Abstract
BackgroundAlongside obesity, insomnia and depression are common public health problems. Sleep problems are currently believed to be associated with excessive food intake and metabolic disturbances. Therefore, we aimed to explore a relationship between insomnia, depressive symptoms and eating habits as well as metabolic parameters in bariatric surgery candidates.MethodsA total of 361 unrelated obese subjects were included in this study. Severity of sleep problems was measured with Athens Insomnia Scale (AIS) and the severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Obstructive sleep apnea (OSA) was assessed by the Apnea Hypopnoea Index (AHI). Information was obtained about demographics, eating habits and lifestyle. Blood samples were collected to measure concentration of lipids (cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol), and glucose.ResultsThe median (interquartile range) score for AIS in the study participants was 5 (3–8) with a range of 0–24 and 47% (171) participants scored ≥6 (met criteria for diagnosis of insomnia). Statistically significant correlations were found between the AIS scores and serum triglycerides and glucose concentrations, and BDI-II total scores. The highest scores on AIS and BDI-II were found in participants with high frequency of snack food consumption, in physically inactive individuals as well as in those who self-reported eating at night or who declared more than 3 intense emotions associated with a desire-to-eat. Adjusted multivariate logistic regression analysis revealed that clinical insomnia was most strongly associated with daily consumption of snack foods, with the odds ratio of 3.26 (95% CI: 1.74–6.11), while depressive symptoms were strongly associated with both eating in response to ≥3 specific emotions with OR = 2.93 (95% CI: 1.26–6.78) as well as with daily consumption of snack foods with OR = 2.87 (95% CI: 1.16–5.14).ConclusionsThe results indicate that insomnia and depression in obese individuals are associated with eating habits, and suggest that in some patients these associations appears as major factors affecting obesity development.
Highlights
Alongside obesity, insomnia and depression are common public health problems
To measure the number of specific emotions associated with a desire-to-eat we used items developed with language similar to that used in the Emotional Overeating Questionnaire (EOQ) [44]; we focused on the most commonly experienced emotions according to the previous research [45, 46]
Out of 436 severely obese individuals who agreed to participate in this study and provided informed consent, 361 subjects successfully completed the Athens Insomnia Scale (AIS) and Beck Depression Inventory (BDI-II), and returned all other questionnaires; a response rate was 83%
Summary
Insomnia and depression are common public health problems. Sleep problems are currently believed to be associated with excessive food intake and metabolic disturbances. The effectiveness of obesity treatment based on reduction of food intake and increase in energy expenditure is low, both at population and patients’ levels [2]. In a cross-sectional study in Japanese females poor sleep quality was found to be significantly associated with consumption of energy drinks and sugar-sweetened beverages, skipping breakfast, and eating irregularly [7]. This finding suggests that unhealthy food habits may be associated with insomnia symptoms, and prospective weight gain in individuals with sleep disorders. Nocturnal snacking was associated with greater depressive symptoms and it was shown that the nocturnal snacking was higher among the bariatric surgery candidates than among participants from general community [20]
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