Skip to content
2000
Volume 4, Issue 1
  • ISSN: 2666-2906
  • E-ISSN: 2666-2914

Abstract

Background and Objectives

Patients with Inflammatory Bowel Disease frequently report disturbances in sleep. Few studies have utilized objective investigations like wrist actigraphy or polysomnography to explore sleep patterns in patients with IBD. To address this, we conducted a systematic review and meta-analysis to determine how disease activity impacts sleep efficiency among IBD patients.

Methods

We conducted a search of Medline, the Cochrane Library, the National Library of Medicine Clinical Trial Database, and EMBASE for relevant studies from the date of establishment to July 2023. Sleep efficiency data in active and quiescent Crohn’s disease was summarised using a fixed-effects model.

Results

Of the 780 articles identified in the initial search, 7 eligible studies were selected. Separate data regarding UC was lacking. There were 5 suitable studies eligible for meta-analysis, comprising 219 participants (107 and 112 patients with active and quiescent Crohn’s Disease, respectively). In this meta-analysis, the 95% CI of four out of five studies included unity, but the pooled analysis revealed greater sleep efficiency in those with remission Crohn’s disease in comparison to active Crohn’s (pooled mean difference (MD), -3.64; 95% Confidence Interval (CI), -5.56, -1.73, = 0.0002). The degree of heterogeneity between studies was minimal (I2 = 0%, = 0.59).

Conclusion

We have demonstrated that worse sleep efficiency is associated with active CD compared to quiescent disease, but there is insufficient data regarding UC. Additional research, applying objective measures to evaluate sleep efficiency is necessary for a better understanding of the relationship between sleep quality and disease activity in IBD.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/ijghd/10.2174/0126662906301415241226055447
2025-02-03
2025-10-28

