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Sleep concerns

J

Jniz

Member
Yet another question hopefully someone here can relate with my sleep struggle. My surgery date should be no more than 3 months from now (covid timetable) And, I’m concerned with sleep after WLS.

About 20 years ago I did a sleep study and at that time I was close to 320 Lbs. I was diagnosed with severe apnea fortunately it is now mild. The CPAP made a drastic change in my life and I lost about 30 lbs without trying. If anyone has sleep issues and hasn’t done so yet please schedule a sleep study it may change your life!!

While the cpap made a big difference in my life I still struggle with sleep rarely sleeping more than 6 hours a night avg 5. My struggle with sleep is worse if I don’t eat a fair amount of food before bedtime without eating too much. But, going to bed with what I’m told I will be eating after surgery makes me nervous. Will my sleep problem be even worse? Can anyone relate to what I’m asking?

In the past I tried Ambien and Lunesta and in time they both quit working for me. Has anyone used prescription sleep aids after surgery and how long do you have to wait after WLS? I plan on asking the Dr. if I can take a prescription sleep aid after WLS surgery temporarily? Melatonin doesn’t work for me however; I do think magnesium helps.

J
 
It is possible that after surgery you might not have that hunger that awakens you or keeps you from going to sleep. Try not to assume it will be a problem. I use to want to eat late at night before too or if I woke up but I don't do that anymore. I have no knowledge about sleeping aids so I can't help you there. I just wanted to give you a little hope that it might not be an issue. Fingers crossed!
 
Thank-you to each and everyone who post on this website and who respond to my questions!!

Sorry for the lengthy response but would like some feedback from someone post-surgery who can relate to my journey and offer some insight after my surgery.

Over the years I have tried the aids you mentioned in your post. Melatonin was the common response whenever I sought outside advice from the professionals as well as many friends who know of my sleep struggles. My experience with melatonin is varied with doses ranging from 1 to 10mg over a ten-year period as well as timed release. My conclusion is the side effects for me are simply not worth it for the minimal gain in sleep. Benadryl is absolutely a last resort for me the hang-over feeling last well into the next day. After all the hype about using magnesium glycinate for help with sleep and, consulting with my Dr. about 6 month ago I started taking 500mg daily. Within a few weeks it was clear my sleep time while not extended my frequency of waking up in the first 4 to 5 hours of sleep was reduced.

Several months ago, I spoke with my Dr. about my sleep issues (mostly not long enough) and she suggested I try the generic for Ambien 5mg. I was dubious because about 15 years ago my insurance would no longer pay for Ambien and they put me on Zolpidem and despite the pharmacist insistence it was exactly the same as Ambien it was not the same for me. I have not used many prescriptions beside sleeps aids over the years but this was my only experience where a generic did not work for me. It has been implied that this is simply a psychosomatic response on my part I strongly disagree. At that point the Ambien had not been working as well and my Dr took me off the Zolpidem and put me on Lunesta. Lunesta worked great for the better part of a year then it became clear to me the side effects were starting to outweigh the benefits. About that time, I read several credible articles about prescription sleep aids. What I gleaned from these articles is when used long term most people experienced diminishing returns and would benefit more from intermittent use. My insurance helped make up my mind they decided they would not pay for the Lunesta and at that time there was no generic option.

The Zolpidem 5mg is not extending my duration of sleep at this point. Does anyone have any experience with timed released prescription aids? I have a virtual meeting with my doc next week to discuss this. I function okay most days but often times I’m extremely tired in the afternoon. It became clear to me years ago my routine for sleep needs to be consistent. I follow the professional’s advice for bedtime no electronic before bed and consistency with my routines it does help.


J
 
I sleep better post surgery. I have never been a good sleeper largely because I am a vivid dreamer and multi times a night I would jolt awake from dreams and then be awake for a couple hours.

Post surgery, while I am still a vivid dreamer I find the more weight I have lost the better I sleep. I fLl asleep quicker and deeper then I normally would. There are several nights I dont wake at all.

I am not a fan of prescription sleep aids as they can make you do some weird things- walk, drive, eat ect and not even know it. I also can not do melatonin as I feel hung over for hours the next day.

First is it possible that your body naturally doesn't require as much sleep to function? On nights that I can't sleep i will play the CALM app as I fall asleep. Mindfulness practices before bed can help. The need to be full before bed in order to sleep is something you have taught your brain and it can also be broken. Part of the pre work for surgery is re learning healthy eating.
 
I appreciate your response and it is reassuring to hear that you sleep better post-surgery.

