Association Between Sleep Quality and Postcolonoscopy Pain

Abstract

Background/Aims: Postcolonoscopy pain remains a key determinant of patient satisfaction and willingness to undergo repeat procedures. Patient-related factors influencing postprocedural pain are not fully understood, and the role of sleep quality has not been systematically elucidated. This study aimed to investigate the association between sleep quality and postcolonoscopy abdominal pain in a real-world cohort.

Materials and Methods: This single-center, prospective observational cohort study included adults aged 18-80 years undergoing diagnostic or surveillance colonoscopy. All procedures were performed by a single experienced endoscopist under standardized conditions. Psychological and sleep-related parameters were assessed using validated instruments, including the Beck Depression Inventory, State– Trait Anxiety Inventory, Van Dream Anxiety Scale, and Pittsburgh Sleep Quality Index. Pain intensity was measured using a Visual Analog Scale at 0 minutes, 30 minutes, 6 hours, and 24 hours after the procedure. Associations between psychometric measures and pain scores were analyzed using Spearman’s correlation.

Results: A total of 103 patients were included (mean age, 54.7 ± 12.4 years; 45.6% female). Postcolonoscopy pain was most prominent 0 minutes after the procedure and decreased progressively over time. Poor sleep quality was significantly associated with higher pain intensity at 6 hours after colonoscopy (r = 0.239, P = .015). Anxiety and depressive symptom severity scores were not associated with pain intensity; however, a prior clinical diagnosis of depression was associated with higher postprocedural pain scores. Higher pain scores were also observed in patients with incomplete procedures, gastrointestinal symptoms, and postprocedural dissatisfaction (P < .05).

Conclusion: Sleep quality may represent an important patient-related factor influencing early postcolonoscopy pain perception. Consideration of sleep and psychosocial factors alongside routine clinical evaluation may help improve the understanding of postprocedural pain variability and enhance patient-centered endoscopy care.

Cite this article as: Bolat H, Tolu T, Kani HT. Association between sleep quality and postcolonoscopy pain. Turk J Gastroenterol. Published online April 30, 2026. doi: 10.5152/tjg.2026.26044.