P1289 Sleep Quality and Associated Factors in Patients with Inflammatory Bowel Disease: A Cross-Sectional Study
Authors: Asgharnezhad M , Maroufizadeh S , Isanazar A , Hedayatzadeh Z , Joukar F , Mansour Ghanaei F 
Published: January 2025

Background

Inflammatory bowel disease (IBD), encompassing crohn’s disease (CD) and ulcerative colitis (UC), considerably impacts patients’ quality of life, with sleep disturbances being a prevalent concern. This study aimed to investigate the association between sleep quality and various factors in IBD patients

Methods

A cross-sectional study was conducted involving 307 IBD patients (50 CD and 257 UC) from Guilan province, North of Iran, between 2021 and 2023. Participants were recruited from Razi hospital and the IBD registry of the Gastrointestinal and Liver Diseases Research Center of Guilan University of Medical Sciences. Data were collected using standardized questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9).

Results

The mean age of participants was 45.4 ±13.1 years, most participants (67.1%) were female. The mean global PSQI score was 3.09, indicating that 11.7% of patients experienced poor sleep quality. Notable correlations were found between PSQI scores and GAD-7 (r=0.158, P=0.005) and PHQ-9 scores (r=0.246, P&lt;0.001). Multivariable analysis revealed that each one-point increase in PHQ-9 score was associated with a 0.18-point increase in PSQI score (P&lt;0.001), and patients with comorbidities had PSQI scores 1.32 points higher than those without (P=0.043).

Conclusion

The study highlights a notable prevalence of poor sleep quality among IBD patients, with important associations identified with psychological factors and comorbid conditions. These findings underscore the importance of addressing sleep disturbances in the comprehensive management of IBD, emphasizing the need for targeted interventions to improve sleep quality and overall patient well-being.

References

1.Danpanichkul P, Duangsonk K, Lopimpisuth C, Ho AH-Y, Fangsaard P, Sukphutanan B, et al. Geographical and sociodemographic epidemiology of inflammatory bowel disease in young females from 2010 to 2019. Digestive and Liver Disease. 2024.

2.Sanat ZM, Vahedi H, Malekzadeh R, Fanni Z. Epidemiologic profile of inflammatory bowel disease in Eastern Mediterranean Region (EMRO) countries: a systematic review and meta-analysis. BMC public health. 2024;24.

3.Habibi F, Habibi ME, Gharavinia A, Mahdavi SB, Akbarpour MJ, Baghaei A, et al. Quality of life in inflammatory bowel disease patients: A cross-sectional study. Journal of Research in Medical Sciences. 2017;22(1):104.

4.Guadagnoli L, Horrigan J, Walentynowicz M, Salwen-Deremer JK. Sleep quality drives next day pain and fatigue in adults with inflammatory bowel disease: A short report. Journal of Crohn’s and Colitis. 2024;18(1):171-4.

5.Marinelli C, Savarino E, Marsilio I, Lorenzon G, Gavaruzzi T, D’Incà R, et al. Sleep disturbance in inflammatory bowel disease: prevalence and risk factors–a cross-sectional study. Scientific reports. 2020;10(1):507.

6.Barnes A, Mountifield R, Baker J, Spizzo P, Bampton P, Mukherjee S. Systematic review and meta-analysis of sleep quality in inactive inflammatory bowel disease. JGH open : an open access journal of gastroenterology and hepatology. 2022;6(11):738-44.

7.Habibi F, Mahdavi SB, Khaniabadi BM, Habibi ME, Gharavinia A, Baghaei A, et al. Sleep quality and associated factors in Iranian inflammatory bowel disease patients. Journal of Research in Medical Sciences. 2019;24(1):59.

8.Kinnucan JA, Rubin DT, Ali T. Sleep and inflammatory bowel disease: exploring the relationship between sleep disturbances and inflammation. Gastroenterology & hepatology. 2013;9(11):718.

9.Barnes A, Mountifield R, Baker J, Spizzo P, Bampton P, Andrews JM, et al. A systematic review and meta-analysis of the prevalence of poor sleep in inflammatory bowel disease. Sleep Advances. 2022;3(1):zpac025.

