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Year 2021 / Volume 113 / Number 7
Original

Prevalence and factors associated with poor sleep quality in inflammatory bowel disease outpatients

512-518

DOI: 10.17235/reed.2020.7202/2020

Elisa García Calvo, Miguel Durà Gil, Benito Velayos Jiménez, Luis I Fernández Salazar,

Abstract

Introduction: sleep disorders are common in the general population and have obvious repercussions on quality of life. Poor sleep quality is associated to inflammatory activity and fatigue in inflammatory bowel disease (IBD) patients. This study aimed to analyze the prevalence of poor sleep quality and the factors associated with it, in IBD outpatients. Methods: an observational and prospective study was performed in which epidemiological, clinical and laboratory data were collected from clinical records and patients who consecutively attended an outpatient clinic. Pittsburgh Sleep Quality index (PSQI), Hospital Anxiety and Depression Scale (HADS) and International Physical Activity Questionnaire (IPAQ) were used to measure sleep quality, anxiety, depression and physical activity, respectively. Treatment optimizations, hospital admissions or surgery were prospectively verified three months after the baseline visit. Results: one hundred and two patients were included and 54.9 % had poor sleep quality (PSQI score > 5). No association was found between poor sleep quality and IBD-related variables such as type of disease, ulcerative colitis (UC) extent, Crohn’s disease (CD) location or behavior, time from diagnosis, treatment, prior admissions or surgery and laboratory values. Rotating night shift job (OR 6.116, 95 % CI: 1.312-28.514), HAD score for depression (OR 1.125, 95 % CI: 1.062-1.490) and frequency (days per week) of vigorous physical activity (OR 0.783, 95 % CI: 0.619-0.991) were independent predictors of poor sleep quality. A Pittsburgh questionnaire score higher than 5 was not significantly associated to treatment optimization in the total patient cohort (15.2 % vs 18.2 %, p = 0.451), in UC patients (18.2 % vs 10.7 %, p = 0.362) or CD patients (12.5 % vs 25.9 %, p = 0.198). Conclusions: poor sleep quality is present in more than half of IBD patients. Aspects not directly related to IBD are associated to poor sleep quality.

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DOI: 10.1093/ecco-jcc/jjz024

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DOI: 10.1093/ibd/izz258

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DOI: 10.1002/ibd.21580

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DOI: 10.1097/MIB.0b013e3182a0ea54

7. Ananthakrishnan AN, Long MD, Martin CF, et al. Sleep disturbance and risk of active disease in patients with Crohn's disease and ulcerative colitis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2013;11(8):965-71.

DOI: 10.1016/j.cgh.2013.01.021

8. Uemura R, Fujiwara Y, Iwakura N, et al. Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare. SpringerPlus. 2016;5(1):1792.

DOI: 10.1186/s40064-016-3408-6

9. Eckert KG, Abbasi-Neureither I, Koppel M, et al. Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease - a scoping review and practical implications. BMC gastroenterology. 2019;19(1):115.

DOI: 10.1186/s12876-019-1034-9

10. Taylor K, Scruggs PW, Balemba OB, et al. Associations between physical activity, resilience, and quality of life in people with inflammatory bowel disease. European journal of applied physiology. 2018;118(4):829-36.

DOI: 10.1007/s00421-018-3817-z

11. Echarri Piudo A. Inflammatory bowel disease - Newer models of care. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva. 2019;111(8):577-8.

DOI: 10.17235/reed.2019.6495/2019

12. Buysse DJ, Reynolds CF, 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research. 1989;28(2):193-213.

DOI: 10.1016/0165-1781(89)90047-4

13. Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. General hospital psychiatry. 2003;25(4):277-83.

DOI: 10.1016/S0163-8343(03)00043-4

14. Rodriguez-Munoz S, Corella C, Abarca-Sos A, et al. Validation of three short physical activity questionnaires with accelerometers among university students in Spain. The Journal of sports medicine and physical fitness. 2017;57(12):1660-8.

15. Marinelli C, Savarino EV, Marsilio I, et al. Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors - A cross-sectional study. Scientific reports. 2020;10(1):507.

DOI: 10.1038/s41598-020-57460-6

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DOI: 10.1007/s10620-015-3580-5

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DOI: 10.17235/reed.2019.6495/2019

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DOI: 10.1016/0165-1781(89)90047-4

13. Herrero MJ, Blanch J, Peri JM, De Pablo J, Pintor L, Bulbena A. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. General hospital psychiatry. 2003;25(4):277-83.

DOI: 10.1016/S0163-8343(03)00043-4

14. Rodriguez-Munoz S, Corella C, Abarca-Sos A, Zaragoza J. Validation of three short physical activity questionnaires with accelerometers among university students in Spain. The Journal of sports medicine and physical fitness. 2017;57(12):1660-8.

15. Marinelli C, Savarino EV, Marsilio I, Lorenzon G, Gavaruzzi T, D'Inca R, et al. Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors - A cross-sectional study. Scientific reports. 2020;10(1):507.

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García Calvo E, Durà Gil M, Velayos Jiménez B, Fernández Salazar L. Prevalence and factors associated with poor sleep quality in inflammatory bowel disease outpatients. 7202/2020

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Publication history

Received: 29/04/2020

Accepted: 21/07/2020

Online First: 25/11/2020

Published: 07/07/2021

Article revision time: 78 days

Article Online First time: 210 days

Article editing time: 434 days

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