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

Uemura, Risa; Fujiwara, Yasuhiro; Iwakura, Narika; Shiba, Masatsugu; Watanabe, Kenji; Kamata, Noriko; Yamagami, Hirokazu; Tanigawa, Tetsuya; Watanabe, Toshio; Tominaga, Kazunari

doi:10.1186/s40064-016-3408-6

Cited by 30 publications

(24 citation statements)

References 31 publications

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“…However, the same effect was not demonstrated for patients with ulcerative colitis (UC) [ 16 ]. Similar results, but accounting for both CD and UC were also found in a study involving 177 Japanese patients, which demonstrated an increased risk for IBD flare within one year in patients with sleep disorders [ 17 ].…”

Section: Introductionsupporting

confidence: 81%

Association of sleep quality and mucosal healing in patients with inflammatory bowel disease in clinical remission

Michalopoulos

Vrakas

Makris

et al. 2018

aog

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BackgroundThe interaction between sleep and the immune system has been increasingly studied over the last decades. The aim of this study was to investigate the association between sleep quality and mucosal healing in patients with inflammatory bowel disease (IBD) currently in clinical remission.MethodsNinety patients with IBD in clinical remission were studied: 54 (60%) with Crohn’s disease and 36 (40%) with ulcerative colitis. All completed the Pittsburgh Sleep Quality Index, and mucosal healing was estimated with ileocolonoscopy. A subgroup analysis was also performed in order to investigate these associations in Crohn’s disease and ulcerative colitis separately.ResultsOf the 90 patients, 45.56% had poor sleep quality. Patients without mucosal healing expressed higher absolute values of the Pittsburgh Sleep Quality Index (P<0.001), while absence of mucosal healing and poor sleep quality were statistically associated (P<0.05). Subgroup analysis showed that the same pattern was present in patients with Crohn’s disease: patients without mucosal healing expressed higher absolute values of the Pittsburgh Sleep Quality Index (P<0.001) and the absence of mucosal healing was statistically associated with poor sleep quality (P<0.05). However, these associations were not observed in the subgroup of patients with ulcerative colitis (P>0.05).ConclusionIn patients with IBD in clinical remission, absence of mucosal healing seems to be associated with poor sleep quality, especially in patients with Crohn’s disease.

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Section: Introductionsupporting

confidence: 81%

Association of sleep quality and mucosal healing in patients with inflammatory bowel disease in clinical remission

Michalopoulos

Vrakas

Makris

et al. 2018

aog

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“…This result was similar to those of previous studies. For example, Uemura et al reported the prevalence of sleep disturbances was 44.1% in Japanese IBD patients (23). In a study from China, 55.8% IBD patients reported poor sleep (16).…”

Section: Discussionmentioning

confidence: 99%

Sleep Characteristics and Influencing Factors of Sleep Quality in Patients With Inflammatory Bowel Disease-Peripheral Arthritis

Zhang¹,

Xu³

et al. 2020

Front. Med.

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Background: Patients with inflammatory bowel disease-peripheral arthritis (IBD-PA) often accompany by sleep problems, but few studies have used polysomnography to investigate the objective sleep characteristics of IBD-PA. Methods: Patients in IBD-PA group, inflammatory bowel disease (IBD) group, healthy control (HC) group were examined by polysomnography (PSG) and the sleep characteristics were compared. PSG and Pittsburgh Sleep Quality Scale (PSQI) indices were compared between active and remission IBD-PA patients. The correlation between disease activity and sleep quality in IBD-PA patients was analyzed. The influencing factors of sleep efficiency of IBD-PA patients were analyzed. Results: The total sleep time (TST), rapid-eye-movement sleep (REM) time, slow wave sleep (S3 + S4) and sleep efficiency (SE) in the IBD-PA group were significantly less than those in the HC group and IBD group (P < 0.05), while the number and time of wake after sleep onset (WASO) and sleep latency (SL) were significantly longer than those in the HC group and IBD group (P < 0.05). To IBD-PA patients, the disease activity was negatively related to sleep quality. There was a significant difference in SE, the number of WASO, S1, S3+S4 of PSG, as well as the PSQI total score between active and remission patients. Abdominal pain, joint pain, depression, and C-reactive protein were the influencing factors of sleep efficiency. Conclusions: The sleep quality of patients with IBD was poor than the control group, and that of patients with IBD-PA was even worse. Therefore, sleep management should be included in IBD management.

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“…IBD are chronic inflammatory disorders of the intestine with unknown pathogenesis, including Crohn’s disease and ulcerative colitis. In a recent study, half of the IBD patients reported sleep disturbances as assessed by the PSQI (550), with strongest associations in patients with active disease (10, 209). Based on data from the Nurses’ Heath Survey with over 400 IBD cases, self-reported sleep duration of <6 h and >9 h per night increased risk of ulcerative colitis (11).…”

Section: The Sleep Response To Immune Activationmentioning

confidence: 99%

The Sleep-Immune Crosstalk in Health and Disease

Besedovsky

Lange

Haack

2019

Physiological Reviews

892

759

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Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body’s defense system. Stimulation of the immune system by microbial challenges triggers an inflammatory response, which, depending on its magnitude and time course, can induce an increase in sleep duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various immune parameters, is associated with a reduced infection risk, and can improve infection outcome and vaccination responses. The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade inflammation and is associated with various diseases that have an inflammatory component, like diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future research.

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

Cited by 30 publications

References 31 publications

Association of sleep quality and mucosal healing in patients with inflammatory bowel disease in clinical remission

Association of sleep quality and mucosal healing in patients with inflammatory bowel disease in clinical remission

Sleep Characteristics and Influencing Factors of Sleep Quality in Patients With Inflammatory Bowel Disease-Peripheral Arthritis

The Sleep-Immune Crosstalk in Health and Disease

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