Association Between Excessive Daytime Sleepiness and Functional Gastrointestinal Disorders: A Population-based Study in China

BACKGROUND/AIMS: Several studies have demonstrated that sleep problems are associated with functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional dyspepsia, etc, but the relationship between excessive daytime sleepiness (EDS) and FGIDs has not been systematically studied in the general population. This study aims to explore the relationship between EDS and specific types of FGIDs and the effect of the number of FGIDs on EDS. METHODS: A sample of 3600 individuals (aged 18–80 years) was selected from 5 regions in China using a randomized, stratified, multi-stage sampling method. EDS was measured by the Epworth Sleepiness Scale, while gastroesophageal reflux disease (GERD) and other FGIDs were assessed by Reflux Disease Questionnaire and the Rome II diagnostic criteria, respectively. RESULTS: The survey was completed by 2906 individuals (response rate: 80.72%), and 644 individuals (22.16%) had EDS. EDS was significantly associated with ulcer-like dyspepsia (OR, 2.50; 95% CI, 1.08–5.79), diarrhea-predominant IBS (OR, 2.00; 95% CI, 1.09–3.66), alternating IBS (OR, 2.32; 95% CI, 1.30–4.13), functional constipation (OR, 1.68; 95% CI, 1.20–2.35), and GERD (OR, 1.72; 95% CI, 1.08–2.72). Risk of EDS increased along with the increasing numbers of FGIDs: with 1 FGID (OR, 1.72; 95% CI, 1.37–2.15); with 2 FGIDs (OR, 2.43; 95% CI, 1.63–3.62); and with 3 or more FGIDs (OR, 3.26; 95% CI, 1.37–7.78). CONCLUSIONS: FGIDs, such as ulcer-like dyspepsia, diarrhea-predominant IBS, alternating IBS, functional constipation, and GERD, were significantly associated with EDS. Those who suffered from more kinds of FGIDs were more susceptible to EDS.

Sleep disorders and posttraumatic stress in raped victims / Alteraciones del sueño y estrés postraumático en víctimas de asalto sexual

Objective. To determine sleep disorders and posttraumatic stress symptoms in a group of raped female victims and to assess the causal influence by a survey of the association between exposed and unexposed groups and compare those events. Material and Methods. A prospective analytic doublegroup study. Sample of raped women selected according to inclusion and exclusion criteria, which went to a Forensic Medicine Institute. A group of nonexposed women matched by age, gender, socioeconomic status, location, timing, and status was selected. We applied the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Impact of Event Scale. Results. Data distribution was not normal. Size, weight, and BMI were similar in both groups. We found statistically significant differences in the total score of the sleep quality variables, subjective quality, efficiency and sleep disturbances, awakening early in the morning, not breathing, coughing or snoring, feeling too cold, feeling too hot, nightmares, use of hypnotics, daytime dysfunction and posttraumatic stress symptoms. Conclusions. The presence of sleep disorders and posttraumatic stress symptoms in victims of rape are significant compared with a matched group of nonraped women in Bogotá.

Objetivo. determinar alteraciones del sueño y síntomas por estrés postraumático en una cohorte de mujeres víctimas de asalto sexual y evaluar la influencia causal mediante la mensura de la asociación entre exposición y comparar eventos con un grupo de no expuestas. Materiales y Métodos. estudio de doble cohorte prospectivo. Muestra de mujeres asaltadas sexualmente seleccionadas según criterios de inclusión y exclusión, que acudieron a valoraciones médico legales y una cohorte no expuesta pareada por edad, género, estrato socioeconómico, lugar, temporalidad y estado civil. Se aplicó el Índice de Calidad del Sueño de Pittsburg, la Escala de Somnolencia de Epworth y la Escala de Impacto de Eventos. Resultados. La distribución de datos no fue normal. La talla, peso e IMC fueron similares en ambos grupos. Se hallaron diferencias estadísticamente significativas en las variables puntaje total calidad de sueño, calidad subjetiva, eficiencia y perturbaciones del sueño, despertar de madrugada, no respirar bien, toser o roncar, sentir frío, sentir calor, pesadillas, consumo de hipnóticos, disfunción diurna y síntomas por estrés postraumático. Conclusiones. La presencia de alteraciones del sueño y síntomas por estrés postraumático en víctimas de asalto sexual son significativas en comparación con mujeres no asaltadas en Bogotá.

Prevalence and Associated Factors of Excessive Daytime Sleepiness in Adults / 간호학회지

PURPOSE: The purpose of the present study was to identify prevalence of excessive daytime sleepiness(EDS) and its associations with sleep habits, sleep problems, depression, subjective health status and obesity in community dwelling adults. METHOD: Data was collected from adults aged 20-59 years by random sampling. Subjects completed a questionnaire which was composed of the Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression Scale, and questions that included items about sleep habits, sleep problems, subjective health status and sociodemographic characteristics. Height and weight were measured for calculation of body mass index. The statistical analyses was based on 3,302 adults (51.5% males and 48.5% females). Descriptive statistics, univariate logistic regression and multiple logistic regression were used. RESULT: The prevalence of EDS was 17.1%. Multiple logistic regression showed that the associated factors of EDS were depression, obesity, dissatisfaction with sleep time, irregular sleep, and habitual snoring. Depression was the most significant associated factor(adjusted odds ratio for severe depression=2.27, 95% Confidence Interval=1.73-2.96). CONCLUSION: EDS is a common symptom in adults. Our finding suggested that persons with a complaint of EDS should be completely assessed for depression and obesity as well as sleep problems.