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Symptomatic endometriosis of the posterior cul-de-sac is associated with impaired sleep quality, excessive daytime sleepiness and insomnia: a case–control study

  • Umberto Leone Roberti Maggiore
    Affiliations
    Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genova, Italy

    Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
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  • Nicolò Bizzarri
    Affiliations
    Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genova, Italy

    Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
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  • Carolina Scala
    Affiliations
    Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genova, Italy

    Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
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  • Emanuela Tafi
    Affiliations
    Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genova, Italy

    Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
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  • Gabriele Siesto
    Affiliations
    Department of Gynaecology, IRCCS Humanitas Clinical and Research Centre, Via Alessandro Manzoni 56, 20089 Rozzano (Milan), Italy
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  • Franco Alessandri
    Affiliations
    Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino-IST, Largo R. Benzi 10, 16132 Genova, Italy
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  • Simone Ferrero
    Correspondence
    Corresponding author at: Unit of Obstetrics and Gynecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genoa, Italy. Tel.: +39 010 511525; fax: +39 0108932843; Mobile: +39 3477211682.
    Affiliations
    Academic Unit of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, Largo R. Benzi 10, 16132 Genova, Italy

    Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy
    Search for articles by this author
Published:November 29, 2015DOI:https://doi.org/10.1016/j.ejogrb.2015.11.026

      Abstract

      Objective

      To assess the impact of endometriosis of the posterior cul-de-sac on quality of sleep, average daytime sleepiness and insomnia.

      Study design

      This age-matched case–control study was conducted in a tertiary referral centre for the diagnosis and treatment of endometriosis between May 2012 and December 2013. It included 145 women with endometriosis of the posterior cul-de-sac (cases; group E) and 145 patients referred to our Institution because of routine gynaecologic consultations (controls; group C). This study investigated whether sleep is impaired in patients with endometriosis of the posterior cul-de-sac. Sleep quality, daytime sleepiness and insomnia were assessed using the following self-administered questionnaires: the Pittsburgh Sleep Quality Index, the Epworth sleepiness scale and the Insomnia Severity Index, respectively. The primary objective of the study was to evaluate sleep quality in the two study groups. Secondary outcomes of the study were to assess average daytime sleepiness and insomnia in the two study groups.

      Results

      The prevalence of poor sleep quality was significantly higher in group E (64.8%) than in group C (15.1%; p < 0.001). The prevalence of excessive daytime sleepiness was significantly higher in group E (23.4%) than in group C (12.9%; p = 0.033). Patients of group E experienced subthreshold insomnia (29.0%) and moderate clinical insomnia (16.6%) significantly more frequently than patients in group C (24.4% and 5.0%; p = 0.002).

      Conclusion

      A substantial proportion of women with endometriosis of the posterior cul-de-sac experiences poor sleep quality, excessive daytime sleepiness and insomnia.

      Keywords

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