Longitudinal changes in positive airway pressure device use after metabolic surgery: a 3-year matched cohort study of National Claims Data.

Background: Metabolic surgery (MS) is the most durable treatment of obesity and can treat obstructive sleep apnea (OSA).

Objectives: To compare trajectories of positive airway pressure (PAP) device use between individuals who had MS and similar individuals who did not have MS (non-MS).

Setting: Merative MarketScan Research Databases - a US-based commercial claims database.

Methods: Those who underwent MS were matched 1:1 with nonoperative controls on baseline demographic and health characteristics. PAP use trajectories were examined in the 3years after the index dates and stratified by baseline PAP use.

Results: A total of 8772 adults who had MS were matched with 8772 adults who did not have MS; in both groups, 17.3% had baseline PAP claims. Among individuals who had baseline PAP claims, those who had MS had significantly higher rates of PAP use cessation (58.9% versus 27.1%; P value < .01). Among individuals who were not using a PAP at baseline, PAP initiation was higher among those who did not have MS than those who had MS (10.8% versus 2.6%; P value < .01).

Conclusions: MS was associated with discontinuation of PAP use and decreased initiation of PAP use among individuals who were not using these devices, suggesting that MS leads to symptomatic and preventive treatment for OSA.