Poorer sleep quality among adult patients with pectus excavatum in Taiwan: A pilot study

Objectives: Patients with pectus excavatum have a poorer quality of life than the general population. Sleep quality is a critical component of quality of life. This pilot study compared the sleep quality of adult patients with pectus excavatum with that of the general population in Taiwan. Methods: Participants comprised 30 healthy adults, 21 adult outpatients with pectus excavatum, and 33 adults with pectus excavatum receiving Nuss surgery. The Pittsburgh Sleep Quality Index measured subjective sleep quality; the Visual Analog Scale for Pain, Brief Symptom Rating Scale-5, Beck Depression Inventory II, and 36-Item Short Form Survey measured quality of life; and the Epworth Sleepiness Scale measured excessive daytime sleepiness. Outcome measurements were obtained at baseline for all groups and 6 months after Nuss surgery for inpatients. Results: Patients with pectus excavatum had poorer sleep quality and worse quality of life than controls. Poorer sleep quality was not related to the severity of pectus excavatum per se, but to psychologic issues (beta = 0.18, P < .001 in multiple linear regression analysis). Measurement time had no effect on sleep quality (beta = 0.31, P = .594 for outpatient group; beta = 0.27, P = .665 for inpatients). Sleep quality of patients with pectus excavatum improved after Nuss surgery (Pittsburgh Sleep Quality Index: 4 vs 7, P = .002). Conclusions: Our findings suggested an association between poor sleep quality and pectus excavatum; thus, sleep quality should be evaluated before and after the Nuss procedure.