Brief behavioral therapy improves sleep disturbance in Crohn’s
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Patients with Crohn’s disease improved sleep disturbance with a stepped-care approach that included brief behavioral therapy, according to study results.
Eva Szigethy, MD, PhD, of the visceral inflammation and pain center at the University of Pittsburgh, and colleagues wrote that behavioral interventions for insomnia have shown promise in sleep improvement and fatigue in some patients with chronic diseases.
“The feasibility of sleep interventions has not been tested in young adults and adolescents with CD,” they wrote.
The study was part of a two-phase open trial that explored interventions for sleep and fatigue. The 12-week intervention included two steps. First, was a brief behavioral therapy for sleep in IBD (BBTS-I) for 4 weeks. The second phase (BUP-SR) added the psychotropic medication bupropion for 8 weeks in the subset of patients who continued to experience fatigue.
Fifty-two patients participated in phase 1 of the BBTS-I intervention, and in phase 2, 33 patients were part of the BUP-SR plus BBTS-I arm and 19 were in the BBTS-I only group.
After 4 weeks of treatment with BBTS-I, researchers observed improvements in sleep quality (P < .001) and fatigue (P < .001). After 8 weeks of phase 2, both intervention groups saw more improvements in sleep, fatigue, anxiety and depressive symptoms. However, the differences between the groups were not significant.
“This study suggests that behavioral therapy for insomnia and fatigue is feasible and associated with clinically meaningful improvements in sleep, fatigue and psychiatric symptoms but not disease activity over time,” Szigethy and colleagues wrote. “These results highlight the importance of screening for modifiable neurobiological symptoms in young adults and adolescents with CD and offering stepped sleep- and fatigue-focused treatments. Inclusion of participants with more active or severe disease in future trials will be necessary to determine the influence of sleep and fatigue improvements on disease activity, particularly the effects of bupropion in patients with sleep and mood manifestations of inflammation.”
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