title: High C-Reactive Protein Is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease.
abstract: BACKGROUND
  Sleep disruption is common in inflammatory bowel diseases (IBD). However, studies demonstrating a similar prevalence in irritable bowel syndrome suggest that nighttime disruption due to diarrhea and abdominal pain may be key drivers of poor sleep quality. Whether inflammation is associated with poor sleep independently has not been examined previously.
  
  
  METHODS
  This single-center study included subjects with IBD recruited to an ongoing prospective registry who completed a questionnaire assessing sleep quality and mood. Inflammatory marker levels [C-reactive protein (CRP), erythrocyte sedimentation rate] and clinical disease activity including nighttime disruption on the day of enrollment were obtained from the medical record. Logistic regression models were used to identify predictors of sleep quality.
  
  
  RESULTS
  The study included 131 subjects (72 women) with a median age of IBD diagnosis of 25 years. Twenty-three subjects (19 %) had a high C-reactive protein level (≥8 mg/dL). Poor sleep was more common in those with high CRP levels than with normal values (70 vs. 39 %, p = 0.009). This association remained significant on multivariate analysis [Odds ratio (OR) 4.12, 95 % confidence interval (CI) 1.38-12.29]. Adjusting for the presence of nighttime disruption did not significant alter this association (OR 3.16, 95 % CI 1.01-9.90). High CRP correlated with poor sleep even in patients not experiencing nocturnal symptoms (n = 101, OR 4.89, 95 % CI 1.24-19.36).
  
  
  CONCLUSIONS
  High CRP is associated with poor sleep quality in IBD independent of the presence of nighttime disruptions, suggesting that a relationship exists between circulating inflammatory markers and sleep.
authors.affiliation: Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Robin G
authors.initials: RG
authors.lastname: Wilson
authors.forename: Betsy W
authors.initials: BW
authors.lastname: Stevens
authors.forename: Abra Y
authors.initials: AY
authors.lastname: Guo
authors.forename: Caitlin N
authors.initials: CN
authors.lastname: Russell
authors.forename: Anna
authors.initials: A
authors.lastname: Thornton
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Cohen
authors.forename: Holly C
authors.initials: HC
authors.lastname: Sturgeon
authors.forename: Cosmas
authors.initials: C
authors.lastname: Giallourakis
authors.forename: Hamed
authors.initials: H
authors.lastname: Khalili
authors.forename: Deanna D
authors.initials: DD
authors.lastname: Nguyen
authors.forename: Vijay
authors.initials: V
authors.lastname: Yajnik
authors.forename: Jenny
authors.initials: J
authors.lastname: Sauk
authors.forename: Ashwin N
authors.initials: AN
authors.lastname: Ananthakrishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000150:complications* / Q000378:metabolism; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology*; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein