Saf Health Work.  2022 Jun;13(2):240-247. 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

Affiliations
  • 1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
  • 2Department of Public Health, Graduate School, Yonsei University, Seoul, 03722, Republic of Korea
  • 3The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
  • 4Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
  • 5Department of Occupational and Environmental Medicine, Wonju Severance Christian Hostpital, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea

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.

Keyword

Multicenter study; Constipation; Insomnia; Shift work
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