C0641 - Sleep Disturbances and Sexual Dysfunction in Patients With Gluten-Associated Disorders

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Punya Chittajallu, MD

UCLA
Los Angeles, CA

Punya Chittajallu, MD¹, Anna H. Lee, MD², Guy A. Weiss, MD³, Sonya Dasharathy, MD¹, Janelle E. Smith, MS, RD⁴, Lucia Chen, MS²
¹UCLA, Los Angeles, CA; ²University of California, Los Angeles, Los Angeles, CA; ³University of California Los Angeles, Los Angeles, CA; ⁴UCLA, Santa Ana, CA

Introduction: Sleep disturbances and sexual dysfunction are well documented in patients with gluten-associated disorders (GAD). However, the effect of strict adherence to a gluten-free diet (GFD) and its effect on sleep and sexual health is less understood, largely due to a lack of a large-scale study population. This study assesses factors associated with sleep and sexual health, including GFD adherence.

Methods: Validated surveys were sent in 2022 to participants enrolled in the Celiac Collective registry. A cross-sectional study was conducted incorporating demographics and medical history, along with multiple patient-reported outcomes (PRO) tools such as the Celiac Dietary Adherence Test (CDAT), Celiac Symptom Index (CSI), Treatment Self-Regulation Questionnaire (TSRQ) for motivation, and PRO Measurement Information System (PROMIS) domains of sleep disturbance and sexual function. Our primary outcomes were prevalence of sleep disturbance or sexual dysfunction in patients with GAD compared to the general population and their association with GFD adherence. Statistical analyses were conducted using chi-square, Fisher’s exact and Wilcoxon rank-sum tests.

Results: Preliminary results demonstrate that 64.9% and 84.6% of subjects with gluten-associated disorders have sleep disturbance or sexual dysfunction, respectively. Both are higher rates than the general population. Sleep disturbances are associated with shorter disease duration and higher amotivation scores, while sexual dysfunction is associated with longer disease duration and female sex.

Discussion: This study demonstrated that patients with GAD have higher sleep and sexual dysfunction compared to the general population, and they tend to have worse psychological distress than people with GAD without these disturbances. Female sex, disease duration, and autonomous (intrinsic) versus controlled (extrinsic) motivation also affect rates of sexual dysfunction and sleep disturbances in patients with GAD. Providers can target sleep quality and sexual function to improve quality of life of people with gluten-associated disorders.

	GAD	GAD + Sleep Disturbance	GAD + Sexual Dysfunction	p-value
Self-Reported Patients
Sleep Disturbance = n (%)	12 (35.1%)	24 (64.9%)
Sexual Dysfunction = n (%)	4 (15.4%)		22 (84.6%)
GFD Adherence (CDAT)
	14.0 (10.0-14.0)	14.0 (12.0-16.0)		0.325
	13.0 (11.8-14.0)		14.0 (12.0-16.0)	0.526
Celiac Disease Activity (CSI)
	36.5 (30.8-47.2)	37.0 (32.0-42.0)		0.942
	34.0 (31.2-37.5)		40.5 (36.2-45.5)	0.162
CSI Categories	Sleep / Sex			Sleep / Sex
Active Disease	37.5% / 0%	9.5%	25%
Moderate Disease Control	37.5% / 75%	71.4%	60%	0.112 / 0.586
Disease Remission	25% / 25%	19%	15%
Anxiety (PROMIS-29)
	7.0 (6.0-10.0)	7.5 (6.0-12.0)		0.634
	7.0 (6.2-8.0)		9.5 (7.0-12.0)	0.184
Depression (PROMIS-29)
	6.0 (4.0-6.0)	5.5 (4.0-11.0)		0.610
	6.5 (4.8-8.8)		6.0 (4.0-10.0)	0.970
Sleep (PROMIS-29)
	6.0 (5.0-8.0)	10.0 (9.0-11.0)		< 0.001
	11.0 (9.5-12.2)		10.0 (8.0-11.0)	0.297
Fatigue (PROMIS-29)
	8.0 (6.0-13.0)	12.0 (9.5-14.5)		0.174
	11.0 (8.5-13.0)		12.5 (9.8-14.2)	0.612
Satisfaction with Social Interaction (PROMIS-29)
	13.0 (9.0-16.0)	10.0 (8.0-14.0)		0.234
	11.5 (7.8-15.2)		10.0 (8.0-13.0)	0.694
Pain (PROMIS-29)
	10.0 (6.5-14.0)	8.0 (7.0-12.0)		0.727
	8.0 (8.0-9.5)		9.0 (6.8-12.0)	0.963
Relationship with Healthcare Provider (HCCQ)
	25.5 (16.0-31.2)	21.0 (14.0-26.0)		0.304
	19.0 (12.0-25.2)		18.0 (9.0-27.0)	0.710

Table: Table 1. Measures associated with presence of sleep disturbance or sexual dysfunction. Data represent score Median (Q1-Q3) unless noted otherwise

Disclosures:

Punya Chittajallu indicated no relevant financial relationships.

Anna Lee indicated no relevant financial relationships.

Guy Weiss: EverlyHealth – Advisory Committee/Board Member.

Sonya Dasharathy indicated no relevant financial relationships.

Janelle Smith indicated no relevant financial relationships.

Lucia Chen indicated no relevant financial relationships.

Punya Chittajallu, MD¹, Anna H. Lee, MD², Guy A. Weiss, MD³, Sonya Dasharathy, MD¹, Janelle E. Smith, MS, RD⁴, Lucia Chen, MS². C0641 - Sleep Disturbances and Sexual Dysfunction in Patients With Gluten-Associated Disorders, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.