title: Impact of sleep disturbances in inflammatory bowel disease.
abstract: BACKGROUND
  Normal sleep is paramount for a healthy lifestyle and high quality of life. Sleep modulates the immune system and thus affects the course of several chronic inflammatory conditions. There are no reported studies that address the role of sleep disturbance in the course of inflammatory bowel disease (IBD). The aim of this study was to characterize sleep disturbance in IBD using validated measures of sleep and quality of life.
  
  
  METHODS
  A self-administered, mail-in questionnaire package was sent to 205 subjects after a brief instruction. The questionnaire package was composed of the Pittsburgh Sleep Quality Index (PSQI), a measure of disease severity and the IBD-Quality of Life Questionnaire. A total of 119 subjects were recruited (58% response rate): 80 with inactive IBD, 24 with irritable bowel syndrome (IBS) and 15 healthy controls.
  
  
  RESULTS
  The IBD subjects reported significantly prolonged sleep latency, frequent sleep fragmentation, higher rate of using sleeping pills, decreased day-time energy, increased tiredness and poor overall sleep quality compared to healthy controls. The abnormal sleep patterns in IBD subjects were similar to IBS subjects. The reported sleep quality was correlated with IBD disease severity score (r(2) = 0.55, P = 0.02). Both IBD and IBS subjects thought that sleep and their disease status were correlated.
  
  
  CONCLUSIONS
  The results show that IBD patients have significant sleep disturbance even when their disease is not active. This problem might affect quality of life, gastrointestinal symptoms and coping ability, and might potentially modify disease severity or increase risk of flare-up. Regardless of the primary or secondary origin of this problem, sleep disturbance should be addressed in the clinical management of patients with IBD.
authors.affiliation: Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University, Chicago, Illinois, USA.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Ranjbaran
authors.forename: Laurie
authors.initials: L
authors.lastname: Keefer
authors.forename: Ashkan
authors.initials: A
authors.lastname: Farhadi
authors.forename: Edward
authors.initials: E
authors.lastname: Stepanski
authors.forename: Shahriar
authors.initials: S
authors.lastname: Sedghi
authors.forename: Ali
authors.initials: A
authors.lastname: Keshavarzian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000150:complications / Q000503:physiopathology; D003424:Crohn Disease / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014481:United States