Sleep disturbance and disease activity in adult patients with inflammatory bowel diseases

Abstract

The aim of the study was to identify whether poor quality of sleep is connected to inflammatory bowel disease (IBD) and if so, whether sleep disturbances are related to disease activity. Prospective, observational cohort study was performed. In all enrolled adult patients, the disease activity was assessed by using Crohn's Disease Activity Index (CDAI) for Crohn's disease (CD) and Partial Mayo Score for ulcerative colitis (UC), respectively. All patients were also asked to respond to a questionnaire to define Pittsburgh Quality Sleep Index (PSQI). Sixty-five patients were enrolled in our study: n = 30 with CD and n = 35 with UC. The poor sleep was noted in 78% (40/51) patients with clinically exacerbation and in 35% (5/14) patients in remission (P = 0.002; OR 6.5, 95% confidence interval, 1.8 - 23.6). A global PSQI score of 5 points yielded a sensitivity of 84%, a specificity of 39%, and a positive predictive value of 89% for discriminating participants with exacerbation of IBD from those in clinical remission; PSQI higher than 6 indicates the exacerbation of IBD with 77% sensitivity and 62% specificity. The poorest sleep quality was reported in IBD patients with severe exacerbations (9.1 ± 2.9). Sleep disturbance was confirmed in adult IBD patients, both in CD and UC. Confirmation of the relationship between sleep abnormalities and IBD may show the new pathway in pathophysiology, course and treatment of IBD.