Insomnia is associated with reduced quality of life in inflammatory bowel disease

Abstract

Abstract Quality of life is reduced in people with inflammatory bowel disease and poor sleep is prevalent in people with inflammatory bowel disease. This study aimed to investigate the influence of sleep on quality of life in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centres, social media and through Crohn’s Colitis Australia. The questionnaire included the EQ-5D-5L measures of health-related quality life of, the insomnia severity index (ISI), the Pittsburgh sleep quality index (PSQI). IBD activity was assessed using validated patient reported scores. Demographic data and mental health scores were also obtained. Results Quality of life was lower in people with IBD than the general South Australian population. Poor sleep and clinically significant insomnia were associated with lower quality of life (EQVAS, and utility score) and moderately correlated with the domains of pain, usual activities and depression-anxiety. After adjusting for demographic variables, IBD anxiety, depression and anxiety, the pain domain continued to be influenced by sleep quality, sleep disturbance and sleep duration, and the usual activities domain continued to be influenced by daytime dysfunction. Insomnia resulted in a reduction in quality of life (EQVAS, utility score) independent of IBD activity and of a similar magnitude to that seen with IBD activity. Conclusion Health related quality of life in IBD is influenced by aspects of sleep quality irrespective of IBD activity and mental health conditions. The presence of insomnia is associated with a significant reduction in health-related quality of life. Consideration should be given to sleep targeting interventional studies in an IBD population.