A quantitative analysis of sleep quality in women with endometriosis

Background: Endometriosis is a complex condition that can negatively affect a woman’s quality of life, including her sleep. This study aims to assess the multifactorial variables associated with poorer quality of sleep in women with endometriosis. Methods: Data from the Endometriosis Pelvic Pain Interdisciplinary Cohort (EPPIC) data registry were analyzed for women who underwent surgery at the BC Women’s Center for Pelvic Pain and Endometriosis with histopathological confirmation of endometriosis (June 2015 to June 2017). The primary outcome was quality of sleep pre-operatively, from the Chronic Pain Sleep Inventory. Bivariate analysis and multivariable linear regression were done to determine any significant associations between pre-operative patient variables and overall quality of sleep, based on p-value of 0.05. Results: Two hundred and seventy-five women met the study criteria. Poorer overall quality of sleep was independently associated with poorer functional quality-of-life (EHP- 30)(b = -.18, p = .0026), more depressive symptoms (PHQ-9) (b = -1.62, p < .001), and painful bladder syndrome (b = -5.82, p = .035). This indicates that a 1 point increase in the EHP-30 (worsening quality-of-life), a 1 point increase in the PHQ-9 (worsening depression) and the presence of painful bladder syndrome, increased the primary outcome (i.e. towards poorer quality of sleep) by 0.18, 1.62, and 5.82 points. Conclusion: Poorer quality of sleep in women with endometriosis is associated with poorer quality-of-life, more depressive symptoms, and bladder pain. Research into interventions that improve sleep is warranted as part of the management of some women with endometriosis.