Poster Presentation ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017

Change in use of sleep medications after gastric bypass surgery or intensive lifestyle treatment in obese adults (#239)

Winda L Ng 1 2 3 4 , Anna Peeters 3 4 , Ingmar Näslund 5 , Johan Ottosson 5 , Kari Johansson 1 , Claude Marcus 6 , Jonathan E Shaw 2 4 , Gustaf Bruze 1 , Johan Sundström 7 , Martin Neovius 1
  1. Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
  2. Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  3. School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
  4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro , Sweden
  6. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  7. Department of Medical Sciences, Uppsala University, Uppsala, Sweden

Background:

Obesity is associated with sleep problems and use of sleep medications. Intentional weight loss is known to improve a range of sleep problems, but its effect on use of sleep medications is unknown. We aim to examine the change in use of hypnotics/sedatives in two obese cohorts; one undergoing gastric bypass surgery, and the other intensive lifestyle modification.

Methods:

Obese adults who underwent gastric bypass surgery or initiated intensive lifestyle modification between 2007 and 2012 were identified through the Scandinavian Obesity Surgery Registry and a Swedish commercial weight loss database, respectively. The two cohorts were matched on body mass index (BMI), age, sex, education, history of hypnotics/sedatives use, and treatment year (surgery n=20,626; lifestyle n=11,973; 77% women, mean age 41 years, mean BMI 41kg/m2). The proportion of participants with filled hypnotics/sedatives prescriptions, and the mean annual treatment dose (Defined Daily Doses (DDDs)), were compared yearly for 3 years.

Results:

In the matched treatment cohorts, 4% had filled prescriptions for hypnotics/sedatives during the year before treatment. At 1 year follow-up, following an average weight loss of 37kg and 18kg in the surgery and intensive lifestyle cohorts respectively, this proportion had increased to 7% in the surgery cohort but remained at 4% in the intensive lifestyle cohort (risk ratio 1.7, 95%CI 1.4-2.1), at 2 years 11% vs 5% (risk ratio 2.0, 95%CI 1.7-2.4), and at 3 years, 14% vs 6% (risk ratio 2.2, 95%CI 1.9-2.6). Among individuals with filled hypnotics/sedatives prescriptions prior to treatment, the mean annual treatment dose increased more in the surgery than the intensive lifestyle cohort (114 vs 67 DDDs during year 3; mean difference 57 DDDs; 95%CI 39-75).

Conclusions:

Gastric bypass surgery was associated with increased use of hypnotics/sedatives compared to intensive lifestyle modification. Use of sleep medications after gastric bypass surgery needs to be closely monitored.