Impaired Sleep Quality in Crohn’s Disease Depends on Disease Activity

Gingold‐Belfer, Rachel; Peled, Nir; Levy, Sigal; Katz, Neriel; Niv, Yaron; Fass, Ronnie; Fraser, Gerald; Dickman, Ram

doi:10.1007/s10620-013-2890-8

Cited by 35 publications

(18 citation statements)

References 21 publications

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“…A majority of these studies utilized validated questionnaires to assess subjective sleep quality including the Pittsburgh Sleep Quality Index (PQSI), the Patient-Reported Outcomes Measurement Information System (PROMIS), the Modified Fatigue Impact Scale (MFIS), or the Epworth Sleepiness Scale (ESS). Data from these studies was consistent and patients with IBD, regardless of whether disease was quiescent or active, reported poorer sleep than healthy controls [5,91,[97][98][99][100][101][102][103][104].…”

Section: Patients With Ibd Report Inadequate Sleepmentioning

confidence: 85%

“…In a case-control study, Ranjbaran et al found that subjects with IBD identified prolonged sleep latency, increased fragmentation, use of sleeping aids, and decreased energy as factors associated with poorer overall sleep [91]. Another prospective cohort study corroborated the higher utilization of sleep medications in patients with IBD [100].…”

Section: Patients With Ibd Report Inadequate Sleepmentioning

confidence: 94%

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Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

et al. 2019

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Fatigue is a burdensome, multidimensional, and multifactorial symptom that is associated with a wide array of chronic illnesses, specifically occurring in nearly 50% of patients with inflammatory bowel disease (IBD). Although common, given its subjective nature, physicians often under-recognize and undertreat this debilitating symptom. There are multiple etiologies that can contribute to fatigue in patients with IBD, including disease activity, anemia, medications, psychosomatic symptoms, and alterations to the gut-brain axis. The management of fatigue in IBD can be challenging, as it is often times multifaceted. In this review, we summarize the available tools for the diagnosis and measurement of fatigue, discuss etiologies, and make recommendations for their management. We identify knowledge gaps for the workup and treatment of fatigue and propose an algorithm to aid physicians in the evaluation and management of fatigue in this unique population. However, future research is needed to address several areas of knowledge deficits and improve the management of fatigue in IBD.

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Section: Patients With Ibd Report Inadequate Sleepmentioning

confidence: 85%

Section: Patients With Ibd Report Inadequate Sleepmentioning

confidence: 94%

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

et al. 2019

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“…4 Several studies in pediatric and adult IBD patients have recorded sleep disturbances in active and inactive IBD. [5][6][7] Indeed, sleepimpaired patients in remission at baseline had an increased risk for disease flare. 8 Similarly, patients with histological evidence of inflammation had sleep disturbances, which were independent of their clinical disease activity status.…”

