Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome.
OBJECTIVE
To evaluate sleep quality, sleep-related symptoms, and degree of excessive daytime sleepiness (EDS) in severe obesity, independently of obstructive sleep apnoea syndrome (OSAS).


METHODS
A cross-sectional study.


METHODS
Primary-care setting.


METHODS
Anthropometric parameters, respiratory function data and sleep related symptoms were evaluated in 78 severely obese patients (aged 16-75 years) without OSAS and in 40 healthy sex- and age-matched normal weight subjects, who underwent a full-night polysomnography.


RESULTS
Obese patients and control subjects had similar sleep latency and rapid eye movement (REM) latency, but they showed lower percentage of REM (P < 0.01) and sleep efficiency (P < 0.05) than controls. All sleep-related symptoms (observed or reported apnoea, awakenings, choking and unrefreshing sleep) were significantly more frequent in obese patients than in control subjects. Loud snoring was present in 46.7% of the obese patients and in 8.1% of the control individuals (P < 0.01). Excess daytime sleepiness was reported by 34.7% of the obese patients and by 2.7% of the normal weight subjects (P < 0.01). The Epworth Sleepiness Scale (ESS) was higher in the obese group than in the control group (P < 0.01), whereas arousals were not different between the two groups.


CONCLUSIONS
This study clearly shows that severe obesity, even in the absence of OSAS, is associated with sleep-related disorders and EDS. All these alterations may be partly responsible for a lower quality of life, a higher prevalence of medical complications, an increased risk of occupational injury, and both social and family problems characterizing obese patients, independently of the presence of OSAS.
Resta
O
O
Respiratory Pathophysiology, Department of Clinical Methodology and Medical-Surgical Technologies, University of Bari, School of Medicine, Bari, Italy.
Foschino Barbaro
M P
MP
Bonfitto
P
P
Giliberti
T
T
Depalo
A
A
Pannacciulli
N
N
De Pergola
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology; D012913:Snoring / Q000209:etiology / Q000503:physiopathology