Año 2021 / Volumen 113 / Número 7
Original
Prevalencia y factores asociados a la mala calidad del sueño en pacientes con enfermedad inflamatoria intestinal no hospitalizados

512-518

DOI: 10.17235/reed.2020.7202/2020

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

Resumen
Introducción: los trastornos del sueño son frecuentes en la población general y tienen repercusiones en la calidad de vida. En los pacientes con enfermedad inflamatoria intestinal (EII), la mala calidad del sueño se relaciona con la actividad inflamatoria y la fatiga. Pretendemos analizar la prevalencia de mala calidad del sueño y los factores a los que esta se asocia en pacientes con EII seguidos en consulta externa. Métodos: se trata de un estudio observacional y prospectivo en el que se han recogido datos epidemiológicos, clínicos y de laboratorio, de pacientes que acudieron a consulta programada por su EII. Se han evaluado la calidad del sueño con la escala de Pittsburgh, la ansiedad y la depresión con las escalas HAD-A y HAD-D, y la actividad física con el cuestionario internacional de actividad física (IPAQ). Se ha comprobado de forma prospectiva si en los tres meses posteriores a la visita basal hubo necesidad de optimizar el tratamiento, de ingreso o de cirugía en relación a la EII. Resultados: se han incluido 102 pacientes. El 54,9 % de ellos tenía mala calidad del sueño (puntuación en la escala de Pittsburgh superior a 5). No se ha encontrado asociación entre la mala calidad del sueño y variables relacionadas con la EII (tipo de enfermedad, extensión, localización o comportamiento, tiempo de evolución, ingresos previos, valores de laboratorio, tratamiento, o cirugía). El trabajo a turnos (OR 6,116, IC 95 %: 1,312-28,514), la puntuación en la escala HAD de depresión (OR 1,125, IC 95 %: 1,062-1,490) y el número de días a la semana con actividad física vigorosa (OR 0,783, IC 95 %: 0,619-0,991) han sido factores predictivos independientes de mala calidad del sueño. La puntuación del cuestionario de Pittsburgh superior a 5 no se ha asociado, de manera estadísticamente significativa, a una mayor frecuencia en la optimización del tratamiento en el total de pacientes (15,2 % vs. 18,2 %, p = 0,451), en los pacientes con colitis ulcerosa (CU) (18,2 % vs. 10,7 %, p = 0,362) o en los pacientes con enfermedad de Crohn (EC) (12,5 % vs. 25,9 %, p = 0,198). Conclusiones: la mala calidad del sueño está presente en más de la mitad de los pacientes con EII. Son, sobre todo, aspectos no relacionados directamente con la EII los que se relacionan con la mala calidad del sueño.
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Bibliografía
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1. Chavarria C, Casanova MJ, Chaparro M, et al. Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study. Journal of Crohn's & colitis. 2019;13(8):996-1002.
2. Sofia MA, Lipowska AM, Zmeter N, et al. Poor Sleep Quality in Crohn's Disease Is Associated With Disease Activity and Risk for Hospitalization or Surgery. Inflammatory bowel diseases. 2019.
3. Iglesias-Rey M, Barreiro-de Acosta M, Caamano-Isorna F, et al. Psychological factors are associated with changes in the health-related quality of life in inflammatory bowel disease. Inflammatory bowel diseases. 2014;20(1):92-102.
4. Graff LA, Vincent N, Walker JR, et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflammatory bowel diseases. 2011;17(9):1882-9.
5. Sobolewska-Wlodarczyk A, Wlodarczyk M, Banasik J, et al. Sleep disturbance and disease activity in adult patients with inflammatory bowel diseases. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society. 2018;69(3).
6. Ali T, Madhoun MF, Orr WC, et al. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflammatory bowel diseases. 2013;19(11):2440-3.
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.
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.
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.
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.
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.
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.
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.
