Abstract
Background
Sleep disturbance is well established in individuals with obesity, and the relationship
between poor sleep and obesity is supported by population, longitudinal, experimental,
and intervention studies. However, the prevalence and characteristics of poor sleep
in individuals seeking bariatric surgery have thus far been poorly examined.
Objectives
We sought to characterize self-reported sleep parameters in individuals seeking bariatric
surgery and to compare these data with controls.
Setting
Two Academic Medical Centers, United States, and an online survey of healthy controls.
Method
Individuals seeking bariatric surgery (n = 427) completed presurgical psychological
evaluations at 2 comprehensive bariatric surgery programs. Data on medical co-morbidities
and from self-report questionnaires on sleep quality, insomnia, anxiety, and depression
were abstracted from charts. Data from controls (n = 180) were collected using an online survey tool and compared with bariatric cases.
Results
Across study sites, 40.4% of bariatric cases took at least 30 minutes to fall asleep,
46.7% had insufficient total sleep time (<6.5 hr), 65.1% reported general poor sleep
quality, and 30.8% reported clinically significant insomnia symptoms. Approximately
20% of the variance in poor sleep quality and insomnia was explained by body mass
index, obstructive sleep apnea, anxiety, and depression. Cases and controls were similar,
although bariatric cases reported significantly poorer sleep efficiency.
Conclusions
Our results suggest that similar to a control population, the majority of patients
seeking bariatric surgery are experiencing sleep difficulties. Presurgical assessment
and treatment of sleep problems may be beneficial to patients and may help improve
weight loss treatment outcomes. Optimally, assessment would include 1 of the 2 self-report
questionnaires used herein, and treatment would involve Cognitive Behavioral Therapy
for Insomnia. Future research assessing sleep patterns with objective measurement
tools and evaluating the impact of sleep on postsurgical outcomes is warranted.
Key words
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Article info
Publication history
Published online: March 17, 2020
Accepted:
March 3,
2020
Received:
June 21,
2019
Identification
Copyright
© 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
