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

Table 1 Comparative sleep quality parameters

	Laryngotracheal stenosis patients (n = 127)	Chinese normative data (n = 112)	t	P value
Subjective sleep quality	1.22 ± 0.64	0.67 ± 0.88	5.569	< 0.0001
Sleep latency	1.59 ± 0.79	0.70 ± 0.98	7.766	< 0.0001
Sleep duration	1.09 ± 0.89	0.46 ± 0.68	6.086	< 0.0001
Sleep efficiency	1.13 ± 0.93	0.02 ± 0.73	10.167	< 0.0001
Sleep disturbances	1.22 ± 0.71	0.83 ± 0.61	4.524	< 0.0001
Use of hypnotic medications	0.24 ± 0.47	0.18 ± 0.63	0.840	0.402
Daytime dysfunction	1.28 ± 0.83	0.79 ± 0.94	4.280	< 0.0001
Total PSQI score	7.79 ± 2.47	3.23 ± 3.12	13.605	< 0.0001

PSQI: Pittsburgh sleep quality index.

Table 2 Anxiety and depression measures of patients

	SAS	SDS
Laryngotracheal stenosis patients (n = 127)	41.72 ± 9.78	48.85 ± 7.49
Chinese normative data	29.78 ± 10.07	41.88 ± 10.57
t	12.720	7.260
P value	< 0.0001	< 0.0001

SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

Table 3 Correlation between self-rating anxiety scale, self-rating depression scale, and sleep quality

	SAS		SDS
	r	P value	r	P value
Subjective sleep quality	0.458	< 0.0001	0.268	0.001
Sleep latency	0.379	< 0.0001	0.509	< 0.0001
Sleep duration	0.366	< 0.0001	0.219	0.014
Sleep efficiency	0.218	0.014	0.273	0.002
Sleep disturbances	0.114	0.203	0.265	0.003
Use of hypnotic medications	0.161	0.071	0.013	0.886
Daytime dysfunction	0.023	0.801	0.277	0.002
Total PSQI score	0.523	< 0.0001	0.589	< 0.0001

SAS: Self-rating anxiety scale; SDS: Self-rating depression scale; PSQI: Pittsburgh sleep quality index.

Table 4 Univariate predictors of sleep disorders, n (%)

	Sleep-disturbed group (n = 61)	Non-sleep-disturbed group (n = 66)	χ2	P value
Gender			4.285	0.038
Male	23 (37.7)	37 (56.1)
Female	38 (62.3)	29 (43.9)
Age (years old)			8.961	0.030
18-30	10 (16.4)	19 (28.8)
31-40	13 (21.3)	22 (33.3)
41-50	24 (39.3)	12 (18.2)
> 50	14 (23.0)	13 (19.7)
Educational level			0.777	0.678
Junior high school or below	20 (32.8)	23 (34.8)
College, technical secondary school or junior high school	23 (37.7)	28 (42.4)
University or above	18 (29.5)	15 (22.7)
Marital status			0.486	0.784
Single	21 (34.4)	25 (37.9)
Married	28 (45.9)	31 (47.0)
Divorced or widowed	12 (19.7)	10 (15.2)
Monthly household income per capita (RMB)			4.158	0.041
≤ 5000	36 (59.0)	27 (40.9)
> 5000	25 (41.0)	39 (59.1)
Etiology of laryngotracheal stenosis			0.647	0.958
Congenital	4 (6.6)	3 (4.5)
Traumatic	36 (59.0)	41 (62.1)
Chemical injury	2 (3.3)	3 (4.5)
Specific inflammation	4 (6.6)	3 (4.5)
Undetermined	15 (24.6)	16 (24.2)
Cotton-Myer grading			0.977	0.807
I	8 (13.1)	7 (10.6)
II	6 (9.8)	9 (13.6)
III	32 (52.5)	37 (56.1)
IV	15 (24.6)	13 (19.7)
Number of prior surgeries			9.920	0.019
None	4 (6.6)	10 (15.2)
1	18 (29.5)	30 (45.5)
2	17 (27.9)	16 (24.2)
≥ 3	22 (36.1)	10 (15.2)
Type of tracheal tubes			0.034	0.984
T-tube	28 (45.9)	31 (47.0)
Metal tracheostomy tube	25 (41.0)	27 (40.9)
Cuffed tracheostomy tube	8 (13.1)	8 (12.1)
Duration of intubation (months)			0.775	0.679
≤ 6	19 (31.1)	25 (37.9)
6-12	26 (42.6)	27 (40.9)
> 12	16 (26.2)	14 (21.2)
Anxiety	27 (44.3)	6 (9.1)	20.391	< 0.0001
Depression	30 (49.2)	9 (13.6)	18.821	< 0.0001

