Abstract: Introduction: obesity is the main cause of Obstructive Sleep Apnea (OSA). The Apnea-Hypopnea Index (AHI) evaluates OSA severity. Lost weight effect over AHI remains unclear. Our objective was to study the efficacy of bariatric surgery in terms of AHI reduction, and to stablish predictive variables of efficacy. Patients and methods: retrospective cohort study of patients with OSA undergoing CPAP treatment, in whom bariatric surgery was performed from 01-01-2016 to 01-12-2020. Clinical, polygraphic and surgical variables were collected. A sleep study was carried out before and after the surgery. ?Effective treatment? was defined as a reduction of AHI greater than 50% and below 20/h, or just greater than 50% if AHI was under 20/h at diagnosis. Results: 86 obese patients [BMI 45.46 (±5.05)], 58 female, mean age of 48 years. The mean pre-operative AHI was 47.26 (SD ± 23.78). Vertical gastrectomy was performance in 34.9% of cases, gastric bypass in 36% and Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADIS) in 29.1%. The median post-surgery AHI obtained was 13.23 (±11.66), which was at the limit of statistical significance (p=0.055). The effectiveness of surgery was 72,1%, although CPAP could only be interrupted in 52.4% of cases. Significant statistical differences between technics were not founded. In the multivariate only remained as predictors HT, DM and ODI. Conclusions: weight loss by itself doesn?t achieve OSA healing or allows CPAP withdrawal, but it helps to reduce AHI and therefore therapeutic pressures for a correct OSA control.

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