Section: Nflammatory Bowel Disease (Ibd) Includingmentioning

confidence: 99%

Clock Gene Disruption Is an Initial Manifestation of Inflammatory Bowel Diseases

Weintraub

Cohen

Chapnik

et al. 2020

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: Sleep disruption modifies the immune system and can trigger flares of inflammatory bowel diseases (IBD). Changes in expression of clock genes have been reported in patients with IBD. We investigated whether a change in the circadian clock is an early event in development of IBD. METHODS: We performed a prospective study of patients younger than 21 years old who underwent diagnostic endoscopies at the pediatric and adult gastroenterology units at the Tel Aviv Sourasky Medical Center from August 2016 through August 2017. Questionnaires were completed by 32 patients with IBD (8-21 years old) and 18 healthy individuals (controls) that provided data on demographics, sleep, disease activity scores. We also obtained data on endoscopic scores, anthropometric parameters, blood level of C-reactive protein (CRP), and fecal level of calprotectin. Peripheral blood and intestinal mucosa samples were analyzed for expression levels of clock gene (CLOCK, BMAL1, CRY1, CRY2, PER1, and PER2). RESULTS: Levels of CRP and fecal calprotectin were significantly higher in patients with IBD compared with controls (P<.05). Expression levels of clock genes (CLOCK, CRY1, CRY2, PER1, and PER2) were significantly lower in inflamed intestinal mucosa from patients compared with intestinal mucosa from controls (P<.05). Expression levels of all clock genes except for PER2, were also significantly lower in non-inflamed intestinal mucosal tissues from patients compared with controls (P<.05). Expression levels of clock genes (CLOCK, BMAL1, CRY1, CRY2, PER1 and PER2) were lower in white blood cells from patients with IBD compared with controls. This reduction was greater in white blood cells from patients with ulcerative colitis than in patients with Crohn's disease. CONCLUSION: Young, newly diagnosed, untreated patients with IBD have reduced expression of clock genes in inflamed and non-inflamed intestinal mucosal samples, and also in blood cells, compared with healthy individuals. Alterations in expression of clock genes might be an early event in IBD pathogenesis. ClinicalTrials.gov Identifier: NCT03662646

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“…In the gastrointestinal tract, significant associations between sleep disturbances and gastroesophageal reflux disease (Fujiwara et al 2012 ), functional dyspepsia (Lacy et al 2011 ), irritable bowel syndrome (Ranjbaran et al 2007a ; Nojkov et al 2010 ), and IBD (Ranjbaran et al 2007a ; Graff et al 2011 ; Ali et al 2013 ; Gingold-Belfer et al 2014 ; Ananthakrishnan et al 2013 , 2014 ) have been reported. Sleep disturbances are commonly found in IBD patients, especially those with active disease (Graff et al 2011 ; Ali et al 2013 ; Gingold-Belfer et al 2014 ; Ananthakrishnan et al 2014 ), and associated with new onset of UC (Ananthakrishnan et al 2014 ) and CD flares (Ananthakrishnan et al 2013 ). However, the prevalence of sleep disturbances in Japanese IBD patients and the association between sleep disturbances and disease flare is unknown.…”

Section: Introductionmentioning

confidence: 99%

Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare

et al. 2016

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BackgroundSeveral studies have reported a significant association between sleep disturbance and inflammatory bowel disease (IBD). The aim of the present study is to compare the clinical characteristics and the health-related quality of life (HR-QOL) of Japanese IBD patients with or without sleep disturbances, and to investigate the risk factors for disease flare in these patients.MethodsIBD patients were asked to complete a self-administered questionnaire including the Pittsburg sleep quality index and the 8-item short-form health survey. The information about disease flare within 1 year from enrollment in the study was analyzed with a multiple logistic regression model to identify risk factors for IBD flare-ups.ResultsThe prevalence of sleep disturbances was 44.1 % (60 out of 136 IBD patients). Use of sleep medications was significantly higher in IBD patients with sleep disturbances whereas use of immuno modulators was significantly higher in IBD patients without sleep disturbances. The scores from all HR-QOL domains were significantly lower in patients with sleep disturbances than in patients without sleep disturbances. Fifty-one patients (37.5 %) had disease flare within 1 year from enrollment in the study and sleep disturbances were identified as a significant risk factor for disease flare (OR 3.09, 95 % CI 1.47–6.43).ConclusionsOur results indicate that sleep disturbances are common in Japanese IBD patients and are associated with poorer HR-QOL. Since the presence of sleep disturbances is a significant risk factor for IBD flare-ups, we encourage physicians to perform a careful examination of sleep disturbances in IBD patients.

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Impaired Sleep Quality in Crohn’s Disease Depends on Disease Activity

Abstract: Impaired sleep quality is associated with active Crohn's disease, but not inactive disease.

Cited by 35 publications

References 21 publications

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Fatigue in Inflammatory Bowel Diseases: Etiologies and Management

Clock Gene Disruption Is an Initial Manifestation of Inflammatory Bowel Diseases

Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare

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