Survey Of Sleep Habits In Irritable Bowel Syndrome Patient

PREFACE:Irritable bowel syndrome(IBS) is a group of bowel dysfunction diseases,without any organic or biochemical anomalies.The most frequent symptoms are abdominal pain, abdominal discomfort and chronic intermittent changes to bowel habits and stool character,accompanied with series of systemic symptoms sometimes.Although IBS is not a fatal disease,owning to its high morbidity,Various symptoms,long course of disease,and non effective diagnostic method and treatment,it costs enormous medical resources,money and time,thus markedly influents the social production and life quality.Its pathogenesis is still unknown and was related with many factors.Among those features,psysiological features including anxiety,depression,panic,sleep disorder and Coping strategies have been identified as physiological feature for subsequent disease development.Psychological feature especially anxiety/depression did influent patient's sleep quality.But is still unknown whether it has exact relation within psychological factors and sleep quality.Whether the sleep disorder is related to psychological factor,or independent of it,or is that related to the severity of GI symptoms,its deserved further study. Objective:We assess the GI symptoms,sleep quality,symptoms of anxiety and depression in selected cases,to get the information of sleep quality and anxiety depression state.On basis of which we analyse whether it has differences of sleep quality between the anxiety depression IBS patient and non-anxiety depression IBS patient,to invest the relation of the GI symptoms and sleep.Thus we explored the effect of sleep disorder on the pathogenesis of IBS.Object and Method:The IBS patients conforming to RomanⅢdiagnostic criteria were enrolled,the healthy examination volunteers duing the corresponding period were served as a control group.We using questionnaire to survey IBS symptoms,sleep quality(Pittsburgh Sleep Quality Index questionnaire PSQI),anxiety score(Self-Rating Anxiety Scale,SAS) and depression score(Self-Rating Depression Scale,SDS).The sleep quality and anxiety depression state were compared and analysed;basing on the SAS and SDS score,we intercompare the sleep state among the subgroups in IBS patient and compare with the control,to analyse the sleep state in all groups.We Use the multivariable regression analysis to survey the related IBS factors.Results:1,General information:IBS group:145 cases(male 63,female 82),average age is 43.29±12.35(19～74),its GI symptom score respectively are 2.32±0.456;the control: 59 cases(male 28,female 31),average age is 40.01±14.31(19～72).In IBS group:99 D-IBS patient(68.28%),21 C-IBS patient(14.48%),25 mixed-type patient(17.24%).2,Evaluation of anxiety depression in IBS patient:IBS group:the SAS raw score is 9.43±15.24,among them 18 for SAS score≥40,positive incidence is 12.41%;The control:the SAS raw score is 26.10±11.55,2 for SAS score≥40,positive incidence is 3.39%.All above have significant difference(p＜0.05).IBS group:SDS raw score is 31.29±13.32,among them 10 for SDS≥40,positive incidence is 3.39%;the control: SDS raw score is 26.51+13.91(p＜0.05),among them 4 for SDS≥40,positive incidence is 6.90%(p＞0.05).It reveals more anxiety depression disorder in IBS patient.3,Sleep Quality in IBS patient:in Sleep Quality Index questionnaire,such as Sleep Quality,Sleep Disorder,Day Function Disorder and PSQI score shows significant difference among the IBS group and the control(P＜0.05).While the the Sleep Latency,Sleep Time,Sleep Efficiency,Hypnotic reveals no significant difference(p＞0.05).Which indicates more sleep disorder in IBS patient.4,The indicators such as Sleep Quality,Sleep Disorder,Day Function Disorder and PSQI score shows significant difference among the 125 cases of non-anxiety depression IBS group and the control(P＜0.05).While other 4 field including Sleep Latency,Sleep Time,Sleep Efficiency,Hypnotic reveals no significant difference(p＞0.05).In 20 anxiety depression IBS cases,6 field including Sleep Quality,Sleep Latency,Sleep Time,Sleep Efficiency,Sleep Disorder,Day Function Disorder and PSQI score shows significant difference to the control(P＜0.05).Only the Hypnotic reveals no significant difference(p＞0.05).All indicators including Sleep Quality, Sleep Latency,Sleep Time,Sleep Efficiency,Sleep Disorder,Day Function Disorder, Hypnotic and PSQI score shows significant difference among the anxiety/depression IBS group and the non-anxiety depression IBS group(P＜0.05).5,Contrasting of the symptoms severity to the Sleep Quality and anxiety deprssion: the mild:moderate:severe number in IBS patient is 89(61.38%):33(22.76%):23(15.86%); among the three groups,the PSQI≥7 is respectively 34(38.20%),14(42.36%), 10(43.47%);SAS raw score≥40 is 5(5.62%),6(18.18%),7(30.43%);SDS raw score≥40 is 7(7.86),2(6.06%),1(4.35%).The PSQI positive rate,SDS positive rate shows no significant differences among the mild/moderate/severe groups(p＞0.05).While the SAS positive rate reveals significant difference(p＜0.05).The GI symptom score and SAS raw score are positiely associated(r＝0.149,P＝0.025).6,Sleep Quality in different job categories:Comparing the physical work group and the mentor work group,the Sleep Quality,Sleep Efficiency,Sleep Disorder and PSQI score has significant difference(p＜0.05),while the Sleep Latency,Sleep Time, Day Function Disorder and Hypnotic has non significant difference(p＞0.05).It is no significant difference in patients of different genders.7,IBS Multivariate correlation analysis:it shows no statistically significant between the IBS and gender,age,SDS raw score,PSQI score(p＞0.05).While statistically significant in SAS raw score,occupy(p＜0.05).SAS is the risk factor (β＝0.064,exp(β)＝1.066 ) and the occupy is the protect factor(β＝-1.017,exp(β)＝0.0362).Conclutions:1,IBS patient has more sleep disorder,major manifested in Sleep Quality,Sleep Disorder,Day Function Disorder and PSQI score.2,No clear associations between the sleep disorder and IBS types,severity of symptoms and gender.3,IBS patient shows more anxiety and depression emotional disorder.4,The state of anxiety and depression worsen the sleep disorder in IBS patient.