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P663 Association of sleep quality and mucosal activity in IBD patients in clinical remission

G. Michalopoulos*, S. Vrakas, V. Ntouli, K. Makris, S. Lamprinakos, C. Tzathas

Tzaneio General Hospital, Department of Gastroenterology, Piraeus, Greece

Background

There is emerging data indicating that sleep disturbances in IBD patients in clinical remission are related with increased risk to develop clinical relapse. It is also known that inflammatory processes can affect sleep pattern.

Sleep qualityGoodPoorTotal
Mucosal Activity
Negative351348
Positive102636
Total453984
PSQI absolute valueCoef.Std. Err.P-value95% C.I.R2
Positive mucosal activity2.670.68<0.0011.31–4.020.23
Sex (females)1.930.670.0050.59–3.28

Aim of this prospective study was to investigate possible relationship between quality of sleep and mucosal activity.

Methods

84 patients, 35 with ulcerative colitis (UC) and 49 with Crohn's disease (CD), in clinical remission defined by partial Mayo score ≤2 or CDAI< 150, completed the Pittsburgh Sleep Quality Index questionnaire (PSQI) [1] . As poor sleep quality was defined PSQI score >5. Mucosal activity was assessed either by ileocolonoscopy (51 patients) or by fecal calprotectine (32 patients). As negative mucosal activity was defined, in case of endoscopic assessment, an endoscopic Mayo score ≤1 in UC and SES-CD ≤ 3 in CD or Rutgeert's score <i2 (postoperatively in CD) and in case of fecal calprotectine assessment a value <50 μg/g. X2 with Yates correction and multivariate anova regression analysis using absolute values of PSQI as dependent variable were performed.

Results

X2 analysis resulted in X²=16.8519 p<0.01 according to table 1. Results from multivariate anova regression analysis are shown in table 2.

Conclusion

Both analyses suggest that poor sleep quality in patients in clinical remission is related with positive mucosal activity determined by endoscopic mucosal lesions and/or increased faecal calprotectine levels. Positive mucosal activity is associated with higher values of PSQI (2.67 units higher) in comparison to negative mucosal activity.Women have higher PSQI scores than men by multivariate analysis

References:

[1] Buysse DJ, (1989), The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research., Psychiatry Res, 193-213