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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Quality of sex life in women with endometriosis and deep dyspareunia.Fertil Steril. 2005; 83: 573-579
- The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres.Hum Reprod. 2012; 27: 1292-1299
- Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries.Fertil Steril. 2011; 96 (366–373.e8)
- Women with deep infiltrating endometriosis: sexual satisfaction, desire, orgasm, and pelvic problem interference with sex.J Sex Med. 2013; 10: 1559-1566
- Anxiety and mood disorders associated with gonadotropin-releasing hormone agonist therapy.Psychopharmacol Bull. 1997; 33: 311-316
- Changes in quality of life after hormonal treatment of endometriosis.Acta Obstet Gynecol Scand. 2001; 80: 628-637
- Depression in women with endometriosis with and without chronic pelvic pain.Acta Obstet Gynecol Scand. 2006; 85: 88-92
- Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis.Eur J Obstet Gynecol Reprod Biol. 2009; 142: 53-56
- Surgical versus low-dose progestin treatment for endometriosis-associated severe deep dyspareunia II: effect on sexual functioning, psychological status and health-related quality of life.Hum Reprod. 2013; 28: 1221-1230
- Sleep Disorders Part I.Elsevier, 2011 (p. 2–685)
- The Pittsburgh Sleep Quality Index (PSQI): a new instrument for psychiatric research and practice.Psychiatry Res. 1989; 28: 193-213
- Sleep disturbance among women with chronic pelvic pain.Int J Gynaecol Obstet. 2014; 126: 232-234
- Pain threshold and sleep quality in women with endometriosis.Eur J Pain. 2015; 19: 15-20
- A gonadotropin-releasing hormone agonist model demonstrates that nocturnal hot flashes interrupt objective sleep.Sleep. 2013; 36: 1977-1985
- Validity of the Italian version of the Pittsburgh Sleep Quality Index (PSQI).Neurol Sci. 2013; 34: 511-519
- Ginsen (gruppo italiano narcolessia studio epidemiologico nazionale). Italian version of the epworth sleepiness scale: external validity.Neurol Sci. 2003; 23: 295-300
- Validation of the Insomnia Severity Index as an outcome measure for insomnia research.Sleep Med. 2001; 2: 297-307
- A new method for measuring daytime sleepiness: the Epworth sleepiness scale.Sleep. 1991; 14: 540-545
- Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile-30.Obstet Gynecol. 2001; 98: 258-264
- Evaluating the responsiveness of the Endometriosis Health Profile Questionnaire: the EHP-30.Qual Life Res. 2004; 13: 705-713
- Measuring quality of life in women with endometriosis: tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile Questionnaire.Hum Reprod. 2006; 21: 2686-2693
- Sleep and pain.Sleep Med Rev. 2001; 5: 385-396
- Sleep deprivation and pain perception.Sleep Med Rev. 2006; 10: 357-369
- High nocturnal body temperatures and disturbed sleep in women with primary dysmenorrhea.Am J Physiol. 1999; 277: E1013-E1021
- Polysomnographic characteristics of sleep disorders in chronic pelvic pain.Prim Care Update Ob Gyns. 1998; 5: 195
- Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents.Depress Anxiety. 2009; 26: 503-512
- Recommendations for the design of epidemiologic studies of endometriosis.Epidemiology. 2000; 11: 654-659
- What makes a good case–control study? Design issues for complex traits such as endometriosis.Hum Reprod. 2002; 17: 1415-1423
- I can’t get no satisfaction: deep dyspareunia and sexual functioning in women with rectovaginal endometriosis.Fertil Steril. 2012; 98 (1503–1511.e1)
Article info
Publication history
Published online: November 29, 2015
Accepted:
November 17,
2015
Received in revised form:
November 9,
2015
Received:
August 10,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. All rights reserved.
