Sleep quality and disease activity in patients with inflammatory bowel disease: a systematic review and meta-analysis

Short sleep or insufficient sleep are significant health concerns among patients with inflammatory bowel disease (IBD). Although an association between sleep quality and disease activity has been reported, findings have been inconsistent. The aim of this systematic review and meta-analysis was to assess the association between sleep quality and disease activity in IBD patients by reviewing findings from cross-sectional and prospective cohort studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to May 2020. Studies that examined the relationship between sleep quality and disease activity in IBD patients were screened for eligibility. Six studies were included for the analysis. Sleep quality was measured using subjective questionnaires in six studies and objective methods in three studies. Disease activity was diagnosed following standard guidelines. A significant association between subjective sleep quality and disease activity was observed (pooled OR = 3.52, 95%CI:1.82,6.83, P < 0.001). A significant association between sleep efficiency and disease activity was observed as well (pooled OR = 4.55, 95%CI:1.92,10.75, P = 0.001). Findings from this study indicate that both subjective and objective poor sleep quality were associated with an increased risk for disease activity. Larger studies with an experimental design are warranted to confirm the effects of sleep quality on intestinal pathological changes in IBD patients.