Weight loss surgery for obstructive sleep apnoea with obesity in adults: a systematic review and meta-analysis protocol

Introduction Obstructive sleep apnoea (OSA) is caused
by complete or partial obstruction of the upper airway
resulting in repeated episodes of interrupted or shallow
breaths. OSA is associated with significant morbidity and
mortality. The prevalence is estimated to range from 3%
to 7% in the general population but may be much higher.
Several studies show that weight loss or bariatric surgery
may have a role in treating OSA. The aim of this systematic
review is to assess the safety and efficacy of randomised
controlled trials (RCTs) of weight loss surgery for adults
with OSA and comorbid obesity.
Methods and analysis A search of the Cochrane Central
Register of Controlled Trials, PubMed, EMBASE and two
major Chinese biomedical databases will be performed
to identify related trials published as of October 2018.
This study will include RCTs, comparing different types
of weight loss surgery for OSA with obesity or weight
loss surgery for OSA with obesity with other upper airway
surgeries. The primary outcomes that will be measured
are apnoea–hypopnoea index, excess weight loss and
in-hospital mortality. The secondary outcomes will
include duration of hospital stay, neck circumference,
reoperation, waist circumference, body mass index,
Epworth Sleepiness Scale score, overt complications
(eg, gastric fistula, bleeding, delayed gastric emptying,
wound infection), quality of life, quality of sleep and/or
functionality. The systematic review will be conducted
according to the recommendations as outlined by the
Cochrane collaboration.
Ethics and dissemination The systematic review and
meta-analysis will include published data available online
and thus ethics approval will not be required. The findings
will be disseminated and published in a peer-reviewed
journal. Review updates will be conducted if there is
new evidence that may cause any change in review
conclusions. Any changes to the study protocol will be
updated in the PROSPERO trial registry accordingly.