Impact of sleep disorders and related anxiety and depression on 126 patients with chronic constipation

Abstract

Objective To investigate the impact of sleep disorders and related anxiety and depression on the somatic symptoms and quality of life (QOL) in patients with chronic constipation (CC). Methods From January 2014 to June 2015, adult outpatients with CC were enrolled. A questionnaire survey was conducted among them, including demographic information, constipation symptom, constipation scoring system (CSS), patient assessment of constipation symptom (PAC-SYM), Pittsburgh sleep quality index (PSQI), generalized anxiety disorder-7(GAD-7), patient health questionnaire-9 (PHQ-9), patient assessment of constipation quality of life (PAC-QOL) and 36-item short form of health survery (SF-36). According to PSQI scores, patients were divided into sleep-disorder group and normal-sleep group. The impact of sleep disorders on common symptoms, somatic symptoms, psychological condition and disease/health-related QOL was analyzed. Chi-square test, t test, nonparametric statistical comparison test and Spearman correlation analysis were used for statistical comparison between the two groups. Results In 126 CC patients, 59 patients were in sleep-disorder group, 67 patients were in normal-sleep group. The incidences of incomplete defection and feeling of anus blocking of sleep-disorder group (84.7%(50/59), 72.9%(43/59), respectively) were both higher than those of normal-sleep group (61.2%(41/67), 55.2%(37/67), respectively), and the differences were satistically significant (χ2=8.674, 4.220, both P 0.05). The CSS scores, PAC-SYM total score and rectum symptom score of sleep-disorder group were all higher than those of normal-sleep group (Z=-2.155, t=2.025, Z=-2.853, all P 0.05). However, the scores of seven dimensions of SF-36 of sleep-disorder group were significantly lower than those of normal-sleep group (Z=-2.551, -2.959, t=-5.038, Z=-3.700, -3.328, -2.193, -3.475, all P<0.05). Furthermore, symptom of constipation (CSS), severe degree of constipation (PAC-SYM) and related life quality of constipation (PAC-QOL) were all positively correlated with scores of GAD-7 and PHQ-9 (all P<0.05). And scores of GAD-7 and PHQ-9 were negatively correlated with health-related quality of life (SF-36) (all P<0.05). Conclusion Sleep disorders and related anxiety and depression may aggravate the clinical symptoms of CC patients, and further more impair their constipation-related and health-related quality of life. Key words: Sleep disorders; Chronic constipation; Depression; Anxiety; Quality of life