  • From This Site

    /content/journals/ijghd/10.2174/0126662906301415241226055447
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. AbrahamC. ChoJ.H. Inflammatory bowel disease.N. Engl. J. Med.2009361212066207810.1056/NEJMra080464719923578
     [Google Scholar]
  2. BaumgartD.C. SandbornW.J. Inflammatory bowel disease: Clinical aspects and established and evolving therapies.Lancet200736995731641165710.1016/S0140‑6736(07)60751‑X17499606
     [Google Scholar]
  3. FakhouryM. Al-SalamiH. NegruljR. MooranianA. Inflammatory bowel disease: Clinical aspects and treatments.J. Inflamm. Res.20147711312010.2147/JIR.S6597925075198
     [Google Scholar]
  4. McDowellC. FarooqU. HaseebM. Inflammatory Bowel Disease (IBD).StatPearls PublishingTreasure Island, FL2020
     [Google Scholar]
  5. Saeid SeyedianS. NokhostinF. Dargahi MalamirM. A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease.J. Med. Life201912211312210.25122/jml‑2018‑007531406511
     [Google Scholar]
  6. RanjbaranZ. KeeferL. FarhadiA. StepanskiE. SedghiS. KeshavarzianA. Impact of sleep disturbances in inflammatory bowel disease.J. Gastroenterol. Hepatol.200722111748175310.1111/j.1440‑1746.2006.04820.x17914945
     [Google Scholar]
  7. CostaG. The impact of shift and night work on health.Appl. Ergon.199627191610.1016/0003‑6870(95)00047‑X15676307
     [Google Scholar]
  8. IrwinM.R. Sleep and inflammation: Partners in sickness and in health.Nat. Rev. Immunol.2019191170271510.1038/s41577‑019‑0190‑z31289370
     [Google Scholar]
  9. HaackM. SanchezE. MullingtonJ.M. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers.Sleep20073091145115210.1093/sleep/30.9.114517910386
     [Google Scholar]
  10. KinnucanJ.A. RubinD.T. AliT. Sleep and inflammatory bowel disease: exploring the relationship between sleep disturbances and inflammation.Gastroenterol. Hepatol.201391171872724764789
     [Google Scholar]
  11. AliT. OrrW.C. Sleep disturbances and inflammatory bowel disease.Inflamm. Bowel Dis.201420111986199510.1097/MIB.000000000000010825025716
     [Google Scholar]
  12. LuysterF.S. StrolloP.J.Jr HolguinF. CastroM. DunicanE.M. FahyJ. GastonB. IsraelE. JarjourN.N. MaugerD.T. MooreW.C. WenzelS.E. Association between insomnia and asthma burden in the severe asthma research program (SARP) III.Chest201615061242125010.1016/j.chest.2016.09.02027720882
     [Google Scholar]
  13. MarinelliC. SavarinoE.V. MarsilioI. LorenzonG. GavaruzziT. D’IncàR. ZingoneF. Sleep disturbance in inflammatory bowel disease: Prevalence and risk factors – A cross-sectional study.Sci. Rep.202010150710.1038/s41598‑020‑57460‑631949257
     [Google Scholar]
  14. QaziT. FarrayeF.A. Sleep and inflammatory bowel disease: An important bi-directional relationship.Inflamm. Bowel Dis.201925584385210.1093/ibd/izy33430388243
     [Google Scholar]
  15. GracieD.J. HamlinP.J. FordA.C. The influence of the brain–gut axis in inflammatory bowel disease and possible implications for treatment.Lancet Gastroenterol. Hepatol.20194863264210.1016/S2468‑1253(19)30089‑531122802
     [Google Scholar]
  16. AliT. MadhounM.F. OrrW.C. RubinD.T. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients.Inflamm. Bowel Dis.201319112440244310.1097/MIB.0b013e3182a0ea5423945186
     [Google Scholar]
  17. AnanthakrishnanA.N. LongM.D. MartinC.F. SandlerR.S. KappelmanM.D. Sleep disturbance and risk of active disease in patients with Crohn’s disease and ulcerative colitis.Clin. Gastroenterol. Hepatol.201311896597110.1016/j.cgh.2013.01.02123376797
     [Google Scholar]
  18. BuysseD.J. ReynoldsC.F.III MonkT.H. BermanS.R. KupferD.J. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research.Psychiatry Res.198928219321310.1016/0165‑1781(89)90047‑42748771
     [Google Scholar]
  19. BadgerT.A. HeitkemperM. LeeK.A. BrunerD.W. An experience with the patient-reported outcomes measurement information system: Pros and cons and unanswered questions.Nurs. Outlook201462533233810.1016/j.outlook.2014.06.00925218082
     [Google Scholar]
  20. IskandarH.N. LinanE.E. PatelA. MooreR. LasanajakY. GyawaliC.P. SayukG.S. CiorbaM.A. Self-reported sleep disturbance in Crohn’s disease is not confirmed by objective sleep measures.Sci. Rep.2020101198010.1038/s41598‑020‑58807‑932029832
     [Google Scholar]
  21. GrandnerM.A. KripkeD.F. YoonI.Y. YoungstedtS.D. Criterion validity of the Pittsburgh Sleep Quality Index: Investigation in a non-clinical sample.Sleep Biol. Rhythms20064212913610.1111/j.1479‑8425.2006.00207.x22822303
     [Google Scholar]
  22. KrystalA.D. EdingerJ.D. Measuring sleep quality.Sleep Med.200891Suppl. 1S10S1710.1016/S1389‑9457(08)70011‑X18929313
     [Google Scholar]
  23. MartinJ.L. HakimA.D. Wrist Actigraphy.Chest201113961514152710.1378/chest.10‑187221652563
     [Google Scholar]
  24. MoherD. LiberatiA. TetzlaffJ. AltmanD.G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.Ann. Intern. Med.20091514264269, W6410.7326/0003‑4819‑151‑4‑200908180‑0013519622511
     [Google Scholar]
  25. PageM.J. McKenzieJ.E. BossuytP.M. BoutronI. HoffmannT.C. MulrowC.D. ShamseerL. TetzlaffJ.M. AklE.A. BrennanS.E. ChouR. GlanvilleJ. GrimshawJ.M. HróbjartssonA. LaluM.M. LiT. LoderE.W. Mayo-WilsonE. McDonaldS. McGuinnessL.A. StewartL.A. ThomasJ. TriccoA.C. WelchV.A. WhitingP. MoherD. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ202137271n7110.1136/bmj.n7133782057
     [Google Scholar]
  26. Critical appraisal skills programme.2018Available from: https://casp-uk.net/casp-tools-checklists/
