Sleep quality and associated factors in patients with inflammatory bowel disease: a cross-sectional study

A stable sleep-wake cycle is essential for immune function, and chronic inflammatory conditions like inflammatory bowel disease (IBD) often lead to sleep disturbances and fatigue that may influence disease progression. This study examined the relationship between sleep quality and contributing factors in patients with IBD.

This cross-sectional study included 307 adult IBD patients (Ulcerative Colitis (UC) and 50 with Crohn's Disease (CD)) enrolled from the Iranian Registry of Crohn's and Colitis (IRCC) between 2022 and 2024 in Guilan, Iran. Data were collected using standardized questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Active and inactive IBD were classified using clinical indices and gastroenterologist confirmation. Data were analyzed using univariable and multivariable linear regression.

The mean age of participants was 45.4 ± 13.1 years, and 67.1% were female. The mean global PSQI score was 3.09, and 11.7% of patients had poor sleep quality. Notable correlations were found between PSQI scores and GAD-7 (r=0.158, P=0.005) and PHQ-9 scores (r=0.246, P<0.001). Multivariable analysis revealed that each one-point increase in PHQ-9 score was associated with a 0.18-point increase in PSQI score (P<0.001), and patients with comorbidities had PSQI scores 1.32 points higher than those without (P=0.043).

Poor sleep quality in IBD patients is more strongly associated with depression and comorbidities than with disease activity. These findings highlight the need for routine mental health and comorbidity screening in managing sleep disturbances and call for further research into targeted interventions.