P684 Sleep disturbances in IBD patients without sedative therapy

• Published in: Journal of Crohn's and colitis Vol. 12; no. supplement_1; pp. S456 - S457
• Main Authors: Gilca-Blanariu, G E, Stefanescu, G, Ciocoiu, M
• Format: Journal Article
• Language: English
• Published: UK Oxford University Press 16.01.2018
• ISSN: 1873-9946; 1876-4479
• DOI: 10.1093/ecco-jcc/jjx180.811

Abstract Background Sleep disturbances are commonly reported in IBD patients, although it is unclear whether sleep fragmentation induces the debut of IBD or it is more likely a modifiable factor, potentially leading to disease exacerbation, consequently an effect of disease. Methods An observational study was performed to assess the correlation between the quality of sleep and disease activity in IBD patients without a sedative therapy. The study included 33 subjects with IBD, admitted consecutively in the Gastroenterology Department, and sleep quality was assessed by the same investigator using Pittsburgh Sleep Quality Index (PSQI), considering the upper normal value a PSQI score of 5. Disease activity was evaluated through MAYO score/CDAI and also by serological markers of inflammation, the assessment of endoscopic activity and histological degree of inflammation. Results Only 12.12% of the evaluated patients were in clinical remission, whereas the rest of the examined patients had mild to moderate disease activity. 88% of the patients with histological evidence or serological markers of inflammation on recent ileocolonoscopy also had abnormal PSQI scores (medium PSQI score of 9), which were independent of their clinical disease activity status. There was no correlation between the PSQI score with the diseases type (Crohn’s disease, ulcerative colitis, proctitis) (p > 0.05). Most of the patients (66.67%) with clinically active disease declared sleep maintanence insomnia, whereas sleep quality was less influenced (21.2%) by digestive symptoms associated with IBD in this patient category. Conclusions There is a strong association between clinically active IBD and poor sleep quality, independent on sleeping disturbances strictly related to disease, which may be due to hormonal imbalances and an upregulation of inflammatory cytokines, consequent to disruption of the circadian rhythm. IBD and sleep disorders are entities which overlap and reciprocally enhance each other, needing further studies, including eventual correlation with hormonal imbalance and also multidisciplinary approach.