Browse > Article
http://dx.doi.org/10.1016/j.shaw.2022.01.001

Association Between Insomnia and Constipation: A Multicenter Three-year Cross-sectional Study Using Shift Workers' Health Check-up Data  

Yun, Byung-Yoon (Department of Preventive Medicine, Yonsei University College of Medicine)
Sim, Juho (Department of Public Health, Graduate School, Yonsei University)
Yoon, Jin-Ha (Department of Preventive Medicine, Yonsei University College of Medicine)
Kim, Sung-Kyung (Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine)
Publication Information
Safety and Health at Work / v.13, no.2, 2022 , pp. 240-247 More about this Journal
Abstract
Background: Although insomnia and constipation are highly prevalent worldwide, studies examining a possible association between them are lacking. We examined the relationship between insomnia and constipation in shift workers who have a high prevalence of insomnia and other diseases. Methods: This study had a multicenter cross-sectional design and conducted using health examination data including self-reported questionnaires. In total, 12,879 and 4,650 shift workers were enrolled in Severance Hospital and Wonju Severance Hospital, respectively, during 2015-2017. Multivariate logistic regression models and subgroup analysis were performed in each center with the same protocol, using a common data model. Results: The mean age of the total population was 44.35 (standard deviation = 8.75); the proportion of males was 56.9%. Female sex, being underweight and non-smoker were strongly associated with an increased risk of constipation symptom (p < 0.001). Pooled odds ratios (ORs) were calculated using ORs of both centers with weights; there was a significant dose-response relationship (sub-threshold 1.76 [95% confidence interval [CI] 1.62-1.91]; moderate 2.28 [95% CI 2.01-2.60]; severe 4.15 [95% CI 3.18-5.41] in the final model, p for trend < 0.001). Subgroup analysis performed by stratifying sex and pooled ORs showed a similar trend to that of the entire group. Conclusion: We observed a strong correlation between insomnia and constipation in this population. Our findings may help in formulating guidelines and policies to improve quality of life in shift workers through the management of sleep quality and proper bowel function. This study is the first to report this relationship among people working in shifts.
Keywords
Multicenter study; Constipation; Insomnia; Shift work;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Palsson OS, Whitehead W, Tornblom H, Sperber AD, Simren M. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology 2020.
2 De Schryver AM, Keulemans YC, Peters HP, Akkermans LM, Smout AJ, De Vries WR, Van Berge-Henegouwen GP. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol 2005;40:422-9.   DOI
3 Drake CL, Roehrs T, Richardson G, Walsh JK, Roth T. Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers. Sleep 2004;27:1453-62.   DOI
4 Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. J Clin Neurol (Seoul, Korea) 2014;10:210.   DOI
5 Chen MJ, Wu MS, Lin JT, Chang KY, Chiu HM, Liao WC, Chen CC, Lai YP, Wang HP, Lee YC. Gastroesophageal reflux disease and sleep quality in a Chinese population. J Formos Med Assoc 2009;108:53-60.   DOI
6 Vallieres A, Azaiez A, Moreau V, LeBlanc M, Morin CM. Insomnia in shift work. Sleep Med 2014;15:1440-8.   DOI
7 Chu H, Zhong L, Li H, Zhang X, Zhang J, Hou X. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in China. Gastroenterol Res Pract 2014:2014.
8 Auer P, Cazes S. Resilience of the long-term employment relationship: evidence from the industrialized countries, the. Int'l Lab. Rev. 2000;139:379.   DOI
9 Chapter IV: Working hours and recess. In: Labor standard act [internet]. Ministry of employment and labor 2012 [cited 2021 6 Nov]. Available from: https://elaw.klri.re.kr/eng_service/lawView.do?hseq=50315&lang=ENG.
