Sleep quality after endovenous ablation with concomitant phlebectomy in patients with chronic venous disease: A...

Chronic venous disease (CVD) of the lower extremities is associated with venous hypertension, leading to symptoms such as leg pain, heaviness, edema, and nocturnal cramps. These symptoms often worsen at night and may significantly impair sleep quality. Although endovenous ablation effectively relieves venous symptoms, its impact on sleep remains insufficiently investigated. This study aimed to assess the prevalence of poor sleep quality in patients with lower extremity CVD before and 1 month after endovenous ablation and to analyze changes in both global and component Pittsburgh Sleep Quality Index (PSQI) scores.

A prospective observational study with a longitudinal pre-post design was conducted in 77 patients with lower extremity CVD undergoing endovenous ablation. Clinical severity and symptom burden were assessed using the Visual Analog Scale, Venous Clinical Severity Score, and Clinical, Etiologic, Anatomic, and Pathophysiologic classification. Sleep quality was evaluated using the PSQI. Assessments were performed at baseline and at 1-month follow-up. Changes between time points were analyzed using paired t-tests, Wilcoxon signed-rank test, and McNemar test.

Among 77 patients with CVD, sleep quality improved significantly after endovenous ablation. The median PSQI score decreased from 6 (interquartile range, 5-10) at baseline to 5 (interquartile range, 4-7) at 1 month (P < .001). The proportion of patients with poor sleep quality (PSQI > 5) declined from 66.2% to 41.6%. Significant improvements were observed in subjective sleep quality, sleep latency, sleep duration, sleep disturbances, and daytime dysfunction, whereas habitual sleep efficiency and use of sleep medication did not change significantly.

Endovenous ablation, frequently combined with phlebectomy, was associated with early improvements in sleep quality. However, given the observational design and lack of a control group, these findings should be interpreted with caution. The parallel reductions in Visual Analog Scale, Venous Clinical Severity Score, Clinical, Etiologic, Anatomic, and Pathophysiologic classification, and PSQI suggest that sleep impairment in CVD may reflect overall symptom burden rather than an independent disorder. Longer-term controlled studies incorporating objective sleep measures are warranted to confirm the durability and underlying mechanisms of these effects.