Sleep is necessary to live a balanced and healthy lifestyle. Having good sleep patterns reduces stress, aids in hormone and neurotransmitter production, increases energy and enhances mood.
Obstructive sleep apnea (OSA) is a sleep disorder characterized by repeated interruptions in breathing. Being overweight and obese can affect sleep apnea, as 70% of patients with OSA are obese.
Bariatric surgery significantly boosts sleep quality and quantity and can alleviate sleep-related comorbidities such as snoring, sleep apnea, obstructive sleep apnea, and breathing problems.
Why is Sleep Quality Important?
Lack of restful sleep has many negative effects, both physically and psychologically. Sleep deprivation is also a common contributing factor in the development of obesity. Even though sleep is a sedentary activity (i.e., it doesn’t burn calories), it is responsible for improving metabolism, coping with stress, reducing hunger, and increasing activity levels.
Insufficient sleep can contribute to an increase in weight, and being overweight can cause poor sleep quality. Sleep health is linked to:
- Chronic fatigue
- High blood pressure
- Cardiovascular disease
- Immune function
- Diabetes
How well you are sleeping translates to more energy, focus, stress management, and problem-solving capabilities, improving your health and quality of life.
About Sleep-Related Comorbidities
When you sleep, the muscles in your neck relax. Those with obesity have excess weight in their neck, which puts pressure on their neck muscles. This causes your throat to close, blocking your airways and preventing breathing. Symptoms of this condition sometimes go unnoticed, but some signs include:
- Loud snoring.
- A choking sensation that awakens you from sleep.
- Unexplained extreme tiredness during the day.
Many people who have sleep apnea do not know they have it. That is because when your body notices you stopped breathing, it temporarily wakes you up so that the muscles are tense again, allowing you to breathe. Most people immediately fall back asleep, forget they were ever awake, and the cycle repeats.
Sleep-related comorbidities are sleep problems that can cause significant health issues. The inability to sleep causes great difficulty for the individual, including the inability to breathe correctly. This can make it hard for the person to sleep well, and lack of sleep can cause health problems such as a low immune system, inability to recover from illness, inability to control cognitive thinking, and much more. Individuals that are unable to sleep well because they have trouble with correct breathing patterns can also cause strain on the heart and, in some cases, stroke.
Symptoms of Sleep-Related Comorbidities
- Tired all the time
- Have trouble focusing during the day
- Don’t feel well often
- Can’t sleep at night
- Waking up during sleep due to snoring or sudden inability to breathe
How Obesity Affects Sleep Quality
Many factors affect getting a good night’s sleep, and many different ways for obesity to disrupt the ability to sleep. For example, those struggling with obesity may have a more difficult time getting
comfortable. Many people put their bodies under more stress, and stress is known to decrease sleep quality. Obesity can also lead to concurrent conditions, like heartburn, which negatively impacts sleep quality.
Perhaps the most common way that obesity interferes with sleep is sleep apnea. Sleep apnea is a common condition in those with obesity among adults as well as teenagers. The research shows that the incidence of obstructive sleep apnea is around 70% in obese adolescents (body mass index above 30), and this figure is even greater at higher body mass index.
Treatment Options
CPAP machines (continuous positive airway pressure): are placed over the mouth and nose when the individual is sleeping. The machine forces the air through the body so that the individual is forced into a proper breathing pattern when asleep.
Polysomnography (PSG) study: A board-certified sleep physician can perform this study and prescribe Inspire implantable device and oral appliance therapy (OAT).
Surgery to the Nose: relieves the pressure that might be there. Not all individuals are right for surgery, and a professional physician must consider it carefully.
Weight loss surgery: this is an option only for those that fit the individual criteria for being an excellent candidate for surgery and lifestyle changes.
Surgery as a Cure
While surgical intervention certainly seems to improve an individual’s overall well-being and allows them to rest better, there is no definitive proof that it will cure sleep-related comorbidities. This said, most individuals who find weight loss surgery successful also find that their sleep-related issues seem to subside. This would suggest that the surgery is a good start in helping an individual to find better overall health and improved sleep. Most patients find that as the weight comes off, they start to have a full night of sleep more often without problems. Many patients will eliminate the need for CPAP machines and other devices when they sleep shortly after the weight begins to drop. This is clear evidence that the operation and lifestyle changes significantly impact how an individual suffering from obesity sleeps.
Improved Sleep Quality After Weight Loss Surgery
When an individual is overweight, their body mass can put tremendous pressure on the lungs and esophagus. This can mean major problems with breathing, particularly in a horizontal position. Obesity leads to poor sleep quality, and losing weight can help improve sleep. Those who undergo bariatric surgery would most likely see this benefit because weight loss surgery improves sleep-related comorbidities.
A study in 2012 looked at 45 bariatric surgery patients and found that after weight loss surgery, patients reported getting both more sleep and better quality sleep than before surgery. Another NCBI study, which looked specifically at the gastric sleeve, found that 6 months after surgery, patients improved sleep quality and reduced daytime sleepiness.
There has also been some evidence that suggests that obese individuals that have trouble with their glucose levels also have trouble with sleep. The two go together, and one without the other can cause significant damage. Once bariatric surgery has been conducted, there is a chance that the pressure on the body and the body’s changes in overall health, glucose production, and general ability to process can improve the individual’s sleep abilities.
Since better sleep is also correlated with increased energy and faster metabolism, this better quality sleep may also contribute to additional weight loss and better health.
Weight Loss Surgery Candidates
Not everyone is a good candidate for weight loss surgery procedures such as gastric sleeve (VSG), endo sleeve (ESG), and RNY gastric bypass. Individuals that will fit the criteria will have an obesity weight of over 100 pounds overweight. They will have significant sleep-related comorbidities and have tried other methods to lose weight with little or no success. The individual will need to be in good overall health to bare the surgery and the recovery. They will need to be willing to make major lifestyle changes for the surgery to be effective. This includes approaching food in a new healthier way, exercising according to the guidelines of the physician, and an overall approach to being committed to a better way. These individuals will have the best success and will be the best candidates for getting the weight loss surgery they seek.
If you are considering bariatric surgery, your physician will need to understand your current weight circumstances, look at the plans and attempts you have made to lose weight in the past, check out your medical history, and discuss what the surgery means to your overall life. The right candidate will be prepared to meet with others to go over proper nutrition and be ready to make overall changes to how life is handled as it relates to health and fitness.
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