Impact of sleep disturbances due to low anterior resection syndrome on the quality of life of patients with rectal cancer.

Purpose: We aimed to analyze the effects of nighttime symptoms on quality of life of patients with low anterior resection syndrome (LARS) and determine the correlation between nighttime symptoms and insomnia.

Methods: A single-center observational study was conducted on patients with rectal adenocarcinoma who underwent sphincter-preserving surgery at Seoul National University Hospital between 2019 and 2023. Eligible patients were surveyed during routine outpatient follow-up. The primary outcomes were bowel function assessed by the Low Anterior Resection Syndrome (LARS) score including nighttime symptoms and sleep disturbance evaluated using the Insomnia Severity Index (ISI).

Results: Among 100 patients, 85 (85.0 ​%), nine (9.0 ​%), and six (6.0 ​%) underwent low anterior, ultra-low anterior, and intersphincteric resection, respectively; 86 (86.0 ​%) had LARS, and 58 (58.0 ​%) had nighttime symptoms. Further, 69 patients (98.6 ​%) met the criteria for insomnia. The LARS score and ISI were positively correlated (p ​= ​0.047). Differences in the frequency of bowel movements (p ​= ​0.015) and nighttime symptoms (p ​= ​0.046) were noted between the no/mild insomnia and moderate/severe insomnia groups. Physical and social functioning were lower (p ​= ​0.004 and p ​= ​0.007, respectively) and stool frequency (p ​= ​0.018), embarrassment caused by defecation pattern (p ​= ​0.025), and sore skin around the anus (p ​= ​0.006) were more severe in the moderate/severe insomnia group.

Conclusions: LARS and insomnia showed a significant correlation; no significant correlation was found between the occurrence of nighttime symptoms and insomnia.