Sleep Quality in Adolescents with Inflammatory Bowel Disease

Background: The incidence and prevalence of Inflammatory BowelDisease (IBD) in the U.S. is increasing. Because adequate sleep
quality and duration play a role in the mental and physical wellbeingof children, this study aimed to determine the prevalence
of sleep difficulties in our urban pediatric IBD cohort and evaluateassociations between sleep quality and disease severity.
Methods: Patients completed the Pittsburgh Sleep Quality Index(PSQI) questionnaire during an office visit. Chart review provided
demographic information, and Pediatric Crohn’s Disease ActivityIndex (PCDAI) and Pediatric Ulcerative Colitis Activity Index
(PUCAI) scores were calculated from the day of the visit.
Results: The prevalence of sleep problems was 33.54% (95%CI: 26.24% to 41.48%; p-value=0.02). PUCAI scores in children
with sleep problems (PSQI mean 19.17 ± 20.43) were significantlyhigher than PUCAI scores in children without sleep problems. There
was no association between total PSQI scores, classification of IBD,age, gender, ethnicity, steroid use, or disease duration.
Conclusion: Our IBD cohort reported a 33% prevalence ofsleep disturbance symptoms. In the small group of patients withUlcerative Colitis (UC), there was a trend toward a greater degree ofsleep disturbances and a higher PUCAI score. Further investigationinto sleep disorders among children with IBD is warranted toprovide further insight into this issue. Additional evaluation of the differences between Crohn’s disease (CD) and ulcerative colitis asthey relate to sleep quality as well as studies implementing objectivesleep assessments, such as polysomnography or actigraphy, arewarranted as they may offer better understanding of the relationshipbetween pediatric IBD and sleep quality.