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Evaluation of Sleep Quality in Morbidly Obese Adolescents Seeking Bariatric Surgery
October 2013, Vol 144, No. 4_MeetingAbstracts Sleep Disorders | October 2013
Evaluation of Sleep Quality in Morbidly Obese Adolescents Seeking Bariatric Surgery Abigail Strang, MD; Thao-Ly Phan, MD; George Datto, MD; Aaron Chidekel, MD A.I. duPont Hospital for Children, Wilmington, DE Chest. 2013;144(4_MeetingAbstracts):1001A. doi:10.1378/chest.1703272
Abstract SESSION TITLE: Sleep Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM PURPOSE: Evidence suggests poor sleep quality is associated with weight gain. The objective of this study was to evaluate the quality of sleep in a cohort of morbidly obese adolescents seeking bariatric surgery. METHODS: This cross-sectional analysis was conducted using baseline polysomnograms of 45 morbidly obese adolescents (mean age 16.4 years, 84% female, 53% Caucasian, mean BMI 52.1 kg/m2, and mean neck circumference [NC] 39.0 cm) enrolled from 2007 to 2012 in an FDAapproved study of the LAP-BAND® Adjustable Gastric-Banding System. All studies were conducted in the same AASM-accredited sleep laboratory. Descriptive statistics were calculated to characterize the measures of sleep. Pearson’s correlation coefficient and t-tests were calculated to measure the association between demographic and anthropometric variables and sleep quality. RESULTS: Mean total sleep time (TST) was 373 (±76.4) minutes. 91% of patients demonstrated reduced sleep efficiency; mean sleep efficiency was 73 (±15)%. Mean time in slow-wave sleep (SWS) was 17.7 (±10.1)%, and mean time in REM was 14.8 (±7.3)%. The mean arousal index (AI) was 30.1 (±18.9) events/hr. Mean sleep and REM latencies were 43.4 (±38.8) and 163.4 (±87.3) minutes, respectively. BMI was associated with time in SWS (r= 0.38, p<0.01). NC was associated with TST (r= -0.35, p<0.05), sleep efficiency (r= -0.35, p<0.05), REM latency (r= 0.34, p<0.05) and AI (r= 0.33, p<0.05). Sleep onset latency was worse in males compared to females by 32 minutes (p<0.05). Sleep efficiency was worse in Caucasians compared to African-Americans by 10.8% (p<0.05). AI was associated with age (r= 0.32, p<0.05). CONCLUSIONS: The majority of morbidly obese adolescents seeking bariatric surgery in this study demonstrated poor sleep quality. BMI, NC, male gender, Caucasian race, and increased age were associated with poorer sleep quality. CLINICAL IMPLICATIONS: This study demonstrates a lack of adequate, restorative sleep in morbidly obese adolescents. Because poor sleep quality is associated with weight gain, this study
highlights the importance of sleep assessment as part of any weight management program for this population. DISCLOSURE: The following authors have nothing to disclose: Abigail Strang, Thao-Ly Phan, George Datto, Aaron Chidekel No Product/Research Disclosure Information
Evaluation of Sleep Quality in Morbidly Obese Adolescents Seeking Bariatric Surgery Abigail Strang, MD; Thao-Ly Phan, MD; George Datto, MD; Aaron Chidekel, MD A.I. duPont Hospital for Children, Wilmington, DE Chest. 2013;144(4_MeetingAbstracts):1001A. doi:10.1378/chest.1703272
Abstract SESSION TITLE: Sleep Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM PURPOSE: Evidence suggests poor sleep quality is associated with weight gain. The objective of this study was to evaluate the quality of sleep in a cohort of morbidly obese adolescents seeking bariatric surgery. METHODS: This cross-sectional analysis was conducted using baseline polysomnograms of 45 morbidly obese adolescents (mean age 16.4 years, 84% female, 53% Caucasian, mean BMI 52.1 kg/m2, and mean neck circumference [NC] 39.0 cm) enrolled from 2007 to 2012 in an FDAapproved study of the LAP-BAND® Adjustable Gastric-Banding System. All studies were conducted in the same AASM-accredited sleep laboratory. Descriptive statistics were calculated to characterize the measures of sleep. Pearson’s correlation coefficient and t-tests were calculated to measure the association between demographic and anthropometric variables and sleep quality. RESULTS: Mean total sleep time (TST) was 373 (±76.4) minutes. 91% of patients demonstrated reduced sleep efficiency; mean sleep efficiency was 73 (±15)%. Mean time in slow-wave sleep (SWS) was 17.7 (±10.1)%, and mean time in REM was 14.8 (±7.3)%. The mean arousal index (AI) was 30.1 (±18.9) events/hr. Mean sleep and REM latencies were 43.4 (±38.8) and 163.4 (±87.3) minutes, respectively. BMI was associated with time in SWS (r= 0.38, p<0.01). NC was associated with TST (r= -0.35, p<0.05), sleep efficiency (r= -0.35, p<0.05), REM latency (r= 0.34, p<0.05) and AI (r= 0.33, p<0.05). Sleep onset latency was worse in males compared to females by 32 minutes (p<0.05). Sleep efficiency was worse in Caucasians compared to African-Americans by 10.8% (p<0.05). AI was associated with age (r= 0.32, p<0.05). CONCLUSIONS: The majority of morbidly obese adolescents seeking bariatric surgery in this study demonstrated poor sleep quality. BMI, NC, male gender, Caucasian race, and increased age were associated with poorer sleep quality. CLINICAL IMPLICATIONS: This study demonstrates a lack of adequate, restorative sleep in morbidly obese adolescents. Because poor sleep quality is associated with weight gain, this study
highlights the importance of sleep assessment as part of any weight management program for this population. DISCLOSURE: The following authors have nothing to disclose: Abigail Strang, Thao-Ly Phan, George Datto, Aaron Chidekel No Product/Research Disclosure Information