Sleep problems among women with noncancerous gynecologic conditions

Abstract

Objective: To estimate the prevalence of and identify factors associated with poor sleep quality and short sleep duration among women with noncancerous gynecologic conditions.

Study design: We conducted a cross-sectional analysis of 838 pre-menopausal women aged 31–54 who enrolled in a study of pelvic problems, hysterectomy and intervention alternatives in 2003/2004. Primary outcomes were poor sleep quality and short sleep duration (six or less hours on average) in the four weeks preceding the interview; hypothesized correlates included sociodemographic characteristics, pelvic problem impact, measured by the Pelvic Problem Impact Questionnaire (PPIQ), and depression, measured by the Patient Health Questionnaire (PHQ).

Results: One-third (33.7%) of the participants reported having poor sleep quality and nearly half (46.8%) reported short sleep duration. In multivariable models, women with major depressive disorder were more likely than those who were not depressed to experience poor sleep quality (adjusted odds ratio (aOR) 4.15, 95% confidence interval (CI) 2.36–7.28, p < 0.001). Women with higher PPIQ scores also were more likely to experience poor sleep quality (aOR 1.59, 95% CI 1.27–1.98, p < 0.001) and short sleep duration (aOR 1.37, 95% CI 1.11–1.69, p < 0.003). Finally, women who self-identified as African-American (aOR 2.81, 95% CI 1.83–4.32, p < 0.001) or Asian/Pacific Islander (aOR 2.32, 95% CI 1.32–4.09, p < 0.003) were more likely than White women to have short sleep duration.

Conclusions: Sleep problems are prevalent among women with noncancerous gynecologic conditions, and are associated with depression and high pelvic problem impact. Providers should be proactive in inquiring about and offering solutions for sleep difficulties experienced by their patients.

• Depression
• gynacological pain
• mental health
• noncancerous gynecologic conditions
• sleep

Current knowledge on the subject

• Sleep problems are known to be common in the American population, particularly in patients with chronic diseases, including diabetes, cardiovascular disease, obesity and depression.

• Women are more likely to have difficulty falling and staying asleep than men, and biological changes during a woman’s life cycle, such as pregnancy and menopause, are also known to be associated with sleep problems.

What this study adds

• The literature on the prevalence of sleep problems among women who are receiving gynecological care is scant.

• We believe the results of this study can help providers that care for women with non-cancerous gynecologic conditions improve their patient’s quality of life by staying alert to sleep difficulties they may be experiencing and being proactive in inquiring about and offering solutions for these difficulties.