Over 10 years ago when my work-life was stressful I tried different types of white noise and soothing music and did not experience any benefit. But I am in a different place in my life now that I’m retired it is definitely worth another go.

I clearly have many bad habits around food and, while there are improvements there are numerous unhealthy habits to improve upon!!
 
I think I'm sleeping better post surgery as well. There is actually a lot of evidence that food eaten close to bedtime actually decreases the quality of sleep. Something to keep in mind is that length of sleep does not necessarily equal quality sleep. Of course, we get into habits and routines and that can have an effect too.

Post surgery is actually a good time to potentially change up the routine to something new because of the phased eating approach and the reduce amount of food you'll be eating. I know it is really hard to imagine. It was hard for me to imagine, but it's a great time to try some new things. That doesn't mean you'll miracuously have an easier time sleeping, but it might be easier to develop new habits.

Interestingly, there was a 3 year study on post-bariatric surgery sleep aid use compared to people who lost weight without surgery. The WLS patients seemed to actually have an increased use of prescription sleep aids as compared to the non surgery weight loss group. There were a few theories on this, such as malabsorption of RNY decreased the effectiveness, or the potential of addiction transfer from food/alcohol/substance addiction to sleep aids, or that due to the higher rate of alcohol/substance abuse that occurs post surgery also led to more sleep issues and a higher dosage need. Basically, they don't know. There was no evidence that the change in BMI had any correlation with the increased dosage requirements of the sleep aid.

I've always been a fairly early riser, but I seem to wake up earlier more often since surgery than I had before, sometimes significantly earlier and I can't just get back to sleep. That being said, I feel like the quality of my sleep is much better. I've been using a CPAP for 12 years-ish and I know that helped my sleep quality, but as I've lost weight, I also think that has helped, especially since it seems my CPAP is being used at a much lower pressure than it was pre-surgery. I recently had a new sleep study with mixed results. When I sleep on my side, my AHI is 5.8, which is just a smidge above normal (0-5 being the normal range), but when I sleep on my back, my AHI is 72, which is insane. Anything over 30 is considered "severe" My average AHI was about 16, which is "moderate" so that meant I was sleeping on my side more than my back, which brought my average down. I don't really mind the CPAP, but I hate travelling with it, so I'm looking into a special pillow that will keep me on my side and a dental insert instead of CPAP. The dental insert apparently lowers AHI about about 12, so it would definitely get me onto the normal range when sleeping on my side.

Sorry...rambling. I hope your sleep improves post surgery without any sleep aids!!
 
I have decided not to follow up with my appointment and will do my best W/O using any sleep aid meds outside of magnesium.

Once again, I sooooooo appreciate all the information posted on this website!! I meet with the surgeon next week and have much more informed relevant questions for him because of all of you. Not to mention all your shared personal experiences which will help me on my journey.
 
I've been using a cpap for about 6 years. About 6 months ago I started waking up to pee, then would be wide awake, try to go back to sleep, couldn't, and would get up. I was averaging 3-4 hrs of sleep; some nights, 2 hrs. My sinuses were blocked when laying down; that was part of the problem. My sleep dr put me on nasal sprays flonase and azelastine; and trazodone as a sleeping pill - I take 20mg at bed time.

I don't know why the insomnia developed. The trazodone makes me go to sleep and I've started sleeping a little better. With the nasal sprays, my nose is clear and I can breath through it. I've been forcing myself back to bed even when I feel awake, and I almost always go back to sleep. I'm trying to get over 5 hours a night and I think I'm making progress. The downside - I doze in my chair a lot during the day.

So I feel for everyone out there who has sleep problems.
 
mmitti said:
I've been using a cpap for about 6 years. About 6 months ago I started waking up to pee, then would be wide awake, try to go back to sleep, couldn't, and would get up. I was averaging 3-4 hrs of sleep; some nights, 2 hrs. My sinuses were blocked when laying down; that was part of the problem. My sleep dr put me on nasal sprays flonase and azelastine; and trazodone as a sleeping pill - I take 20mg at bed time.

I don't know why the insomnia developed. The trazodone makes me go to sleep and I've started sleeping a little better. With the nasal sprays, my nose is clear and I can breath through it. I've been forcing myself back to bed even when I feel awake, and I almost always go back to sleep. I'm trying to get over 5 hours a night and I think I'm making progress. The downside - I doze in my chair a lot during the day.

So I feel for everyone out there who has sleep problems.
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I use an app called relax melodies. There are some things that cost, but a lot is free. It has a section for insomnia and getting back to sleep.
 
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