10 Bouchoucha M, Mary F, Bon C, Bejou B, Airinei G, Benamouzig R. Sleep quality and functional gastrointestinal disorders. A psychological issue. J Digest Dis 2018;19:84-92.   DOI
11 Mayer EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47:861-9.   DOI
12 Costa G. Shift work and occupational medicine: an overview. Occup Med 2003;53:83-8.   DOI
13 Walsh JK, Coulouvrat C, Hajak G, Lakoma MD, Petukhova M, Roth T, Sampson NA, Shahly V, Shillington A, Stephenson JJ, Kessler RC. Nighttime insomnia symptoms and perceived health in the America Insomnia Survey (AIS). Sleep 2011;34:997-1011.   DOI
14 Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011;34:601-8.   DOI
15 ILO. World Employment 1996/97: National policies in a global context. International Labour Office Geneva; 1996.
16 Budnick LD, Lerman SE, Baker TL, Jones H, Czeisler CA. Sleep and alertness in a 12-hour rotating shift work environment. J Occup Med 1994:1295-300.
17 Lee W, Lim S-S, Kim B, Won J-U, Roh J, Yoon J-H. Relationship between long working hours and periodontitis among the Korean workers. Sci Rep 2017;7:1-9.   DOI
18 Balikji S, Mackus M, Brookhuis KA, Garssen J, Kraneveld AD, Roth T, Verster JC. The association of insomnia, perceived immune functioning, and irritable bowel syndrome complaints. J Clin Med 2018;7:238.   DOI
19 Lee SK, Yoon DW, Lee S, Kim J, Choi K-M, Shin C. The association between irritable bowel syndrome and the coexistence of depression and insomnia. J Psychosomat Res 2017;93:1-5.   DOI
20 Cho YW, Shin WC, Yun CH, Hong SB, Kim J, Earley CJ. Epidemiology of insomnia in Korean adults: prevalence and associated factors. J Clin Neurol 2009;5:20-3.   DOI
21 Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. Bmj 2016;355.
22 Kervezee L, Kosmadopoulos A, Boivin DB. Metabolic and cardiovascular consequences of shift work: the role of circadian disruption and sleep disturbances. Eur J Neurosci 2020;51:396-412.   DOI
23 Thach T-Q, Mahirah D, Dunleavy G, Zhang Y, Nazeha N, Rykov Y, Nah A, Roberts AC, Christopoulos GI, Soh C-K. Association between shift work and poor sleep quality in an Asian multi-ethnic working population: a cross-sectional study. PLos One 2020;15:e0229693.   DOI
24 Ali T, Choe J, Awab A, Wagener TL, Orr WC. Sleep, immunity and inflammation in gastrointestinal disorders. World J Gastroenterol: WJG 2013;19:9231.   DOI
25 Orr WC, Fass R, Sundaram SS, Scheimann AO. The effect of sleep on gastrointestinal functioning in common digestive diseases. Lancet Gastroenterol Hepatol 2020;5:616-24.   DOI
26 Chojnacki C, Walecka-Kapica E, Lokiec K, Pawlowicz M, Winczyk K, Chojnacki J, Klupinska G. Influence of melatonin on symptoms of irritable bowel syndrome in postmenopausal women. Endokrynol Pol 2013;64:114-20.
27 Sundboll J, Szepligeti SK, Adelborg K, Szentkuti P, Gregersen H, Sorensen HT. Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study. BMJ Open 2020;10:e037080.   DOI
28 Bharucha AE, Pemberton JH, Locke 3rd GR. American Gastroenterological Association technical review on constipation. Gastroenterology 2013;144:218-38.   DOI
29 Thomas J, Karver S, Cooney GA, Chamberlain BH, Watt CK, Slatkin NE, Stambler N, Kremer AB, Israel RJ. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med 2008;358:2332-43.   DOI
30 Andrews CN, Storr M. The pathophysiology of chronic constipation. Can J Gastroenterol 2011;25:16b-21b. Suppl B.   DOI
31 Frazzitta G, Ferrazzoli D, Folini A, Palamara G, Maestri R. Severe constipation in Parkinson's disease and in Parkinsonisms: prevalence and affecting factors. Front Neurol 2019;10:621.   DOI
32 Tomita T, Kazumori K, Baba K, Zhao X, Chen Y, Miwa H. Impact of chronic constipation on health-related quality of life and work productivity in Japan. J Gastroenterol Hepatol 2020.
