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Relationship between disease activity index and sleep disorders in children with inflammatory bowel diseases

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Abstract

The aim of the study was to assess the prevalence of sleep disturbance in pediatric IBD patients and evaluate the relationship between clinical features of IBD, disease activity, inflammatory markers and quality of sleep. A total of 99 patients who were followed-up with the diagnosis of IBD (44 Crohn’s disease (CD), 55 Ulcerative colitis (UC)) between 2015–2020 and 80 healthy controls were enrolled in the study. The clinical and demographic characteristics, laboratory parameters and disease activities were obtained from medical reports retrospectively. Pittsburgh sleep quality index (PSQI) was administered to all participants. PSQI score was significantly higher in patient group than the control group (P < 0.001). The sleep time of patient group, especially patients with UC was later than the control group (P = 0.008). Sleep duration was longer in control group than the patient group (P < 0.001). A positive strong correlation was obtained in disease activity index (r = 0.886; P < 0.001) and abdominal pain (r = 0.781; P < 0.001) with PSQI scores of CD patients. Disease activity index, rectal bleeding, diarrhea and number of stool had statistically significant positive strong correlation with PSQI scores of UC patients (P < 0.001). Pediatric Crohn’s disease activity index and Pediatric ulcerative colitis activity index were the only independent risk factors affecting sleep disturbances (80% sensitivity and 91.67% specificity, 93.1% sensitivity and %96.15 specificity, respectively).

   Conclusion: Increased disease activity has adverse effects on sleep quality. PSQI and PCDAI were strong tests for predicting sleep disorders in pediatric patients with IBD.

What is Known:

• Sleep disturbances are common complaint in inflammatory bowel disease (IBD), even in clinical remission.

• Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality of patients.

What is New:

•  PSQI and Pediatric Crohn Disease Activity index (PCDAI) were strong tests for predicting sleep disorders in pediatric patients with IBD.

• PSQI and PCDAI scores correlated significantly with the severity of the sleep disturbances.

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Data availability

N/a.

Abbreviations

CD:

Crohn’s disease

IBD:

Inflammatory bowel disease

PCDAI:

Pediatric Crohn’s disease activity index

PSQI:

Pittsburgh sleep quality index

PUCAI:

Pediatric ulcerative colitis activity index

UC:

Ulcerative colitis

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Authors and Affiliations

  1. Pediatrics, SBU Sisli Hamidiye Etfal Training and Research Hospital, MD, Istanbul, Turkey

    Dilsat Gundogdu

  2. Division of Pediatric Gastroenterology, SBU Sisli Hamidiye Etfal Training and Research Hospital, Kazim Karabekir Pasa, Bahcekoy No: 62 Sariyer, Istanbul, Turkey

    Nafiye Urgancı & Merve Usta

Authors
  1. Dilsat Gundogdu
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  2. Nafiye Urgancı
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  3. Merve Usta
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Contributions

Conceptualization: Dilsat Gundogdu, Nafiye Urganci; Methodology: Dilsat Gundogdu, Nafiye Urganci; Formal analysis and investigation: Dilsat Gundogdu, Nafiye Urganci, Merve USTA; Writing -original draft preparation: Dilsat Gundogdu, Nafiye Urganci,; Writing - review and editing: Dilsat Gundogdu, Nafiye Urganci, Merve USTA.

Corresponding author

Correspondence to Nafiye Urgancı.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of T SBU Sisli Hamidiye Etfal Training and Research Hospital (No:1267/28.05.2019).

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Written informed consent was obtained from the parents.

Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

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Communicated by Peter de Winter

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Gundogdu, D., Urgancı, N. & Usta, M. Relationship between disease activity index and sleep disorders in children with inflammatory bowel diseases. Eur J Pediatr 182, 4095–4102 (2023). https://doi.org/10.1007/s00431-023-05081-2

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