Effectiveness of CPAP on Obstructive Sleep Apnea in Bariatric Patients

Running head: NURSING RESEARCH
NURSING RESEARCH
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1NURSING RESEARCH
Background
Obstructive sleeping apnea has shown several co-morbidities such as heart failure,
cardiovascular disease, arrhythmia, hypertension, metabolic syndrome and collectively, these
factors lead to stroke (Pinto et al., 2016). The preoperative sleeping disorder for the bariatric
surgical patients raises the factor of the death or near-death condition. Hence, the risk and
liability for these identified critical complications can be analysed with other factors such as the
critical respiratory events and other several risk factors as well. It has been found in a study that
among the general population, at least 9 per cent to 25 per cent people have the complexion of
obstructive sleeping apnea. The factor of sleeping disorder, hypoxia and disoriented breathing
are the factors for the identification of the disease. The possible treatment of this disease is the
implementation of the Continuous Positive Airways pressure (CPAP), and the following PICOT
question would analyse the effectiveness of the procedure:
Does the use of Continuous Positive Airway Pressure (CPAP) (I) reduce postoperative
adverse events (O) of obstructive sleep apnea (OSA) on bariatric patients (P) compared with no-
CPAP (C) or not?
Population= Bariatric patients
Intervention= Continuous Positive Airway Pressure (CPAP)
Comparison= No preoperative use of positive pressure.
Outcome= The number of admissions or length of stay in intensive care.
Time: No adverse event 30 days post-operatively

2NURSING RESEARCH
To analyse the factor of the effectiveness of the CPAP procedure in the Obstructive
sleeping apnea intervention, two articles would be used. The articles are "CPAP in the
preoperative setting: evidence of support” by Chung et al., 2016 (Article 1) and “Death or near-
death in patients with obstructive sleep apnea: a compendium of case reports of critical
complications” by Subramani et al., (Article 2).
Discussion
In article 1, the authors described the risks of the obstructive sleeping apnea and also
provided the statistics that show among the people of Switzerland 49.7 per cent males, and 23.4
per cent female has the disease. They also stated that according to the International Classification
of Disease-9, it has the severity of 7 per cent to 10 per cent. They also stated that the use of
polysomnography would be more effective in the identification of the prevalence of the disease
than using the International Classification of Disease-9 database and the severity could be up to
70 per cent. They also stated that the bariatric surgical patients are under high risk of death for
this disease. The disease can have the relation with other diseases that are cardiovascular disease,
heart failure, stroke, arrhythmia, hypertension and others. According to the authors, preoperative
CPAP used by the obstructive sleep apnea patients showed better sleeping. Whereas the patients
without preoperative CPAP treatment has need postoperative CPAP treatment.
On the other hand, the article 2 stated that the obstructive sleep apnea has the risk of
death or near death condition in the surgical cases. Hence, the studies show that the 60 people
with obstructive sleeping apnea sub-grouped into death and near death condition and critically
respiratory events and 43 people showed the death and near death condition whereas only 12
people have shown the critical respiratory events. Hence, the two articles are discussing risks of