Effect of biliopancreatic diversion on sleep quality and daytime sleepiness in patients with obesity and type 2 diabetes

Abstract

Objective: The poor quality of sleep and the deprivation thereof have been associated with disruption of metabolic homeostasis, favoring the development of obesity and type 2 diabetes (T2DM). We aimed to evaluate the influence of biliopancreatic diversion (BPD) surgery on sleep quality and excessive daytime sleepiness of obese patients with T2DM, comparing them with two control groups consisting of obese and normal weight individuals, both normal glucose tolerant. Subjects and methods: Forty-two women were divided into three groups: LeanControl (n = 11), ObeseControl (n = 13), and ObeseT2DM (n = 18). The LeanC and ObeseC groups underwent all tests and evaluations once. The ObeseT2DM underwent BPD and were reassessed after 12 months. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were applied before and 12 months after BPD. Results: Before surgery, there was less daytime sleepiness in LeanC group (p = 0.013) compared with ObeseC and T2DMObese groups. The two obese groups did not differ regarding daytime sleepiness, demonstrating that the presence of T2DM had no influence on daytime sleepiness. After surgery, the daytime sleepiness (p = 0.002) and the sleep quality (p = 0.033) improved. The score for daytime sleepiness of operated T2DMObese group became similar to LeanC and lower than ObeseC (p = 0.047). Conclusion: BPD surgery has positively influenced daytime sleepiness and sleep quality of obese patients with T2DM, leading to normalization of daytime sleepiness 12 months after surgery. These results reinforce previously identified associations between sleep, obesity and T2DM in view of the importance of sleep in metabolic homeostasis, quality of life and health. Arch Endocrinol Metab.2017;61(6):623-7

Effect of Lifestyle Modification Module on Patients’ Compliance Postoperative Bariatric Surgery

“…This is because patients stated that the recommended instructions about sleep and rest after bariatric surgery in the module was easy and simple to applied and followed. This enhances quality, duration of sleep and improves obstructive sleep apnea, and body posture.This result is consistent with Mello et al who stated that bariatric surgery have demonstrated improvement in sleep disorders in people after surgery due to the impact of weight reduction [19] .…”

Perfil Clínico-Epidemiológico Da Sonolência Diurna Excessiva Quanto a Sua Avaliação Por Intermédio Da Aplicação De Escalas Subjetivas Do Sono: Escala De Sonolência De Epworth E Índice De Qualidade Do Sono De Pittsburgh

“…Por outro lado, dada a relevância do sono na homeostase metabólica e a associação entre a qualidade do sono, obesidade e DM2, um estudo feito pelo Laboratório de Investigação em Metabolismo e Diabetes (LIMED), em parceria com o Departamento de Cirurgia Bariátrica e Metabólica, ambos provenientes da Universidade Estadual de Campinas (Unicamp), avaliaram a sonolência diurna excessiva e a qualidade do sono em indivíduos obesos com DM2, comparandoos com dois grupos de controle, 42 mulheres na pré-menopausa que compuseram os seguintes grupos: 11 voluntárias com peso normal (LeanC) (IMC = 23,2 kg / m 2 ) com tolerância normal a glicose (NGT); 13 voluntárias obesas (ObeseC) (IMC = 35 ± 5 kg / m 2 ) com NGT; 18 voluntárias obesas (T2DMObese) (IMC = 35 ± 5 kg / m 2 ) com DM2 submetidas à cirurgia de Desvio Bileopancreático (DBP) (MELLO et al, 2017).…”

“…A extremidade proximal do íleo foi anastomosada de 80 a 120 cm de distância do válvula ileocecal. O comprimento total de absorção intestinal foi reduzido para 280-300 cm, cujos 80-120 cm foram chamados canal comum final (MELLO et al, 2017).…”

“…Os principais resultados foram: 1) indivíduos obesos, independentes da presença de DM2, apresentaram maior sonolência diurna do que pacientes com peso normal e tolerância normal à glicose; 2) a DBP diminuiu a sonolência diurna e melhorou a qualidade do sono; 3) indivíduos operados apresentaram normalização da sonolência diurna, com escores semelhantes ao LeanC e reduzidos em relação ao ObeseC (MELLO et al, 2017).…”