title: Risk factors for poor sleep quality among patients with interstitial cystitis in Taiwan.
abstract: OBJECTIVE
  Previous research has suggested that patients with interstitial cystitis have more sleep disturbances and higher levels of depression. However, reports that employ validated sleep questionnaires are rare for this population. The present study investigates the relationship between sleep quality, anxiety, depression, and the severity of urologic interstitial cystitis symptoms in outpatients, and risk factors for poor sleep quality.
  
  
  METHODS
  A total of 69 patients (52 female) with interstitial cystitis met National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases (NIDDK) criteria, completed all instruments. The O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) was performed to assess interstitial cystitis severity. The Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate quality of sleep and depression level, respectively. Multiple linear regressions were used to identify independent factors of sleep quality.
  
  
  RESULTS
  Mean PSQI global score was 9.5 +/- 4.2 (range: 1-19); 81.2% of subjects had poor sleep quality (PSQI > 5). Regression analysis suggested that the severity of interstitial cystitis (Beta coefficient = 0.42, P < 0.001) and level of anxiety and depression (Beta coefficient = 0.26, P < 0.05) were significant independent risk factors for poor sleep quality, after controlling for age, gender, marital status, years of education, and years of symptomatic duration. Further analysis of ICSI subdomain scores shows that association between nighttime urination and poor sleep quality remains significantly (Beta coefficient = 0.32, P < 0.05), after adjustment for demographic data and anxiety and depression.
  
  
  CONCLUSIONS
  Poor sleep quality is common in interstitial cystitis patients and severity of urological symptoms and depression levels are important independent risk factors.
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chia-Fen
authors.initials: CF
authors.lastname: Tsai
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Ouyang
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Tsai
authors.forename: Chen-Jee
authors.initials: CJ
authors.lastname: Hong
authors.forename: Tong-Long
authors.initials: TL
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D018856:Cystitis, Interstitial / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D010045:Outpatients; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014554:Urination