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The Relationship Between Sleep Disturbance and Disease Activity in Pediatric Patients With Inflammatory Bowel Disease
Chaowapong Jarasvaraparn1, Kimberly Zlomke2, Noelle C Vann2
1Department of Pediatrics.
Insights
Children with inflammatory bowel disease (IBD) experience significant sleep disturbances, which correlate with disease activity. Early screening for sleep issues in pediatric IBD patients is recommended.
Area of Science:
- Pediatric Gastroenterology
- Sleep Medicine
- Inflammatory Bowel Disease Research
Background:
- Sleep disturbances are common in pediatric patients with inflammatory bowel disease (IBD).
- The relationship between sleep quality, disease activity, and inflammatory markers in pediatric IBD is not fully understood.
Purpose of the Study:
- To assess the prevalence of sleep disturbance in children with IBD.
- To investigate the associations between sleep, inflammatory markers, and disease activity in pediatric IBD patients.
Main Methods:
- A prospective cross-sectional study involving 53 pediatric patients with IBD (Crohn disease, ulcerative colitis, indeterminate colitis).
- Utilized validated questionnaires including the Pittsburgh Sleep Quality Index (PSQI), Pediatric Daytime Sleepiness Scale, Adolescent Sleep Wake Scale (ASWS), and Child Sleep Habits Questionnaire (CSHQ).
- Assessed disease activity using the Pediatric Crohn Disease Activity Index and Pediatric Ulcerative Colitis Activity Index.
Main Results:
- Significant correlations were found between CSHQ scores and the Pediatric Crohn Disease Activity Index (P=.002).
- Significant correlations were observed between PSQI scores and the Pediatric Ulcerative Colitis Activity Index (P=.04).
- Pediatric patients with ulcerative colitis and indeterminate colitis reported more sleep disturbance than those with Crohn disease.
Conclusions:
- Increased disease activity in pediatric IBD is associated with poorer sleep quality.
- Pediatric patients with IBD frequently experience sleep disturbances that warrant clinical attention.
- Routine screening for sleep disturbance is recommended for all pediatric patients diagnosed with IBD.
Objective:
The aim of this prospective cross sectional study was to assess the prevalence of sleep disturbance in children with inflammatory bowel disease (IBD), including the relationships between sleep, inflammatory markers, and disease activity of pediatric patients with IBD.
Methods:
Pediatric patients with IBD and parents were enrolled in the study. Patients completed the Pittsburgh Sleep Quality Index (PSQI), the Pediatric Daytime Sleepiness Scale, and the Adolescent Sleep Wake Scale (ASWS) surveys. Parents completed the Child Sleep Habits Questionnaire (CSHQ). Disease activity for Crohn disease (CD) was determined by the Pediatric Crohn Disease Activity Index and the Pediatric Ulcerative Colitis Activity Index was used to define disease activity in ulcerative colitis (UC)/indeterminate colitis patients.
Results:
Fifty-three pediatric patients with IBD (38 CD, 12 UC, and 3 indeterminate colitis) participated in the study. The significant correlations between the CSHQ and Pediatric Crohn Disease Activity Index (P = 0.002) and the PSQI and Pediatric Ulcerative Colitis Activity Index (P = 0.04) were found. Youth with UC and indeterminate colitis significantly reported more sleep disturbance than patients with CD, (P = 0.03, 0.05, and 0.04; PSQI, Pediatric Daytime Sleepiness Scale, ASWS, respectively). Patients self-reported significantly more sleep disturbance than was observed by parents (P < 0.0001). This study showed the significant correlations between CSHQ score compared to erythrocyte sedimentation rate and albumin (P = 0.001 and 0.03, respectively).
Conclusions:
Results suggest that increased disease activity is associated with adverse effects on sleep quality. Based on the results of this study, pediatric patients with IBD should be screened for sleep disturbance.
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