Ann Joo Lee1, Dale F Kraemer2,3, Ozdemir Kanar4, Andrew C Berry5, Carmen Smotherman3, Emely Eid1. 1. Department of Gastroenterology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. 2. Department of Neurology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. 3. Center for Health Equity and Quality Research, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. 4. Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL. 5. Department of Medicine, University of South Alabama, Mobile, AL.
Abstract
BACKGROUND: Inflammatory bowel disease (IBD) can disrupt normal sleep physiology and amplify a negative perception about quality of life. Evidence suggests increased circulation of inflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-1, may play a role. METHODS: A total of 56 patients completed the Pittsburgh Sleep Quality Index (PSQI) to measure 7 sleep domains: sleep quality, sleep latency, sleep duration, sleep efficacy, sleep disturbance, sleep medications, and daytime dysfunction. Domain scores were summed to determine the presence or absence of sleep impairment. We compared patients taking immunomodulators or biologic agents to patients not on immunomodulator or biologic agent therapy. Demographics and IBD-related clinical information were collected to adjust for potential confounders that may secondarily affect sleep, such as body mass index, depression/anxiety, and sleep-affecting medications. RESULTS: The majority of patients with IBD (46 [82%]) reported poor sleep quality; 22 (79%) of the patients taking immunomodulators or biologic agents and 24 (86%) of the patients not on these therapies had a global PSQI score ≥5, suggestive of poor sleep quality. However, we found no significant difference between the 2 groups. When we analyzed the 7 PSQI sleep domains individually, we found improved sleep duration in the group taking immunomodulators or biologic agents compared to the group not on therapy, although the difference was not statistically significant. CONCLUSION: The majority of patients with IBD experience some degree of sleep impairment, and treatment with immunomodulators and biologic agents does not appear to improve sleep quality. A multicenter study with a larger sample size is warranted to better assess the diverse population of patients with IBD and the factors that impact their sleep. Routine assessment of sleep quality during IBD clinical encounters is recommended.
BACKGROUND: Inflammatory bowel disease (IBD) can disrupt normal sleep physiology and amplify a negative perception about quality of life. Evidence suggests increased circulation of inflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-1, may play a role. METHODS: A total of 56 patients completed the Pittsburgh Sleep Quality Index (PSQI) to measure 7 sleep domains: sleep quality, sleep latency, sleep duration, sleep efficacy, sleep disturbance, sleep medications, and daytime dysfunction. Domain scores were summed to determine the presence or absence of sleep impairment. We compared patients taking immunomodulators or biologic agents to patients not on immunomodulator or biologic agent therapy. Demographics and IBD-related clinical information were collected to adjust for potential confounders that may secondarily affect sleep, such as body mass index, depression/anxiety, and sleep-affecting medications. RESULTS: The majority of patients with IBD (46 [82%]) reported poor sleep quality; 22 (79%) of the patients taking immunomodulators or biologic agents and 24 (86%) of the patients not on these therapies had a global PSQI score ≥5, suggestive of poor sleep quality. However, we found no significant difference between the 2 groups. When we analyzed the 7 PSQI sleep domains individually, we found improved sleep duration in the group taking immunomodulators or biologic agents compared to the group not on therapy, although the difference was not statistically significant. CONCLUSION: The majority of patients with IBD experience some degree of sleep impairment, and treatment with immunomodulators and biologic agents does not appear to improve sleep quality. A multicenter study with a larger sample size is warranted to better assess the diverse population of patients with IBD and the factors that impact their sleep. Routine assessment of sleep quality during IBD clinical encounters is recommended.
Entities:
Keywords:
Immunologic factors; inflammatory bowel disease; sleep medicine
Authors: Ashwin N Ananthakrishnan; Millie D Long; Christopher F Martin; Robert S Sandler; Michael D Kappelman Journal: Clin Gastroenterol Hepatol Date: 2013-02-01 Impact factor: 11.382
Authors: Laurie Keefer; Edward J Stepanski; Ziba Ranjbaran; Laura M Benson; Ali Keshavarzian Journal: J Clin Sleep Med Date: 2006-10-15 Impact factor: 4.062
Authors: A N Vgontzas; E Zoumakis; E O Bixler; H-M Lin; H Follett; A Kales; G P Chrousos Journal: J Clin Endocrinol Metab Date: 2004-05 Impact factor: 5.958
Authors: F Pace; P Molteni; S Bollani; P Sarzi-Puttini; R Stockbrügger; G Bianchi Porro; D A Drossman Journal: Scand J Gastroenterol Date: 2003-10 Impact factor: 2.423
Authors: Quentin J Pittman; Mark G Swain; Keith A Sharkey; Nina L Cluny; Kewir D Nyuyki; Wagdi Almishri; Lateece Griffin; Benjamin H Lee; Simon A Hirota Journal: J Neuroinflammation Date: 2022-04-04 Impact factor: 8.322