33 Mazur M, Furgala A, Jablonski K, Mach T, Thor P. Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patients. Med Sci Mon: Int Med J Exp Clin Res 2012;18:CR493.   DOI
34 Li LF, Chan RLY, Lu L, Shen J, Zhang L, Wu WKK, Wang L, Hu T, Li MX, Cho CH. Cigarette smoking and gastrointestinal diseases: the causal relationship and underlying molecular mechanisms (Review). Int J Mol Med 2014;34:372-80.   DOI
35 Carabottia M, Sciroccoa A, Masellib MA, Severia C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol 2015;28:1-7.
36 Khanijow V, Prakash P, Emsellem HA, Borum ML, Doman DB. Sleep dysfunction and gastrointestinal diseases. Gastroenterol Hepatol 2015;11:817.
37 Chung S, Cho SW, Jo MW, Youn S, Lee J, Sim CS. The prevalence and incidence of insomnia in Korea during 2005 to 2013. Psychiatry Investig 2020;17:533-40.   DOI
38 Jeong KS, Ahn Y-S, Jang T-W, Lim G, Kim HD, Cho S-W, Sim C-S. Sleep assessment during shift work in Korean firefighters: a cross-sectional study. Safe Health Work 2019;10:254-9.   DOI
39 Sumida K, Molnar MZ, Potukuchi PK, Thomas F, Lu JL, Yamagata K, Kalantar-Zadeh K, Kovesdy CP. Constipation and risk of death and cardiovascular events. Atherosclerosis 2019;281:114-20.   DOI
40 Webster LR. Opioid-induced constipation. Pain Med 2015;16:S16-21.   DOI
41 Lundstrom O, Manjer J, Ohlsson B. Smoking is associated with several functional gastrointestinal symptoms. Scand J Gastroenterol 2016;51:914-22.   DOI
42 Ohlsson B. The role of smoking and alcohol behaviour in management of functional gastrointestinal disorders. Best Pract Res Clin Gastroenterol 2017;31:545-52.   DOI
43 Oyane NM, Pallesen S, Moen BE, Akerstedt T, Bjorvatn B. Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses. PLoS One 2013;8:e70228.   DOI
44 Fujiwara Y, Kubo M, Kohata Y, Machida H, Okazaki H, Yamagami H, Tanigawa T, Watanabe K, Watanabe T, Tominaga K. Cigarette smoking and its association with overlapping gastroesophageal reflux disease, functional dyspepsia, or irritable bowel syndrome. Int Med 2011;50:2443-7.   DOI
45 Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 2003;98:1790-6.   DOI
46 Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM. Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes Metab Syndr Obes: Targets Ther 2017;10:513.   DOI
47 Verkuijl SJ, Meinds RJ, Trzpis M, Broens PMA. The influence of demographic characteristics on constipation symptoms: a detailed overview. BMC Gastroenterol 2020;20:168.   DOI
48 Leung FW. Etiologic factors of chronic constipation-review of the scientific evidence. Digest Dis Sci 2007;52:313-6.   DOI
49 Roth T, Coulouvrat C, Hajak G, Lakoma MD, Sampson NA, Shahly V, Shillington AC, Stephenson JJ, Walsh JK, Kessler RC. Prevalence and perceived health associated with insomnia based on DSM-IV-TR; international statistical classification of diseases and related health problems, tenth revision; and research diagnostic criteria/international classification of sleep disorders, second edition criteria: results from the America insomnia survey. Biol Psychiatr 2011;69:592-600.   DOI
50 Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A. Impact of sleep disturbances in inflammatory bowel disease. J Gastroenterol Hepatol 2007;22:1748-53.   DOI
51 Schmidt FMQ, de Gouveia Santos VLC. Prevalence of constipation in the general adult population: an integrative review. J Wound Ostomy Cont Nurs 2014;41:70-6.   DOI
52 Sundboll J, Thygesen SK, Veres K, Liao D, Zhao J, Gregersen H, Sorensen HT. Risk of cancer in patients with constipation. Clin Epidemiol 2019;11:299.   DOI
53 Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001;2:297-307.   DOI
54 Chatterjee K, Ambekar P. Study of insomnia in rotating shift-workers. Indust Psychiatr J 2017;26:82.   DOI
55 Overhage JM, Ryan PB, Reich CG, Hartzema AG, Stang PE. Validation of a common data model for active safety surveillance research. J Am Med Inform Assoc 2012;19:54-60.   DOI
56 Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Pract Res Clin Gastroenterol 2011;25:3-18.   DOI