Abstract
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. 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. 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). 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.
Highlights
The growing obesity epidemic has favored the concomitant increase in the prevalence of type 2 diabetes (T2DM) and sleep disorders [1]
The biliopancreatic diversion technique (BPD) has a higher percentage of T2DM remission and sustained weight loss in the long term [6]. In light of these questions, we hypothesized that massive surgical induced weight loss as observed in BPD surgery decreases the level of daytime sleepiness and improves sleep quality after long-term weight loss, as previously demonstrated in Roux-in-Y gastrectomy and sleeve gastrectomy techniques [5,7]
The two obese groups did not differ regarding daytime sleepiness, demonstrating that the presence of T2DM had no influence on Epworth Sleepiness Scale (ESS) (Figure 1)
Summary
The growing obesity epidemic has favored the concomitant increase in the prevalence of type 2 diabetes (T2DM) and sleep disorders [1]. Studies with bariatric surgery have demonstrated improvement in sleep disorders in patients after surgery due to the impact of weight reduction [5]. The biliopancreatic diversion technique (BPD) has a higher percentage of T2DM remission and sustained weight loss in the long term [6]. In light of these questions, we hypothesized that massive surgical induced weight loss as observed in BPD surgery decreases the level of daytime sleepiness and improves sleep quality after long-term weight loss, as previously demonstrated in Roux-in-Y gastrectomy and sleeve gastrectomy techniques [5,7]
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