Sleep quality and duration before and after bariatric surgery

Abstract

Background: Shortened sleep duration causes hormonal and metabolic changes that favor fat accumulation and weight gain. Obesity, in turn, may reduce sleep quality and contribute to sleep loss. The purpose of this study was to evaluate the sleep durations of individuals with morbid obesity, compared to their nonobese counterparts, and to determine the effects of surgical weight reduction on sleep duration and sleep quality.

Methods: The study population included 45 bariatric (BA) surgical patients (mean body mass index [BMI] = 49) and 45 gender-matched nonobese controls (NC; BMI = 24). Self-reported sleep durations were obtained and overall sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).

Results: The data show that average sleep durations of the preoperative BA patients were significantly (p < 0.0001) less than those of the NC, i.e., 6.0 and 7.2 h, respectively. Sleep loss for the BA patients was associated with poor sleep quality, along with an increased frequency of conditions that interfere with sleep, including coughing and snoring, difficulty breathing, feeling too hot, and experiencing pain. Overall, 78% of the BA patients, compared to 36% of the NC, had PSQI scores indicative of poor sleep quality. Surgery after 3 to 12 months resulted in significant (p < 0.0001) weight loss (percentage total change in BMI = 34) and improved sleep quality, i.e., PSQI = 8.8 preoperatively vs. 4.6 postoperatively. Sleep durations increased significantly (p < 0.0001) post-surgery from 6.0 to 6.8 h.

Conclusions: Individuals with extreme obesity, compared to the nonobese, obtain less sleep and experience poorer sleep quality. Bariatric surgery improves sleep duration and quality.