Clinical and Nutritional Factors Associated with Sleep Quality in Patients With Inflammatory Bowel Disease
AIBD 2023
Background:
Inflammatory bowel disease (IBD), Crohn’s disease (CD), and ulcerative colitis (UC) can lead to complications, worse quality of life and impairment of other functions, such as sleep. Poor sleep quality is associated with changes in body composition, such as overweight and obesity.
Methods:
The objective was to evaluate the quality of sleep of people with IBD and investigate the association with disease activity, quality of life and body composition. METHOD: Cross-sectional study including patients with IBD at the Faculty of Medicine of Botucatu – Department of Clinical Medicine District of Rubião Júnior, s/n CEP 18618-970 Botucatu São Paulo Brazil Tel 55 14 3882 2969/Fax 55 14 3882 2238 Campus Botucatu clinical activity and/or remission. Disease activity was assessed according to the Mayo score for UC and the Harvey-Bradshaw Index (HBI) for CD. The Pittsburgh Questionnaire (PSQI) was used to assess sleep quality. Quality of life was assessed using the Inflammatory Bowel Disease Questionnaire (IBDQ). Presence of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Body composition was assessed using anthropometric measurements and calculated using the Durnin & Womersley, Siri and Weltman formulas.
Results:
107 patients included, 52 (48.60%) CD and 55 (51.40%) UC; 54.21% women; age 41.57±13.21 years. In CD, 80.39% of patients in remission, 13.73% mild activity and 5.88% moderate activity. In UC, 48.15% in remission, 40.74% mild activity and 11.11% moderate activity. For the PSQI score, patients with IBD had 33.02% good sleep quality, 46.23% poor sleep and 20.75% sleep disorders. The presence of poor sleep and sleep disorders were associated with older age (p=0.0160), female sex (p=0.0220), elevated C-Reactive Protein (CRP) (3.42±6.15 vs. 3.05±7.56) (P< 0.0001), non-use of immunosuppressants (p=0.0469) and CD activity (p=0.0004). Muscle strength was preserved in patients with good sleep quality versus poor sleep or sleep disorders (37.36±9.97 vs 32.22±10.45 vs 30.60±10.40) (p=0.0346). To the anxiety and depression scales were worse as sleep quality worsened. Anxiety (3.91±3.78 vs 7.33±4.93 vs 10.41±5.02) (P< 0.0001) and depression (3.86 ± 3.11 vs 5.92±4.45 vs 8.45±4.62) (p=0.0009). For IBDQ, the better the quality of sleep, better quality of life (190.06±23.09 vs 164.78±33.14 vs 134.41±42.07) (P< 0.0001). There was no association between sleep quality and body composition.
Conclusions:
Patients with IBD present significant associations between their clinical variables and sleep quality, being a fundamental parameter for outpatient monitoring.
