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

Abstract

IntroductionObstructive sleep apnea (OSA) is one of the most important co-morbid conditions related with morbid obesity. Bariatric procedures are associated with significant improvement in OSA. The aim of the current study was to evaluate the effect of bariatric surgery on daytime sleepiness and quality of sleep in patients that had undergone laparoscopic sleeve gastrectomy.MethodsFifty-nine patients were prospectively enrolled in the study. Pre-operative and post-operative (6 months) demographics, medical history, weight, and height of the patients were recorded, and patients were asked to complete Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. OSA screenings were performed using the STOP-Bang questionnaire.ResultsThe mean age of the patients was 37.1 ± 1.2 years and 76% were female. Pre-operative and post-operative median (range) BMIs were 47 kg/m2 (39–67 kg/m2) and 35 kg/m2 (25–44 kg/m2), respectively (P < 0.001). The mean ± standard deviation excess weight loss was 51.6 ± 13.2%. In univariate analysis, total PSQI, STOP-Bang, and ESS scores were found to significantly improve 6 months after surgery (all P < 0.001). Multivariate mixed-model analysis showed a high correlation between the decrease in BMI and all key predictors. Mixed-model analysis revealed that every 1 kg/m2 decrease in BMI was associated with a 0.32, 0.13, and 0.26 improvements in PSQI, STOP-Bang, and ESS scores, respectively (all P < 0.001).ConclusionLaparoscopic sleeve gastrectomy is associated with rapid weight loss and improvements in sleep quality, daytime sleepiness, and the risk of OSA 6 months after surgery.

Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating

“…Nearly 60% of this sample of sleeve gastrectomy patients endorsed poor sleep quality, and for this subgroup, the mean sleep duration was 5.6 hours per night, which falls below the National Sleep Foundation’s recommended 7–9 hours per night [31]. The total PSQI score in the present study ( M = 7.58) was indicative of poor sleep quality at approximately 6 months following surgery and is higher than reported in two previous studies assessing post-operative sleep quality with means of 3.0 (at 3–12 months post-operatively; [11]) and 4.6 (at 6 months post-operatively; [12]), respectively. While these studies found significant post-operative gains in sleep quality such that the mean scores indicated “good” sleep quality [11, 12], our results diverge, suggesting that sleep quality might be worse for post-operative bariatric patients with LOC eating.…”

“…Recently, more attention has been directed towards examining the role of post-surgical sleep duration and quality [10, 11, 12]. For instance, average sleep duration was less in a sample of pre-operative bariatric patients ( M = 6.0 hours) compared with non-obese matched controls ( M = 7.2 hours) however, importantly, improvements in sleep duration ( M = 6.8 hours) and quality up to 12 months post-operatively were observed for the bariatric surgery group [11].…”

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

“…Sleep quality improvement after bariatric surgery has been previously reported [8,18,19]. Obesity is the main risk factor for OSA, a major cause of disturbed sleep and excessive daytime sleepiness in this patient population, and previous studies confirm the effectiveness of obesity surgery for the control the OSA [19,20].…”

When to resume bariatric surgery after COVID-19 pandemic? – results of patients’ and surgeons’ survey.&nbsp;&nbsp;

“…A good example of how important bariatric treatments play a role in improving the quality of life is the problem of Obstructive Sleep Apnea (OSA). Bariatric surgeries reduce the symptoms of OSA and improve sleep quality and daytime sleepiness [12]. Lack of possibility of surgical treatment results in shortened quality adjusted life years.…”