10.Malekzadeh MM, Sima A, Alatab S, Sadeghi A, Daryani NE, Adibi P, et al. Iranian Registry of Crohn’s and Colitis: study profile of first nation-wide inflammatory bowel disease registry in Middle East. Intest Res. 2019;17(3):330-9.

11.Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine. 2006;166(10):1092-7.

12.Omani-Samani R, Maroufizadeh S, Ghaheri A, Navid B. Generalized anxiety Disorder-7 (GAD-7) in people with infertility: a reliability and validity study. Middle east fertility society journal. 2018;23(4):446-9.

13.Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Slack Incorporated Thorofare, NJ; 2002. p. 509-15.

14.Maroufizadeh S, Omani-Samani R, Almasi-Hashiani A, Amini P, Sepidarkish M. The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility. Reproductive health. 2019;16:1-8.

15.Gholizadeh L, Shahmansouri N, Heydari M, Davidson PM. Assessment and detection of depression in patients with coronary artery disease: validation of the Persian version of the PHQ-9. Contemporary nurse. 2019;55(2-3):185-94.

16.Shadzi MR, Rahmanian M, Heydari A, Salehi A. Structural validity of the Pittsburgh Sleep Quality Index among medical students in Iran. Scientific reports. 2024;14(1):1538.

17.Helles M, Fletcher R, Münch M, Gibson R. Examining the structure validity of the Pittsburgh Sleep Quality Index among female workers during New Zealand’s initial COVID-19 lockdown. Sleep and Biological Rhythms. 2024;22(2):217-25.

18.Ballesio A, Zagaria A, Baccini F, Micheli F, Di Nardo G, Lombardo C. A meta-analysis on sleep quality in inflammatory bowel disease. Sleep Medicine Reviews. 2021;60:101518.

19.Hao G, Zhu B, Wang P, Li L, Hou L. Sleep quality and disease activity in patients with inflammatory bowel disease: a systematic review and meta-analysis. Sleep medicine. 2020;75:301-8.

20.Sochal M, Małecka-Panas E, Gabryelska A, Talar-Wojnarowska R, Szmyd B, Krzywdzińska M, et al. Determinants of sleep quality in inflammatory bowel diseases. Journal of clinical medicine. 2020;9(9):2921.

21.Sariyildiz MA, Batmaz I, Bozkurt M, Bez Y, Cetincakmak MG, Yazmalar L, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. Journal of clinical medicine research. 2014;6(1):44.

22.Zhang L, Li G, Bao Y, Liu M. Role of sleep disorders in patients with cardiovascular disease: A systematic review. International Journal of Cardiology Cardiovascular Risk and Prevention. 2024:200257.

23.Liu C, Zhang J, Chen M, An P, Xiang J, Yu R, et al. Gender differences in psychological symptoms and quality of life in patients with inflammatory bowel disease in China: a multicenter study. Journal of Clinical Medicine. 2023;12(5):1791.

24.Yunus MB. The role of gender in fibromyalgia syndrome. Current rheumatology reports. 2001;3(2):128-34.

25.Wu L, Shi P-L, Tao S-S, Tao J-H, Wu G-C. Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis. Clinical Rheumatology. 2021;40:913-22.

26.Hinze AM, Chu P, Sen DP, Al-Hammadi N, Ju Y-ES, Kim AH. 55 Poor sleep quality assessed subjectively associated with worsening SLE disease activity. Archives of Disease in childhood; 2019.

27.Hood MM, Wilson R, Gorenz A, Jedel S, Raeisi S, Hobfoll S, et al. Sleep quality in ulcerative colitis: associations with inflammation, psychological distress, and quality of life. International journal of behavioral medicine. 2018;25:517-25.

28.Miller MA, Cappuccio FP. Inflammation, sleep, obesity and cardiovascular disease. Current vascular pharmacology. 2007;5(2):93-102.

29.Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A. Impact of sleep disturbances in inflammatory bowel disease. Journal of gastroenterology and hepatology. 2007;22(11):1748-53.

30.Graff LA, Walker JR, Russell AS, Bissonnette R, Bernstein CN. Fatigue and quality of sleep in patients with immune-mediated inflammatory disease. The Journal of Rheumatology Supplement. 2011;88:36-42.