Association between anxiety and depression and sleep quality in benign laryngotracheal stenosis patients and analysis of risk factors

Abstract

BACKGROUND

Benign laryngotracheal stenosis (LTS) is a condition characterized by mucosal inflammation and fibrosis. It is difficult to treat with a high incidence rate. Respiratory distress and voice disorders of varying severity also affect patients’ sleep quality and quality of life.

AIM

To investigate the association between anxiety and depression and sleep quality in patients with benign LTS and identify significant risk factors for sleep disorders.

METHODS

This retrospective cohort study enrolled 127 consecutive patients with benign LTS admitted to The First People’s Hospital of Changde City between January 2021 and January 2024. Comprehensive assessments included demographic collection and Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scoring. Correlation analyses were conducted to examine relationships between psychological measures and sleep parameters, followed by multivariate logistic regression to determine independent risk factors.

RESULTS

The cohort demonstrated significantly impaired sleep quality (mean PSQI, 7.79 ± 2.47), with 48.0% (n = 61) meeting the criteria for clinically significant sleep disturbance. The scores of all PSQI dimensions, as well as SAS and SDS scores of patients with LTS, significantly exceeded Chinese normative values. Strong positive correlations emerged between PSQI scores and both SAS and SDS measures. Multivariate logistic analysis identified middle age (41-50 years), multiple surgical interventions (≥ 3 procedures), lower socioeconomic status (monthly household income per capita ≤ 5000 RMB), and concurrent anxiety/depression as independent predictors of sleep disturbance.

CONCLUSION

The results demonstrate a high prevalence of sleep disorders and comorbid anxiety or depressive moods among patients with LTS. These psychological factors both correlate with and independently predict sleep impairment. These results underscore the need for integrated and proactive approaches addressing both physical and mental health components in LTS management, focusing on high-risk subgroups stratified based on age, monthly household income per capita, anxiety/depression status, and number of prior surgeries.

Keywords: Benign laryngotracheal stenosis; Anxiety; Depression; Sleep quality; Sleep disorders

Core Tip: Laryngotracheal stenosis (LTS) is a condition characterized by mucosal inflammation and fibrosis. Changes in the diameter of the laryngotracheal airway and length of the narrowed segment can alter airflow, leading to progressive respiratory distress. Currently, domestic and international research on LTS has primarily focused on treatment modalities, with limited studies on the psychological and sleep-related aspects of patients with LTS. This study aimed to investigate the sleep quality of patients with LTS and its influencing factors, providing a theoretical basis for implementing effective intervention measures to improve the sleep quality of patients with LTS.