Insomnia is associated with impaired quality of life among bariatric surgery candidates

Little is known about the prevalence or impact of insomnia symptoms in obese individuals pursuing bariatric surgery. The present study from the Rhode Island Bariatric Surgery (RIBS) project examined insomnia symptoms among 2300 individuals pursuing bariatric surgery. Patients were evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID), Schedule for Affective Disorders (SADS), Rhode Island Bariatric Surgery Interview (RIBSI), and the SF-36 as a measure of quality of life. The presence of insomnia symptoms was determined via ratings for the SCID items assessing initial, middle, and terminal insomnia symptoms, and the SADS insomnia item was used to measure severity of insomnia symptoms. Clinical and demographic variables were obtained from the SCID and self-report measures. Insomnia symptoms were endorsed by 25.8% of participants. Bariatric patients with insomnia symptoms were rated as having a more severe clinical presentation and lower functioning, and were more likely to have a history of psychiatric treatment and/or hospitalization, compared to bariatric patients without insomnia. Linear regression analyses demonstrated that insomnia severity was a significant predictor for scores on each of the 8 SF-36 subscales after accounting for age, gender, race, education level, BMI, depression severity, and sleep apnea. Additionally, a multivariate analysis of covariance (MANCOVA) controlling for depression severity and sleep apnea demonstrated significantly poorer scores on 6 of the 8 SF-36 subscales for bariatric patients with current insomnia symptoms. Results revealed that insomnia symptoms are common among bariatric patients and are associated with reduced quality of life and poorer current functioning. This suggests that insomnia symptoms are an important clinical target in bariatric patients prior to surgery.