Does Surgically Induced Weight Loss Improve Daytime Sleepiness?

Abstract

Morbid obesity is associated with excessive daytime sleepiness and reduced health-related quality of life. We prospectively evaluated the pre- and postoperative responses of bariatric surgery recipients with the Epworth Sleepiness Scale (ESS) and the Short Form-12. Participants (n = 223; 79% women) with a mean body mass index (BMI) and ESS of 44.8 ± 7.9 kg/m(2) and 7.9 ± 4.5, respectively, received a vertical gastrectomy (76%) or Roux-en-Y gastric bypass (12%). Preoperatively, 30% of patients complained of excessive daytime sleepiness (ESS > 10). Patients with preoperative excessive daytime sleepiness were more obese (p = 0.002), had higher fasting glucose levels (p = 0.02), more likely to have a diagnosis of sleep-disordered breathing (p < 0.001), report snoring (p < 0.001), and had lower health-related quality of life measures particularly physical function (p < 0.001), depression (p = 0.006), and sexual satisfaction (p = 0.04) than non-sleepy patients. At 12-months postoperatively, most patients experienced a significant reduction in BMI (28.6 ± 5.5 kg/m(2), p < 0.001) and excessive daytime sleepiness (mean ESS 5.3 ± 3.3, p < 0.001). Patients with a clinically relevant improvement in the ESS at 12-months post-operatively had greater improvements in physical function (p = 0.009) and snoring (p = 0.010) and were more likely still using positive airway pressure therapy (p = 0.032) than patients without a clinically relevant improvement. Statistically and clinically significant improvements in all health-related quality of life measures were noted at 24 months. Bariatric surgery is associated with dramatic weight loss and improvements in physical functioning and daytime sleepiness.

Obesity, Hypersomnolence, and Quality of Sleep: the Impact of Bariatric Surgery

“…The majority of the subjects in the present study showed an improvement in excessive daytime sleepiness after surgery, in agreement with previous investigations [22][23][24]. It has been suggested that the decrease in hypersomnolence after bariatric surgery may be related to an improvement in nocturnal sleep, secondary to the reduction in OSA, as mentioned above, although other factors, such as a reduction of metabolic and inflammatory abnormalities, could also play a role [9,25,26].…”

Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin’s lymphoma: a report from the Childhood Cancer Survivor Study

“…Such sleepiness is routinely associated with obesity in otherwise healthy individuals [39-41], and weight management strategies are a common treatment approach in the general population [42]. Our results suggest that weight reduction in HL survivors may not only improve physical functioning but also excessive daytime sleepiness.…”

Laparoscopic Sleeve Gastrectomy Improves Excessive Daytime Sleepiness and Sleep Quality 6 Months Following Surgery: A Prospective Cohort Study

“…In a previous study, Holty et al [ 41 ] described significant reductions in mean ESS scores 24 months after bariatric surgery; however, in that study the operation of choice was vertical gastrectomy and Roux-en-Y gastric bypass. In the current study, the authors found that the 6-month post-operative mean ESS scores after sleeve gastrectomy were significantly reduced from 9.0 ± 4.6 to 3.5 ± 2.2 ( P < 0.001).…”