6 months after gastric
 balloon insertion to assess the relationship of weight reduction by reducing appetite and
 plasma level of the hormones
Inclusion Criteria:

 -  morbidly obese patients with BMI > 30

 -  confirmed obstructive sleep apnea with RDI > 10/hr

 -  able to sign consent

 Exclusion Criteria:

 -  patients undergoing weight reduction surgery

 -  sleep apnea other than obstructive sleep apnea

 -  untreated endocrine disorder

 -  patient refusal