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Poor sleep linked to Crohn’s disease relapse, not ulcerative colitis
Patients with Crohn’s disease in remission who reported sleep disturbances were more likely to experience active disease or disease flares, while those with ulcerative colitis were not in a recent study.
Researchers evaluated data from 3,173 adult patients with IBD enrolled in the longitudinal, Internet-based Crohn’s and Colitis Foundation of America Partners study. The cohort included 507 patients with ulcerative colitis (UC) and 1,291 with Crohn’s disease (CD) in clinical remission at baseline. Sleep disturbance was assessed by the Patient Reported Outcomes Measurement Information Systems questionnaire. The Crohn’s Disease Activity Index was used to assess CD activity, and the Simple Clinical Colitis Activity Index measured UC activity.
Sleep disturbance at study enrollment was reported by 60% of participants. Active disease was significantly more common among those with impaired sleep (55% of cases vs. 26%; P<.001). Poor sleep was significantly associated with depression(OR=2.75; 95% CI, 2.34-3.23), disease activity (OR=2.61; 95% CI, 2.19-3.11), tobacco use (OR=2.17; 95% CI, 1.55-3.03), female sex (OR=1.18; 95% CI, 0.99-1.41) and use of narcotics (OR=1.65; 95% CI, 1.17-2.35) or corticosteroids (OR=1.33; 95% CI, 1.04-1.7).
Among CD patients in remission (n=1,291), 50% reported sleep disturbances. These patients were more likely to experience active disease (adjusted OR=2.00; 95% CI, 1.45-2.76) or disease flare (OR=1.64; 95% CI, 1.27-1.11) after 6 months than those who did not report impaired sleep. No such association was observed among patients with UC in remission (OR=1.14; 95% CI, 0.75-1.74).
“We identified sleep impairment during remission to be a risk factor for disease flares in CD in a large IBD cohort,” the researchers concluded. “Continued research is needed to further understand the mechanisms behind such an association. Furthermore, our findings suggest that sleep quality could be a modifiable factor in reducing risk of disease relapses in IBD. There is a need for further research on the potential benefits of routine assessment of sleep quality, as well as intervention-based studies to improve sleep quality in patients with CD, which ultimately may impact patient outcomes.”
Disclosure: The researchers report no relevant financial disclosures.