Affiliation:
1. Department of Gastroenterology Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre Bedford Park South Australia Australia
2. College of Medicine and Public Health Flinders University Bedford Park South Australia Australia
3. School of Medicine, Faculty of Health and Medical Sciences University of Adelaide Adelaide South Australia Australia
4. Department of Gastroenterology Queen Elizabeth Hospital Woodville South Australia Australia
5. Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute College of Medicine and Public Health, Flinders University Bedford Park South Australia Australia
6. Department of Respiratory and Sleep Medicine Southern Adelaide Local Health Network (SALHN) Flinders Medical Centre Bedford Park South Australia Australia
Abstract
AbstractBackground and AimQuality of life is reduced in people with inflammatory bowel disease (IBD) and poor sleep is prevalent in people with IBD. This study aimed to investigate the influence of sleep on quality of life (QoL) in people with inflammatory bowel disease.MethodsAn online questionnaire was administered through three tertiary IBD centers, social media, and through Crohn's Colitis Australia. The questionnaire included the EQ‐5D‐5L measures of health‐related QoL, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index (PSQI), and validated IBD activity and mental health scores.ResultsThere were 553 responses included with a diagnosis of Crohn's disease (62.2%), with over half on biologic therapy (53.1%). Poor sleep and clinically significant insomnia were associated with lower QoL (EQ‐5D‐5L scores: EQVAS, utility score, P < 0.001 for all). Sleep quality scores correlated with the EQ‐5D‐5L domains of “pain” (ρ 0.35, P < 0.001), “usual activities” (ρ 0.32, P < 0.001), and “depression‐anxiety” (ρ 0.37, P < 0.001). After adjusting for demographic variables, IBD activity, and depression and anxiety via multivariate regression, the “pain” domain continued to be associated with PSQI components “sleep quality” (P < 0.001), “sleep disturbance” (P < 0.001), and “sleep duration” (P < 0.001). Clinically significant insomnia was associated with a reduction in QoL (EQVAS, utility score) independent of IBD activity (P < 0.001) and of a similar magnitude to that seen with IBD activity.ConclusionHealth‐related QoL 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 reduction in health‐related QoL. Consideration should be given to sleep targeting interventional studies in an IBD population.