Sintomas alimentares noturnos, qualidade do sono e sintomas depressivos em candidatos a cirurgia bariátrica

Abstract

The Night Eating syndrome (NES), is often elevated in obese but its cause has not been well established. In particular, this condition has not been investigated in Brazil. The objective of this work was investigate the frequency of NES symptoms in candidates for bariatric surgery and assess its implications in sleep quality and depressive symptoms. 100 patients from Bariatric Surgery Outpatient Clinic of a tertiary hospital in Fortaleza were selected, and these night eating symptoms were measured by the Night eating Questionnaire (NEQ), sleep quality by the Pittsburgh Sleep Quality Index (PSQI), the daytime sleepiness by the Epworth Sleepiness Scale (ESS), the depressive symptoms, by Beck Depression Inventory short form and the risk for obstructive sleep apnea by Berlin Questionnaire. It was performed a comparative analysis of the results obtained from patients with night eating symptom scores suggestive of NES. The patients included in the study were predominantly women (76%), with age between 18 and 64 (mean ± SD = 34.8 ± 9.3) years and BMI between 31.3 and 72.4 (46.9 ± 8.5) kg/m². Poor quality sleep (PSQI > 5) was observed in 56 patients, excessive daytime sleepiness (ESS > 10) in 27; depressive symptoms (Beck > 4) in 80 and high risk for obstructive sleep apnea in 73. Seventeen patients showed symptoms suggestive of NES, without difference in age, BMI, degree of daytime sleepiness and risk of sleep apnea in obese when compared to the other patients. The group with symptoms suggestive of NES had a worse sleep quality (9.3 ± 4.9 and 6.6 ± 3.7, p = 0.01) and more depressive symptoms (16, 7 ± 7.6 and 9.5 ± 7.0, p = 0.001) than the other obese. A higher proportion of patients with symptoms suggestive of NES was in use of antidepressants than other patients (29.4 and 10.8%,p = 0.04). These data show that NES symptoms are common in bariatric surgery candidates and their presence is associated with more depressive symptoms and worse quality of sleep. Also, in particular, the high frequency of severe depressive symptoms among patients with a suggestive picture of NES highlights the importance of identifying this condition in the context of specialized services to treat obesity. Further studies on the impact of the NES and its treatment are needed to allow a better approach to this problem.