Table 5 Disease-related information among patients of different age groups, n (%)

	18-30 years old (n = 29)	31-40 years old (n = 35)	41-50 years old (n = 36)	> 50 years old (n = 27)	χ2	P value
Cotton-Myer grading					6.058	0.734
I	1 (3.4)	5 (14.3)	5 (13.9)	4 (14.8)
II	4 (13.8)	5 (14.3)	4 (11.1)	2 (7.4)
III	17 (58.6)	16 (45.7)	22 (61.1)	14 (51.9)
IV	7 (24.2)	9 (25.7)	5 (13.9)	7 (25.9)
Number of prior surgeries					4.595	0.868
None	1 (3.4)	6 (17.1)	4 (11.1)	3 (11.1)
1	11 (38.0)	14 (40.0)	12 (33.3)	11 (40.7)
2	9 (31.0)	7 (20.0)	10 (27.8)	8 (29.6)
≥ 3	8 (27.6)	8 (22.9)	10 (27.8)	5 (18.6)
Type of tracheal tubes					7.114	0.311
T-tube	13 (44.8)	19 (54.3)	16 (44.5)	11 (40.7)
Metal tracheostomy tube	12 (41.4)	14 (40.0)	17 (47.2)	9 (33.4)
Cuffed tracheostomy tube	4 (13.8)	2 (5.7)	3 (8.3)	7 (25.9)
Duration of intubation (months)					5.153	0.525
≤ 6	12 (41.4)	14 (40.0)	9 (25.0)	9 (33.4)
6-12	9 (31.0)	12 (34.3)	20 (55.6)	12 (44.4)
> 12	8 (27.6)	9 (25.7)	7 (19.4)	6 (22.2)

Table 6 Multivariate logistic regression analysis of sleep quality determinants in laryngotracheal stenosis patients

Variable	β	SE	Wald	P value	HR	95%CI
Constant	-3.580	1.148	9.730	0.002	0.028	-
Gender (0 = female, 1 = male)	-0.443	0.490	0.819	0.366	0.642	0.246-1.676
Age	-	-			-	-
18-30			8.066	0.045
21-40	0.111	0.706	0.025	0.785	1.118	0.280-4.457
41-50	1.507	0.692	4.737	0.030	4.512	1.162-17.527
> 50	1.309	0.718	3.327	0.068	3.703	0.907-15.117
Monthly household income per capita (0 = > 5000 RMB, 1 = ≤ 5000 RMB)	1.510	0.521	8.398	0.004	4.527	1.630-12.570
Number of prior surgeries	-	-			-	-
None			9.385	0.025
1 surgery	0.528	0.884	0.356	0.551	1.695	0.300-9.592
2 surgeries	1.626	0.919	3.132	0.077	5.086	0.840-30.810
≥ 3 surgeries	2.143	0.943	5.169	0.023	8.527	1.344-54.096
Anxiety (0 = no, 1 = yes)	2.094	0.599	12.211	0.000	8.114	2.508-26.255
Depression (0 = no, 1 = yes)	1.943	0.596	10.630	0.001	6.977	2.170-22.431