Sleep quality in women seeking care for pelvic organ prolapse

Objectives: To identify the prevalence of sleep disturbance in women seeking treatment for pelvic organprolapse (POP) and identify correlates of poor sleep quality in this population by using a validated sleepscale.Study design: This is a cohort study of female patients with pelvic organ prolapse.Main outcome measures: Pittsburgh Sleep Quality Index (PSQI), Pelvic Floor Disorders Inventory (PFDI),and Pelvic Floor Impact Questionnaire (PFIQ) measures were completed. Demographic data, medicalcomorbidities, medications, and physical examinations were also recorded.Results: 407 Women were enrolled. Analysis was performed on the 250 subjects who completed allPSQI components. Subjects were predominantly white, with a mean age of 61 ± 11 years and meanBMI of 28 ± 5 kg/m2. The majority (71%) had Stage III prolapse. Half (N = 127) had poor sleep quality(PSQI > 5). Women with poor sleep quality were younger, had more medical comorbidities, more pelvicfloor symptoms, more nocturia, more depressive symptoms, and took more time to fall asleep. Factorsassociated with sleep quality were evaluated using multivariable linear regression models. Worse sleepscores were associated with each of the PFDI subscores (urinary, prolapse, bowel), depressive symptoms,severe nocturia symptoms, and number of comorbidities.Conclusions: Poor sleep is prevalent in women with prolapse. Pelvic floor symptoms as measured by PFDIsub-scales, were associated with poor sleep quality. Future studies are needed to better understand howsleep disturbances may contribute to the impact of pelvic floor symptoms on quality of life.