Systematic review and meta‐analysis of sleep quality in inactive inflammatory bowel disease

Barnes, A. D.; Mountifield, Réme; Baker, Justin N.; Spizzo, Paul; Bampton, Peter A.; Mukherjee, Sutapa

doi:10.1002/jgh3.12817

Cited by 12 publications

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References 39 publications

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“…IBD may impair sleep through its myriad of disabling symptoms, including abdominal pain and nocturnal diarrhea 11 . Poor sleep is more common in those with IBD than controls, 11 more common in those with active IBD than inactive IBD, 11,12 and remains more common in those with inactive IBD than controls 13 . Endoscopically or histologically active IBD in the absence of any IBD symptoms may be sufficient to disrupt sleep 14,15 .…”

Section: Introductionmentioning

confidence: 99%

“…11 Poor sleep is more common in those with IBD than controls, 11 more common in those with active IBD than inactive IBD, 11,12 and remains more common in those with inactive IBD than controls. 13 Endoscopically or histologically active IBD in the absence of any IBD symptoms may be sufficient to disrupt sleep. 14,15 There have been several association studies of sleep and IBD with comorbid depression [16][17][18][19][20][21][22][23] frequently associated with poor sleep, and low physical activity associated with poor sleep.…”

Section: Introductionmentioning

confidence: 99%

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Examining the influence of inflammatory bowel disease medications on sleep quality

et al. 2023

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Background and Aim: Inflammatory bowel disease (IBD) can disrupt sleep, leading to poor sleep quality. This may in part be due to the symptoms of IBD and the influence of pro-inflammatory cytokines on sleep. This study aimed to investigate the potential influence of IBD medications on sleep quality. Methods: An online survey of adults with IBD was conducted, which included measures of sleep quality, IBD activity, anxiety, depression, and physical activity. Logistic regression was used to investigate possible associations between IBD medications (corticosteroids, immunomodulators, biologics, aminosalicyate) and outcome of poor sleep. A generalized linear model was built for outcome of sleep quality score. Results: There were 544 participants included in the final analysis, median age of 42, and 61% with Crohn's disease. Increased odds of poor sleep were seen in those taking opioids, medications for anxiety or depression, corticosteroids, vitamin D, methotrexate, and infliximab. A multivariate model was built incorporating demographic and IBD variables with opioids present in the final model and associated with increased odds of poor sleep. This was in addition to medications for sleep, depression, anxiety, IBD activity, and body weight. In a multivariate generalized linear model, opioids and methotrexate were associated with worse sleep quality scores. Conclusions: Opioids were associated with increased odds of poor sleep independent of other factors. This provides further support for avoiding these medications in people with IBD. Infliximab was associated with increased body weight and consequently increased odds of poor sleep.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Examining the influence of inflammatory bowel disease medications on sleep quality

et al. 2023

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“…Poor sleep quality is highly prevalent in active IBD patients, ranging from 73 to 100% ( 4 ), much higher than in healthy controls. Inactive IBD patients were also found to have poorer sleep quality than healthy controls, suggesting that sleep quality in IBD patients is not only due to IBD-related symptoms ( 5 ). Therefore, it needs to describe the associations between sleep quality and IBD to inform the development of therapies that enhance the quality of life among IBD patients.…”

Section: Introductionmentioning

confidence: 99%

“…It also found that poor sleep quality is one of the main concerns for patients with chronic intestinal disease, which can negatively impact health and work productivity in the long term ( 6 ). As an immune-related gastrointestinal disease, the sleep quality in IBD can affect not only its symptoms but also might act as an extraintestinal manifestation and aggravating or etiological factor ( 5 ). However, although poor sleep quality is a significant health concern among IBD patients, it is often underappreciated in clinical medicine.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for poor sleep quality in patients with inflammatory bowel disease in China: A multicenter study

