Hyperarousal Is a Treatable Reason Behind Poor Sleep in Endometriosis

TOPLINE:

A new study exploring the well-established yet perplexing link between endometriosis and sleep disorders is the first to find that hyperarousal plays a mediating role. And hyperarousal, the study notes, is treatable.

METHODOLOGY:

• This study was a case-control survey study with 847 participants.
• In all, 430 participants with endometriosis who were seen at the authors’ centre in Italy were compared with 417 participants without endometriosis drawn from the general population.
• At least four questionnaires were administered to identify symptoms and history of endometriosis, the Hyperarousal Scale (H-scale), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI).
• The path analysis was performed to confirm and quantify the mediating role of hyperarousal in the association between endometriosis and sleep disorders.

TAKEAWAY:

• Endometriosis patients had nearly three times higher hyperarousal scores than control participants (odds ratio [OR], 2.9; 95% CI, 2.4-3.8).
• Endometriosis patients had more than four times higher scores on the PSQI (indicative of worse sleep disturbance) than control participants (OR, 4.3; 95% CI, 3.2-5.7).
• Endometriosis patients had more than four times higher ISI severity scores than control participants (OR, 4.6; 95% CI, 3.5-6.1).
• The path analysis revealed that hyperarousal (from the H-scale) mediated around one quarter (22.3%-27.8%) of the entire association between endometriosis and sleep disturbance.

IN PRACTICE:

The authors concluded, “Endometriosis patients complaining [of] sleep disorders may benefit by investigating the presence of hyperarousal given [that] cognitive behavioural therapy was reported effective in improving hyperarousal and associated sleep disorders.”

SOURCE:

The corresponding author is Antonio Bruno of the University of Messina, Messina, Italy. The study appeared in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

LIMITATIONS:

Limitations included an observational design, an unknown representativeness of sample to endometriosis patients, and a single-centre study.

DISCLOSURES:

None of the authors reported conflicts of interest. The study’s funding source(s) was not disclosed.