Sleeve gastrectomy in patients with severe obesity restores circadian rhythms and their relationship with sleep pattern

ABSTRACT

Advances in research have linked alterations of circadian rhythms with obesity. However, few studies have focused on the recovery of the circadian expression after a weight loss treatment. Our aim was to study the alterations of the circadian rhythmicity due to morbid obesity and the recovery of the circadian pattern after weight loss in a cohort of patients who underwent sleeve gastrectomy. For this purpose, 41 patients with severe obesity (75% women; age [mean (SD)] 49.7 ± 10 years; BMI 44.3 ± 6.2 kg/m2) were monitored before bariatric surgery and 9 months afterward. On both occasions, activity and wrist temperature were determined by actigraphy and were related with weight loss. Anthropometric, biochemical, and sleep-related variables, along with dietary intake and physical activity, were analyzed in relation with circadian rhythmicity. Results show significant differences in the circadian expression before and after 9 months of bariatric surgery, with more stable and less fragmented rhythms after weight loss. Moreover, only after surgery were the circadian variables associated to sleep timing and chronotype. The findings of this study indicate that weight loss treatment in patients with morbid obesity improves the circadian rhythm expression, and in such a way that it could be associated with better sleep quality. Moreover, it allows the recovery of the relationship between sleep patterns and circadian rhythm that was lost due to the obesity.

KEYWORDS:

• Obesity
• circadian rhythm
• circadian alterations
• wrist temperature
• actigraphy
• bariatric Surgery

Acknowledgements

MFZR was supported by a scholarship from the ‘Consejo Nacional de Ciencia y Tecnologia’ CONACYT from Mexico.

Author contributions

CB, MIP and TC designed the study; CB and JFC acquired the data; CB, ADN MFZR and TC analyzed the data; CB and TC wrote the first draft; TC, ADN, MFZR and MIP revised the manuscript. All authors read and approved the final manuscript.