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P174 High frequency of fatigue and sleep alterations impact on the quality of life in Mexican patients with inflammatory bowel disease

J.K. Yamamoto-Furusho MD- PhD1, N.N. Parra-Holguin2, A. Fresán-Orellana3

1National Institute of Medical Science and Nutrition Salvador Zubiran, Department of Gastroenterology, Mexico City, Mexico, 2IBD Clinic- Department of Gastroenterology- Instituto Nacional de Ciencias Medicas y Nutricion, Gastroenterology, Mexico, Mexico, 3Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Epidemiology, Mexico, Mexico

Background

Inflammatory bowel disease (IBD) refers to ulcerative colitis (UC) and Crohn’s disease (CD). All patients with chronic diseases can have serious effects on their sleep quality and high levels of fatigue, which directly affect the quality of life of patients with IBD. It has been reported that up to 44% of patients have alterations in sleep quality and up to 72% have symptoms of fatigue The aim of the present study is the validation of the Fatigue Scale in IBD (IBD-F) in Mexican patients and to evaluate the quality of sleep and fatigue in IBD patients according to their quality of life.

Methods

This is a cross-sectional study which included 98 patients aged 18 to 65 years with diagnosis of IBD, during the period from March to June 2019; three evaluation instruments will be applied to them: IBD-F, Pittsburgh Sleep Quality Index (PSQI) and Quality of life in patients with IBD (IBDQ-32). The clinical variables and demographics were collected through the review of clinical records. All analyses were performed with version 22.0 of the SPSS statistical program and the level of statistical significance was set at p < 0.05.

Results

A total of 98 patients were included in the study, 58.2% were female with an average age of 44.9 years (S.D.= 12.1, range 19–64 years). The clinical remission of IBD was 79.6%, the predominant extension in UC was pancolitis in 74.4% followed by left colitis in 12.8% (n = 11) and proctosigmoiditis in 12.8% (n = 11). For CD, the most frequent location was ileocolonic in 75%, ileal in 16.7% and colonic in 8.3%. The stricturing phenotype occurred in 75%, inflammatory in 16.7% and fistulizing in 8.3%. The clinical activity of the disease presented in 21.4% (n = 21) patients and 78.6% (n = 77) patients were in remission. Severe fatigue occurred in 28.6% (n = 28) patients, mild-moderate fatigue in 60.2%(n = 59) and 11.2% (n = 11) with no fatigue. Sleep disturbances requiring medical attention and treatment were presented in 52.1% (n = 51) patients, alterations requiring medical attention in 18.4% (n = 18) patients and 29.6% (n = 29) patients with no sleep disturbances. Patients with severe fatigue showed greater alterations in the quality of life on three dimensions of digestive (p < 0.001), systemic (p < 0.05) and emotional symptoms (p < 0.05). Patients with sleep quality alterations also affected globally the four dimensions of quality of life.

Conclusion

This study demonstrates a high frequency of fatigue and sleep quality alterations that impact in the decrease of the quality of life in IBD patients