  27. Cochrane handbook for systematic reviews of interventions.2018Available from: https://training.cochrane.org/handbook
  28. HigginsJ.P.T. ThompsonS.G. DeeksJ.J. AltmanD.G. Measuring inconsistency in meta-analyses.BMJ2003327741455756010.1136/bmj.327.7414.55712958120
     [Google Scholar]
  29. BazinT. Micoulaud FranchiJ.A. TerrasN. TaillardJ. LaharieD. ZerbibF. Altered sleep quality is associated with Crohn’s disease activity: An actimetry study.Sleep Breath.201943397197731512092
     [Google Scholar]
  30. QaziT. VermaR. HamiltonM.J. KaplanE.R. RedlineS. BurakoffR. The use of actigraphy differentiates sleep disturbances in active and inactive Crohn’s disease.Inflamm. Bowel Dis.20192561044105310.1093/ibd/izy32430395256
     [Google Scholar]
  31. van LangenbergD.R. PapandonyM.C. GibsonP.R. Sleep and physical activity measured by accelerometry in Crohn’s disease.Aliment. Pharmacol. Ther.20154110991100410.1111/apt.1316025783784
     [Google Scholar]
  32. ConleyS. JeonS. LehnerV. ProctorD.D. RedekerN.S. Sleep characteristics and rest–activity rhythms are associated with gastrointestinal symptoms among adults with inflammatory bowel disease.Dig. Dis. Sci.202166118118910.1007/s10620‑020‑06213‑632193859
     [Google Scholar]
  33. SofiaM.A. YvellezO. ZmeterN. El JurdiK. OllechJ. AndersenM.J.Jr Aharoni GolanM. RodriquezD.M. RubinD.T. P178 Sleep fragmentation measured by wearable device is an indicator of clinical disease activity in inflammatory bowel disease.J. Crohn’s Colitis201812Suppl. 1S188S18910.1093/ecco‑jcc/jjx180.305
     [Google Scholar]
  34. PaixãoD.L. PoyaresD. de PaulaM.S. DuarteJ.W. CasteloP.M. Ambrogini-JúniorO. MiszputenS.J. OshimaC.T.F. ChagasJ.R. PaiottiA.P.R. Evaluation of home polysomnography findings, quality of sleep, and fatigue in inflammatory bowel disease: A case series.J. Clin. Sleep Med.2019151394510.5664/jcsm.756630621826
     [Google Scholar]
  35. SterneJ.A.C. SuttonA.J. IoannidisJ.P.A. TerrinN. JonesD.R. LauJ. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials.2011Available from: https://www.bmj.com/content/343/bmj.d4002 10.1136/bmj.d4002
  36. AlmedimighA. SzetoS. DaveJ. AlsulaimiN. MyintA. BorumM.L. P108 sleep disorders in inflammatory bowel disease: The forgotten discussion.Inflamm. Bowel Dis.201824Suppl. 1S39S910.1093/ibd/izy019.120
     [Google Scholar]
  37. GraffLA ClaraI WalkerJE LixLM CarrR MillerN Changes in fatigue over 2 years are associated with activity of inflammatory bowel disease and psychological factors.Clin Gastroenterol Hepatol201311911401146
     [Google Scholar]
  38. OhayonM. WickwireE.M. HirshkowitzM. AlbertS.M. AvidanA. DalyF.J. DauvilliersY. FerriR. FungC. GozalD. HazenN. KrystalA. LichsteinK. MallampalliM. PlazziG. RawdingR. ScheerF.A. SomersV. VitielloM.V. National Sleep foundation’s sleep quality recommendations: First report.Sleep Health20173161910.1016/j.sleh.2016.11.00628346153
     [Google Scholar]
  39. Salwen-DeremerJ.K. SiegelC.A. SmithM.T. Cognitive behavioral therapy for insomnia: A promising treatment for insomnia, pain, and depression in patients with IBD.Crohns Colitis 360202023otaa05210.1093/crocol/otaa05236776493
     [Google Scholar]
  40. DardenM. EspieC.A. CarlJ.R. HenryA.L. KanadyJ.C. KrystalA.D. Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: A markov simulation model in the United States.Sleep2020444zsaa223
     [Google Scholar]
  41. BarberioB. ZingoneF. SavarinoE.V. Inflammatory bowel disease and sleep disturbance: As usual, quality matters.Dig. Dis. Sci.20216613410.1007/s10620‑020‑06268‑532323074
     [Google Scholar]
  42. ChoiK. ChunJ. HanK. ParkS. SohH. KimJ. LeeJ. LeeH. ImJ. KimJ. Risk of anxiety and depression in patients with inflammatory bowel disease: A nationwide, population-based study.J. Clin. Med.20198565410.3390/jcm805065431083476
     [Google Scholar]
  43. QuigleyE.M.M. Overlapping irritable bowel syndrome and inflammatory bowel disease: Less to this than meets the eye?Therap. Adv. Gastroenterol.20169219921210.1177/1756283X1562123026929782
     [Google Scholar]
  44. KhanI CooneyJ SalemJ PollokR. PMO-8 the relationship between inflammatory bowel disease activity and sleep efficiency: A systematic review and meta-analysis.Gut202170A7910.1136/gutjnl‑2021‑BSG.147
     [Google Scholar]
/content/journals/ijghd/10.2174/0126662906301415241226055447
Loading
The Relationship between Inflammatory Bowel Disease Activity and Sleep Efficiency in Adult Patients: A Systematic Review
Int J Gastroenterol Hepatol Dis 4, E26662906301415 (2025); https://doi.org/10.2174/0126662906301415241226055447
/content/journals/ijghd/10.2174/0126662906301415241226055447
/content/journals/ijghd/10.2174/0126662906301415241226055447
Loading

Data & Media loading...

Supplements

Critical appraisal of included studies using the Critical Appraisal Skills Programme (CASP) checklist. PRISMA 2020 Checklist for Systematic Reviews. Search strategy used for databases (Medline, Cochrane Library, National Library of Medicine Clinical Trial Database and EMBASE). The methodical details of the strategy used for the searching four databases (Medline, Cochrane Library, National Library of Medicine Clinical Trial Database, and EMBASE) are displayed in Supplementary Material.

file format download Download

  • Article Type:     Review Article
Keyword(s): crohn’s disease; disease activity; Inflammatory bowel disease; sleep efficiency; sleep quality; wrist actigraphy

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test