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P233 Sleep Disorders and Chronic Inflammatory Bowel Disease: What's the Connection?

Hassine, A.(1);Hamami, A.(1);Dahmani, W.(1);Ben Ameur, W.(1);Elleuch, N.(1);Braham, A.(1);Bannour, R.(2);Jaziri, H.(1);Jmaa, A.(1);

(1)Hôpital universitaire Sahloul, service de gastro-entérologie, Sousse, Tunisia;(2)Hôpital universitaire Sahloul, service de sécurité des soins, Sousse, Tunisia

Background

The quality of sleep is a major determinant of quality of life, which has become a therapeutic target in the management of Chronic Inflammatory Bowel Diseases (IBD). The relationship between IBD and sleep disorders is still unclear. Although poor quality sleep is believed to be strongly linked to disruptions to clinical disease activity, IBD patients are reported to experience sleep disturbance even when the disease is clinically inactive. The objective of this work was to assess the prevalence and risk factors of sleep disorders as well as their impact on the quality of life of patients with IBD.

Methods

We conducted a cross-sectional study, including all patients followed for IBD, who presented to our consultation during the three months preceding our study. The quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The quality of sleep is impaired when the PSQI score> 5. The activity of Crohn's disease (CD) was evaluated by the Harvey-Bradshaw index (HBI), that of ulcerative colitis (UC), by the Clinical Mayo score. Quality of life was assessed by the Short Inflammatory Bowel Disease Questionnaire (S-IBDQ).

Results

We included 100 patients, mean age 42.18 ± 15.71 years with a predominance of men (sex ratio M / F = 1.5). The mean course of IBD was 9.02 ± 6.57 years. Sixty eight patients (68%) had CD, the location was ileal in 32 patients (47%), ileocolonic in 22 patients (32.4%), and colonic in 14 cases (20.6%). Ano-perineal manifestations were present in 38.2% of cases. Severe disease activity was noted in 14 patients (20.6%). Thirty two patients (32%) had UC. Pancolitic involvement was noted in 14 patients (43.7%) UC activity was severe in 10 patients (31.3%). The mean PSQI score was 8.2 ± 4.42. A PSQI score> 5 was noted in 68% of patients. There is a significant association between the PSQI score and disease activity in both patients with CD (p = 0.003) and those with UC (p = 0.026). The quality of sleep was altered in 44.4% of patients in remission vs. 81.25% of patients in relapse, with a statistically significant difference (p <0.001). There was a strong negative correlation between the PSQI score and the S-IBDQ (p <0.001, r = -0.61).

Conclusion

Our study showed that 68% of patients with IBD suffer from impaired quality of sleep. This disturbance was strongly correlated with the deterioration in the quality of life of these patients, requiring multidisciplinary management.

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