Self-reported sleep disturbance in Crohn's disease is not confirmed by objective sleep measures

• Type of Material: Article
• Authors: Heba Iskandar, Emory University; Emily E. Linan, Washington University; Ami Patel, Duke University; Renee Moore, Emory University; Yi Lasanajak, Emory University; C. Prakash Gyawali, Washington University; Gregory S. Sayuk, Washington University; Matthew A. Ciorba, Washington University
• Language: English
• Date: 2020-02-06
• Publisher: Nature Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: © 2020, The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-020-58807-9
• Title of Journal or Parent Work: Scientific Reports
• Volume: 10
• Issue: 1
• Start Page: 1980
• End Page: 1980
• Grant/Funding Information: Philanthropic support for IBD research from the Givin’ it all for Guts Foundation and the Lawrence C. Pakula MD IBD Research Innovation and Education Fund at Washington University in St. Louis.; ACG Clinical Research Award ACG-CR-043-2013, UL1TR002378; MC: 1K08DK089016; GS: K23 DK084113, AMI, RO1, NIDDK P30 DK052574, Washington University School of Medicine Mentors in Medicine Program.; This work was partly funded by an ACG clinical research award pilot grant. HI: 5T32DK007130-36, UL1TR000448
• Keywords: Index; Inflammatory bowel disease; Science & Technology; Melatonin; Quality; Parameters; Instrument; Multidisciplinary Sciences; Science & Technology - Other Topics; Symptoms
• Research Categories: Health Sciences, Pathology; Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Sleep disturbance and fatigue are commonly reported among patients with Crohn’s disease (CD). In this prospective study, we aimed to define sleep quality in CD patients at various disease activity states and compare to healthy controls using objective and subjective measures. A prospective observational cohort study of CD patients seen at a tertiary academic inflammatory bowel diseases (IBD) clinic was compared to healthy volunteers. CD activity was assessed using the Harvey-Bradshaw Index (HBI). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) and objectively over 1-week using actigraphy (motion-based) and morning urinary melatonin metabolite. 121 subjects (CD patients N = 61; controls N = 60) completed the study. 34 had active CD (HBI > 4). Sleep disturbance was more frequently reported by CD subjects than controls (PSQI: 57% vs. 35%, p = 0.02) and in patients with active CD versus in remission state (PSQI 75.8% vs. 33.3%, p < 0.01; ESS: 45.5% vs. 19%, p = 0.03). Sleep parameters as measured by actigraphy and urine melatonin metabolite did not vary by group. Crohn’s patients report significantly more disturbed sleep than controls. However, poor sleep was not confirmed by objective measures of sleep quality. Excessive daytime sleepiness in CD patients may be driven by factors beyond objectively measured poor sleep.