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.
16. Madrid-Valero JJ, Martínez-Selva JM, Ribeiro do Couto B, et al. Age and gender effects on the prevalence of poor sleep quality in the adult population. Gaceta sanitaria. 2017;31(1):18-22.
17. Wilson RG, Stevens BW, Guo AY, et al. High C-Reactive Protein Is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease. Digestive diseases and sciences. 2015;60(7):2136-43.
18. Frey DJ, Fleshner M, Wright KP, Jr. The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults. Brain, behavior, and immunity. 2007;21(8):1050-7.
19. Barreiro-de Acosta M, Marín-Jiménez I, Panadero A, et al. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients. Gastroenterologia y hepatologia. 2018;41(2):118-27.
1. Chavarria C, Casanova MJ, Chaparro M, Barreiro-de Acosta M, Ezquiaga E, Bujanda L, et al. Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study. Journal of Crohn's & colitis. 2019;13(8):996-1002.
2. Sofia MA, Lipowska AM, Zmeter N, Perez E, Kavitt R, Rubin DT. Poor Sleep Quality in Crohn's Disease Is Associated With Disease Activity and Risk for Hospitalization or Surgery. Inflammatory bowel diseases. 2019.
3. Iglesias-Rey M, Barreiro-de Acosta M, Caamano-Isorna F, Rodriguez IV, Ferreiro R, Lindkvist B, et al. Psychological factors are associated with changes in the health-related quality of life in inflammatory bowel disease. Inflammatory bowel diseases. 2014;20(1):92-102.
4. Graff LA, Vincent N, Walker JR, Clara I, Carr R, Ediger J, et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflammatory bowel diseases. 2011;17(9):1882-9.
5. Sobolewska-Wlodarczyk A, Wlodarczyk M, Banasik J, Gasiorowska A, Wisniewska-Jarosinska M, Fichna J. Sleep disturbance and disease activity in adult patients with inflammatory bowel diseases. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society. 2018;69(3).
6. Ali T, Madhoun MF, Orr WC, Rubin DT. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflammatory bowel diseases. 2013;19(11):2440-3.
7. Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD. 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.
8. Uemura R, Fujiwara Y, Iwakura N, Shiba M, Watanabe K, Kamata N, et al. Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare. SpringerPlus. 2016;5(1):1792.
9. Eckert KG, Abbasi-Neureither I, Koppel M, Huber G. 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.
10. Taylor K, Scruggs PW, Balemba OB, Wiest MM, Vella CA. 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.
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.
12. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research. 1989;28(2):193-213.
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.
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.
16. Madrid-Valero JJ, Martínez-Selva JM, Ribeiro do Couto B, Sánchez-Romera JF, Ordoñana JR. Age and gender effects on the prevalence of poor sleep quality in the adult population. Gaceta sanitaria. 2017;31(1):18-22.
17. Wilson RG, Stevens BW, Guo AY, Russell CN, Thornton A, Cohen MA, et al. High C-Reactive Protein Is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease. Digestive diseases and sciences. 2015;60(7):2136-43.
18. Frey DJ, Fleshner M, Wright KP, Jr. The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults. Brain, behavior, and immunity. 2007;21(8):1050-7.
19. Barreiro-de Acosta M, Marín-Jiménez I, Panadero A, Guardiola J, Cañas M, Gobbo Montoya M, et al. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients. Gastroenterologia y hepatologia. 2018;41(2):118-27.
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Instrucciones para citar
García Calvo E, Durà Gil M, Velayos Jiménez B, Fernández Salazar L. Prevalencia y factores asociados a la mala calidad del sueño en pacientes con enfermedad inflamatoria intestinal no hospitalizados. 7202/2020


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Ficha Técnica

Recibido: 29/04/2020

Aceptado: 21/07/2020

Prepublicado: 25/11/2020

Publicado: 07/07/2021

Tiempo de revisión del artículo: 78 días

Tiempo de prepublicación: 210 días

Tiempo de edición del artículo: 434 días


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