Digestive Diseases and Sciences

, Volume 60, Issue 7, pp 2136–2143 | Cite as

High C-Reactive Protein Is Associated with Poor Sleep Quality Independent of Nocturnal Symptoms in Patients with Inflammatory Bowel Disease

  • Robin G. Wilson
  • Betsy W. Stevens
  • Abra Y. Guo
  • Caitlin N. Russell
  • Anna Thornton
  • Melissa A. Cohen
  • Holly C. Sturgeon
  • Cosmas Giallourakis
  • Hamed Khalili
  • Deanna D. Nguyen
  • Vijay Yajnik
  • Jenny Sauk
  • Ashwin N. Ananthakrishnan
Original Article



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.


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.


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).


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.


Sleep Inflammatory bowel disease C-reactive protein Inflammation 



We acknowledge the valuable contributions of the participants and the research staff of our registry. This work was presented as a poster at the American College of Gastroenterology Annual Meeting 2014, Philadelphia, PA. This work is supported by the National Institutes of Health (NIH) (P30 DK043351) to the Center for Study of Inflammatory Bowel Diseases. Ananthakrishnan is supported in part by a grant from the National Institutes of Health (K23 DK097142).

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Robin G. Wilson
    • 1
  • Betsy W. Stevens
    • 1
  • Abra Y. Guo
    • 1
  • Caitlin N. Russell
    • 1
  • Anna Thornton
    • 1
  • Melissa A. Cohen
    • 1
  • Holly C. Sturgeon
    • 1
  • Cosmas Giallourakis
    • 1
    • 2
  • Hamed Khalili
    • 1
    • 2
  • Deanna D. Nguyen
    • 1
    • 2
  • Vijay Yajnik
    • 1
    • 2
  • Jenny Sauk
    • 1
    • 2
  • Ashwin N. Ananthakrishnan
    • 1
    • 2
    • 3
  1. 1.Division of GastroenterologyMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Massachusetts General Hospital Crohn’s and Colitis CentreBostonUSA

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