title: Sleep quality in women seeking care for pelvic organ prolapse.
abstract: OBJECTIVE
  To identify the prevalence of sleep disturbance in women seeking treatment for pelvic organ prolapse (POP) and identify correlates of poor sleep quality in this population by using a validated sleep scale.
  
  
  METHODS
  This is a cohort study of female patients with pelvic organ prolapse.
  
  
  METHODS
  Pittsburgh Sleep Quality Index (PSQI), Pelvic Floor Disorders Inventory (PFDI), and Pelvic Floor Impact Questionnaire (PFIQ) measures were completed. Demographic data, medical comorbidities, medications, and physical examinations were also recorded.
  
  
  RESULTS
  407 Women were enrolled. Analysis was performed on the 250 subjects who completed all PSQI components. Subjects were predominantly white, with a mean age of 61 ± 11 years and mean BMI of 28 ± 5 kg/m(2). 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 pelvic floor symptoms, more nocturia, more depressive symptoms, and took more time to fall asleep. Factors associated with sleep quality were evaluated using multivariable linear regression models. Worse sleep scores 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 PFDI sub-scales, were associated with poor sleep quality. Future studies are needed to better understand how sleep disturbances may contribute to the impact of pelvic floor symptoms on quality of life.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, United States; Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, United States. Electronic address: ghettic@wustl.edu.
authors.forename: Chiara
authors.initials: C
authors.lastname: Ghetti
authors.affiliation: Biostatistics/Epidemiology/Research Design (BERD) Core Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States.
authors.forename: MinJae
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, United States; Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
authors.forename: Sallie
authors.initials: S
authors.lastname: Oliphant
authors.affiliation: Western Psychiatric Institute and Clinic, Pittsburgh, PA, United States; University of Colorado, Colorado Springs, CO, United States.
authors.forename: Michele
authors.initials: M
authors.lastname: Okun
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Lowder
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D053158:Nocturia / Q000453:epidemiology*; D017773:Pelvic Floor; D059952:Pelvic Floor Disorders / Q000453:epidemiology*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Pelvic floor symptoms; Pelvic organ prolapse; Sleep quality