Objective:
To examine sleep behaviors and their associations with health characteristics in a cohort of adolescents with severe obesity undergoing bariatric surgery at Children’s Hospital Colorado.
Methods:
A retrospective chart review of electronic medical records was performed. All patients receiving care at the Children’s Hospital Colorado (CHCO) Bariatric Surgery Center between 06/17-08/19 were included. Demographic, medical and family history, self-reported sleep behaviors, and laboratory measures were abstracted, including medical problem list (e.g., type 2 diabetes (T2D), hypertension) and body mass index (BMI). A sleep behavior risk score (SBRS) was developed using five criteria (short sleep defined as <8 hrs/night, variability of sleep timing greater than 60 minutes, daytime naps, bedtime past midnight, and mobile devices in bed). Participants were classified as having a high SBRS if they met three or more of the criteria. T-tests were used to examine the differences between baseline health characteristics by SBRS score.
Results:
Data from 78 patients, aged 16.82.1, were reviewed. The majority of patients were female (71%), Hispanic (52%) and in 10-12
th
grade in school (64%). Prior to surgery, 24% of the patients were diagnosed with hypertension and 20% with type 2 diabetes. The majority of patients (60%) had a high SBRS at baseline. High SBRS was significantly associated with higher baseline BMI (49.2 vs 45.0; p=0.03). SBRS score was not significantly associated with diagnosis of hypertension, type 2 diabetes, hyperlipidemia, or obstructive sleep apnea.
Conclusions:
In a population of adolescents seen in the Bariatric Surgery Center at CHCO, a majority of patients met criteria for high risk sleep behaviors, and worse sleep behaviors preoperatively were related to higher baseline BMI. A high SBRS may adversely impact adolescents’ overall health prior to surgery, which may have implications for weight loss success post-surgery. The evaluation for sleep health should be more rigorously evaluated and standardized as part of efforts to improve health outcomes in patients undergoing bariatric surgery.