A clinical investigation of patients with functional gastrointestinal disorders complicated with sleep disorders

Objective To analyze the status of sleep disorders in patients with functional gastrointestinal disease (FGID) and its relation with symptom characteristics. Methods From January to December 2014, questionnaire was carried out in FGID patients who met the Rome Ⅲ criteria and visited the outpatient department of gastroenterology at six third-level general hospitals in Tianjin City to assess the severity of symptoms, sleep quality (Pittsburgh sleep quality index, PSQI), and psychological state (anxiety and depression). Chi-square test and Mann-Whitney rank sum test were performed for statistical analysis. Results Among 931 patients with FGID, 651(69.92%) patients had sleep disorders and 280 (30.08%) patients had no sleep disorders. Among 828 patients with functional dyspepsia (FD), 360 (43.48%) patients had sleep disorders complicated with and depression. Among 292 patients with irritable bowel syndrome (IBS), 138 (47.26%) had sleep disorders complicated with anxiety and depression. Among 618 patients with FD complicated with sleep disorders, 70 (11.33%) patients overlapped with IBS; among 210 patients with FD, but without sleep disorder, 11 (5.24%) patients overlapped with IBS and the percentage of the former was higher than the latter, and the difference was statistically significant (χ2=6.580, P=0.01). The proportion of lower abdominal pain, sheep fecal or hard stool, laborious defecation or incomplete defecation in FGID patients without sleep disorder were 22.14% (62/280), 11.79% (33/280), 19.29% (54/280) and 27.86% (78/280), respectively; which were lower than those of FGID patients with sleep disorders (36.10%(235/651), 21.20%(138/651), 32.41%(211/651) and 44.39%(289/651)); and the differences were statistically significant (χ2=17.552, 11.569, 16.566 and 22.419; all P<0.01). FGID patients with sleep disorders have more severe symptoms such as lower abdominal pain, lower abdominal discomfort (non-pain), sheep fecal or hard stool, laborious defecation incomplete defecation, and urgency than FGID patients without sleep disorders; and the differences were statistically significant (Z=-4.423, -1.973, -3.360, -4.467, -4.550 and -2.420; all P<0.05). Conclusions Sleep disorders, anxiety and depression often coexist in patients with FGID. Sleep disorders are closely related with lower gastrointestinal symptoms in patients with FGID. Key words: Sleep disorders; Anxiety; Depression; Functional gastrointestinal disorders; Lower gastrointestinal symptoms