The causes of disordered sleep, frequently reported by patients with inflammatory bowel diseases (IBD), are poorly understood. The study aimed to evaluate sleep quality in IBD patients and to identify factors affecting their sleep. IBD patients (n = 133) and healthy controls (HC; n = 57) were included in the study and completed sleep questionnaires (Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Epworth sleepiness scale (ESS)), Beck Depression Inventory (BDI), and pain scales (Visual Analogue Scale and Laitinen Pain Scale). IBD patients attained higher scores in all sleep questionnaires compared to HC: PSQI, AIS, and ESS (all p < 0.001). They also had prolonged sleep latency (p < 0.001) with reduced sleep efficiency (p < 0.001). Patients in exacerbation of IBD had higher scores in PSQI (p = 0.008), ESS (p = 0.009), but not in AIS, compared to those in remission. Participants with comorbid chronic diseases had higher scores in PSQI and AIS, but not in ESS, compared to others. Multiple regression revealed that the sleep questionnaire results were significantly affected by mood level (BDI), but not by the aforementioned pain scales. Sleep impairment in IBD patients is a common problem that deserves attention in everyday clinical practice and mood level seems to be the main factor affecting the quality of sleep in IBD patients.

Introduction: Anti-TNF-α therapy of Crohn's disease (CD) represents considerable progress in inflammatory bowel disease (IBD) treatment; however, many patients still require surgical intervention. The Polish National Insurance Fund currently only covers up to 2 years of infliximab (IFX) therapy in CD patients and 1 year of adalimumab (ADA). Aim: To estimate the effectiveness and side effects of the anti-TNF-α Polish therapeutic program in CD patients. Material and methods: In this retrospective study, medical documentation of 80 CD patients treated with anti-TNF-α (IFX or ADA) was analysed. Fifty-two patients finished 1 year of therapy, and 28 individuals did not complete it due to lack of response to treatment or severe side effects. Results: After treatment, 27 (67.50%) patients achieved a semi-annual remission and 14 (35%) achieved yearly remission. Twenty percent of patients experienced severe side effects such as anaphylactic shock, pneumonia, shingles, or upper respiratory tract infections. A strong negative correlation between the number of patients in remission and the period since therapy termination (r =-0.996, p < 0.001) was found. During the 1-year follow-up, 20 patients were re-enrolled in the biological therapy program (the median time to next therapy was 231 days IQR: 126.5-300.5) Conclusions: Anti-TNF-α treatment in CD is relatively safe. The restricted time period of the therapy affects the clinical course of the disease and entails the need to resume biological therapy.

factors in the efficacy evaluation of anti -TNF -α therapy limited to 1 year.Therefore, in this study, we aimed to develop a simple index based on blood count parameters and clinical variables to predict the efficacy of limited, 1 -year adalimumab therapy.Patients and methods This retrospective study included 47 patients with CD who received adalimumab for 52 weeks. The inclusion criteria for biologic treatment were as follows: Crohn Disease Activity Index above 300, no response or intolerance and / or contraindications to conventional treatment with glucocorticosteroids and / or immunosuppressants, or persistent fistulas. The biologic treatment consisted of 12-week induction therapy and 40-week maintenance therapy; adalimumab at a dose of 160 mg was administered subcutaneously at the beginning of the therapy, at 80 mg after 2 weeks, and then at 40 mg every 2 weeks.Venous blood was drawn from patients before and after 12 -week induction therapy and the following parameters were analyzed: white blood cell (WBC) count, platelet count, and MPV. Clinical data were collected, with a particular emphasis on the history of CD complications (ie, fistulas, abscesses, fissures, intestinal stenosis, and obstruction). Six months after the end of the treatment, data on clinical exacerbation of CD regarding surgical therapy and glucocorticoid use or biologic retreatment during this period were obtained from patients' medical records.We developed an index based on selected blood count parameters and clinical variables related to the course of the disease. Only variables with significant odds ratios (ORs) were included in the index and weights were allocated for each parameter based on the OR value.