Sleep disturbances tied to day-before, split-dose PEG regimens for colonoscopy

Day-before and split-dose high-volume polyethylene glycol (PEG) regimens for patients scheduled to have a colonoscopy are associated with the greatest sleep disturbance, reports a Canada study.

In this randomized multicentre clinical trial, the investigators randomly assigned participants undergoing colonoscopy between 7:30 am and 10:30 am (early morning) to 4-L single-dose PEG given in the evening before, 2-L split-dose PEG (+bisacodyl 15 mg), or 4-L split-dose PEG. The team also randomized patients undergoing colonoscopy between 10:30 am and 4:30 pm (afternoon) to 2-L single-dose PEG (+bisacodyl 15 mg) in the morning, 2-L split-dose PEG (+bisacodyl 15 mg), or 4-L split-dose PEG.

Participants then recorded information on bowel movement kinetics, sleep, and travel to the endoscopy unit. Finally, the investigators compared continuous and categorical variables between groups using a Kruskal-Wallis test and χ² test, respectively, and performed intention-to-treat analyses.

A total of 641 patients were included in this study. Those undergoing early morning colonoscopies had the most sleep awakenings in the night when assigned to 4-L single-dose day-before PEG and the greatest reduction in sleep hours when assigned to split-dose PEG.

No significant differences were observed in urgent bowel movements, foecal incontinence episodes, or travel interruptions between groups.

In addition, 17 percent of participants who travelled for more than an hour had to make a stop for a bowel movement, with no significant between-group difference.