et al. 2023

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ObjectivesThis study aimed to determine the prevalence and risk factors for poor sleep quality in inflammatory bowel disease (IBD) patients.Methods2,478 IBD patients were enrolled to investigate their sleep quality using the Pittsburgh sleep quality index (PSQI). Clinical and psychological characteristics were collected to explore the risk factors for poor sleep quality. A hurdle model was conducted to predict poor sleep quality based on the risk factors. Among this hurdle model, the logistic regression model was used to determine risk factors of the presence of poor sleep quality, and the zero-inflated negative binomial model was employed to identify risk factors of the severity of poor sleep quality.ResultsIn this study, 1,491 (60.17%) IBD patients had poor sleep quality, and the proportion in the older group was higher than younger group (64.89% vs. 58.27%, p = 0.003). According to multivariable logistic regression, age (OR, 1.011; 95% CI [1.002,1.020]; p = 0.014), Patient Health Questionnaire-9 (PHQ-9) score (OR, 1.263; 95% CI [1.228,1.300]; p < 0.001), systemic (OR, 0.906; 95% CI [0.867,0.946]; p < 0.001) and emotional performance (OR, 1.023; 95% CI [1.005,1.043]; p = 0.015) were risk factors of the presence of poor sleep quality. The area under the curve (AUC) of the prediction model was 0.808. According to zero-truncated negative binomial regression, age (RR, 1.004; 95% CI [1.002,1.005]; p < 0.001) and PHQ-9 score (RR, 1.027; 95% CI [1.021,1.032]; p < 0.001) were risk factors of the severity of poor sleep quality.ConclusionThe prevalence of poor sleep quality among the older group in IBD patients was relatively high. Old age and depressive mood are risk factors for both the presence and severity of poor sleep quality.

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“… 2 Poor sleep is more common in those with IBD than controls, 3 more common in those with active IBD than inactive IBD, 3 , 4 and more common in those with inactive IBD than controls. 5 Mental health conditions such as anxiety and depression have been associated with poor sleep in an IBD population. 6–13 …”

Section: Introductionmentioning

confidence: 99%

Simple Novel Screening Tool for Obstructive Sleep Apnea in Inflammatory Bowel Disease

Barnes

Andrews

Mukherjee

et al. 2023

Crohn's &Amp; Colitis 360

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Introduction Inflammatory bowel disease (IBD) has been associated with increased risk of obstructive sleep apnoea (OSA). We aimed to examine the associations of obstructive sleep apnoea, sleepiness and IBD related data and comorbidities, with the aim of developing a screening tool for sleep apnoea in this population. Methods An online survey of adults with IBD was administered which included measures of assessment of risk of OSA, and measures of IBD activity, IBD related disability, anxiety, and depression. Logistic regression was performed to investigate the associations between risk of OSA and IBD data, medications, demographics, and mental health conditions. Further models were built for an outcome of severe daytime sleepiness and a combined outcome of risk of OSA and at least mild daytime sleepiness. A simple score was constructed for the purpose of screening for OSA. Results There were 670 responses to the online questionnaire. The median age was 41 years, the majority had Crohn’s disease (57%), median disease duration was 11.9 years and approximately half were on biologics (50.5%). Moderate-high risk of OSA was demonstrated in 22.6% of the cohort. A multivariate regression model for moderate-high risk of OSA included increasing age, obesity, smoking and abdominal pain sub-score. For a combined outcome of moderate-high risk of OSA and at least mild daytime sleepiness a multivariate model included abdominal pain, age, smoking, obesity, and clinically significant depression. A simple score was constructed for screening for OSA utilising age, obesity, IBD activity and smoking status with an area under the receiver operation curve of 0.77. A score above 2 had a sensitivity of 89% and a specificity of 56% for moderate-high risk of OSA and could be utilised for screening for OSA in IBD clinic. Conclusion Over one fifth of an IBD cohort met significantly high-risk criteria for OSA to warrant referral for a diagnostic sleep study. The risk of OSA was associated with abdominal pain, along with more traditional risk factors such as smoking, increasing age, and obesity. Consideration should be given for screening for OSA in IBD patients utilising a novel screening tool that utilises parameters typically available in IBD clinic.

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Systematic review and meta‐analysis of sleep quality in inactive inflammatory bowel disease

Cited by 12 publications

References 39 publications

Examining the influence of inflammatory bowel disease medications on sleep quality

Examining the influence of inflammatory bowel disease medications on sleep quality

Risk factors for poor sleep quality in patients with inflammatory bowel disease in China: A multicenter study

Simple Novel Screening Tool for Obstructive Sleep Apnea in Inflammatory Bowel Disease

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