Immunomodulator and biologic agent effects on sleep quality in patients with inflammatory bowel disease

Ann Joo Lee, Dale Kraemer, Ozdemir Kanar, Andrew C. Berry, Carmen Smotherman, Emely Eid

Research output: Contribution to journalArticle

Abstract

Background: Inflammatory bowel disease (IBD) can disrupt normal sleep physiology and amplify a negative perception about quality of life. Evidence suggests increased circulation of inflammatory cytokines, such as tumor necrosis factor–alpha and interleukin-1, may play a role. Methods: A total of 56 patients completed the Pittsburgh Sleep Quality Index (PSQI) to measure 7 sleep domains: sleep quality, sleep latency, sleep duration, sleep efficacy, sleep disturbance, sleep medications, and daytime dysfunction. Domain scores were summed to determine the presence or absence of sleep impairment. We compared patients taking immunomodulators or biologic agents to patients not on immunomodulator or biologic agent therapy. Demographics and IBD-related clinical information were collected to adjust for potential confounders that may secondarily affect sleep, such as body mass index, depression/anxiety, and sleep-affecting medications. Results: The majority of patients with IBD (46 [82%]) reported poor sleep quality; 22 (79%) of the patients taking immunomodulators or biologic agents and 24 (86%) of the patients not on these therapies had a global PSQI score ≥5, suggestive of poor sleep quality. However, we found no significant difference between the 2 groups. When we analyzed the 7 PSQI sleep domains individually, we found improved sleep duration in the group taking immunomodulators or biologic agents compared to the group not on therapy, although the difference was not statistically significant. Conclusion: The majority of patients with IBD experience some degree of sleep impairment, and treatment with immunomodulators and biologic agents does not appear to improve sleep quality. A multicenter study with a larger sample size is warranted to better assess the diverse population of patients with IBD and the factors that impact their sleep. Routine assessment of sleep quality during IBD clinical encounters is recommended.

Original languageEnglish (US)
Pages (from-to)76-80
Number of pages5
JournalOchsner Journal
Volume18
Issue number1
DOIs
StatePublished - Mar 1 2018
Externally publishedYes

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Immunologic Factors
Biological Factors
Inflammatory Bowel Diseases
Sleep
Biological Therapy

Keywords

  • Immunologic factors
  • Inflammatory bowel disease
  • Sleep medicine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Immunomodulator and biologic agent effects on sleep quality in patients with inflammatory bowel disease. / Lee, Ann Joo; Kraemer, Dale; Kanar, Ozdemir; Berry, Andrew C.; Smotherman, Carmen; Eid, Emely.

In: Ochsner Journal, Vol. 18, No. 1, 01.03.2018, p. 76-80.

Research output: Contribution to journalArticle

Lee, Ann Joo ; Kraemer, Dale ; Kanar, Ozdemir ; Berry, Andrew C. ; Smotherman, Carmen ; Eid, Emely. / Immunomodulator and biologic agent effects on sleep quality in patients with inflammatory bowel disease. In: Ochsner Journal. 2018 ; Vol. 18, No. 1. pp. 76-80.
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abstract = "Background: Inflammatory bowel disease (IBD) can disrupt normal sleep physiology and amplify a negative perception about quality of life. Evidence suggests increased circulation of inflammatory cytokines, such as tumor necrosis factor–alpha and interleukin-1, may play a role. Methods: A total of 56 patients completed the Pittsburgh Sleep Quality Index (PSQI) to measure 7 sleep domains: sleep quality, sleep latency, sleep duration, sleep efficacy, sleep disturbance, sleep medications, and daytime dysfunction. Domain scores were summed to determine the presence or absence of sleep impairment. We compared patients taking immunomodulators or biologic agents to patients not on immunomodulator or biologic agent therapy. Demographics and IBD-related clinical information were collected to adjust for potential confounders that may secondarily affect sleep, such as body mass index, depression/anxiety, and sleep-affecting medications. Results: The majority of patients with IBD (46 [82{\%}]) reported poor sleep quality; 22 (79{\%}) of the patients taking immunomodulators or biologic agents and 24 (86{\%}) of the patients not on these therapies had a global PSQI score ≥5, suggestive of poor sleep quality. However, we found no significant difference between the 2 groups. When we analyzed the 7 PSQI sleep domains individually, we found improved sleep duration in the group taking immunomodulators or biologic agents compared to the group not on therapy, although the difference was not statistically significant. Conclusion: The majority of patients with IBD experience some degree of sleep impairment, and treatment with immunomodulators and biologic agents does not appear to improve sleep quality. A multicenter study with a larger sample size is warranted to better assess the diverse population of patients with IBD and the factors that impact their sleep. Routine assessment of sleep quality during IBD clinical encounters is recommended.",
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