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SLEEP DISTURBANCE: A PREVALENT CONDITION ASSOCIATED WITH DIGESTIVE DISEASES
S Dhaliwal, D Armstrong, R Hunt
Division of Gastroenterology, McMaster University, Hamilton, Ontario
Aims: There is increasing recognition of the association between gastroesophageal reflux disease (GERD) and sleep disturbance. However, there are few data on sleep disturbance in patients with other digestive diseases (DD), especially in comparison with healthy subjects. We, therefore, sought to establish the prevalence of self-reported sleep disturbance in patients attending a tertiary care, DD clinic and in healthy community-based, control subjects.
Methods: Patients referred to gastroenterologists in a tertiary care, DD clinic completed a standardized questionnaire before they were seen in consultation. The questionnaire recorded subjects' demographics, gastrointestinal (GI) history, GI symptom frequency and severity, sleep history, sleep and arousal patterns, sleep disturbance frequency and symptoms that interrupted sleep. The same questionnaire was administered to a control population of healthy subjects recruited in a community setting (shopping mall).
Results: In all, 205 DD patients (female: 113 [55.1%], male 92 [44.9%]; mean age 51 yrs [min-max: 15-93 yrs]) and 201 control subjects (female: 120 [59.7%], male 81 [40.3%]; mean age 39 yrs [min-max: 18-80 yrs]) were recruited. The percentages (95% CI) of subjects with sleep disturbance are shown in the table. Of the DD patients, 45.9% (38.9 to 52.9) reported that their GI symptoms were worse at night than during the day. Sleep disturbances occurring at least 2 to 3 times per week affected 30.7% (24.6 to 37.6) of all DD patients, 35.3% (20.3 to 53.5) of GERD, 55.6% (31.4 to 77.6) of irritable bowel syndrome (IBS) and 27.3% (11.6 to 50.4) of inflammatory bowel disease (IBD) patients. Overall, DD patients went to bed earlier, woke up more during the night, woke up tired, suffered morning headaches, had difficulty concentrating during the day and felt sleepy when driving, more often than healthy subjects.
Conclusions: Sleep disturbance is highly prevalent in DD patients, regardless of their GI diagnosis, although patients with upper and lower GI disorders report different GI symptoms associated with their disturbed sleep. The high prevalence of sleep disturbance in patients with digestive disorders merits further study to determine its effect on patient symptomatology, health-related quality of life and safety when driving.