Insomnia in Urologic Chronic Pelvic Pain Syndrome: Prevalence, Psychosocial Influences, and Clinical Implications

To understand how disease-based and other psychosocial factors influence insomnia disorder in urologic chronic pelvic pain syndrome (UCPPS), this study examined rates of insomnia disorder in UCPPS, factors associated with insomnia disorder in UCPPS, and the relative impacts of urinary, cognitive, and affective factors in predicting insomnia disorder likelihood in UCPPS.

Individuals with UCPPS and clinically significant chronic pelvic pain were recruited to an ongoing clinical trial. This study examined baseline data from validated self-report measures capturing genitourinary symptoms, affective distress, cognitive patterns, and a formal diagnostic interview evaluating insomnia disorder. We assessed insomnia prevalence, its relation to clinical characteristics, and the odds of insomnia disorder given a person's urinary symptoms, anxiety, and pain catastrophizing using correlation and binomial logistic regression.

Of the full sample (N = 152), 24.3% of participants met criteria for insomnia disorder (36% male, 22% female). Insomnia diagnosis was correlated with cognitive-affective symptoms but not with genitourinary symptoms. Model results indicated that anxiety predicted odds of meeting criteria for insomnia disorder above and beyond urinary severity and pain catastrophizing (OR = 1.05, P = .007).

The estimated prevalence of insomnia disorder in our sample is nearly double the population rate. The odds of insomnia disorder are influenced by a person's anxiety level. In addition to addressing urinary symptoms, clinical intervention targeting anxiety may benefit patients with UCPPS suffering from insomnia.