J Neurogastroenterol Motil.  2021 Oct;27(4):602-611. 10.5056/jnm20135.

Internet Survey of Japanese Patients With Chronic Constipation: Focus on Correlations Between Sleep Quality, Symptom Severity, and Quality of Life

• Yamamoto S
• Kawamura Y
• Yamamoto K
• Yamaguchi Y
• Tamura Y
• Izawa S
• Nakagawa H
• Wakita Y
• Hijikata Y
• Ebi M
• Funaki Y
• Ohashi W
• Ogasawara N
• Sasaki M
• Maekawa M
• Kasugai K

• KMID: 2521164
• DOI: http://doi.org/10.5056/jnm20135

Abstract

Background/Aims
Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population.
Methods
This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor). Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors.
Results
The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (allP < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep.
Conclusions
Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.

Keyword

Constipation; Irritable bowel syndrome; Quality of life; Sleep disorders