An initial report of sleep disturbance in inactive inflammatory bowel disease.
An initial report of sleep disturbance in inactive inflammatory bowel disease.
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DOI：
10.5664/jcsm.26656
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发表时间：
2006-10
期刊：
影响因子：
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通讯作者：
L. Keefer;E. Stepanski;Z. Ranjbaran;Laura M. Benson;A. Keshavarzian
中科院分区：
文献类型：
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作者：
L. Keefer;E. Stepanski;Z. Ranjbaran;Laura M. Benson;A. Keshavarzian
背景夜班工人的胃肠道症状、消化性溃疡疾病和结肠癌的患病率增加，他们的睡眠经常受到干扰。睡眠主诉是肠易激综合征(IBS)的锥体外系症状。睡眠障碍可能会削弱免疫系统抵御内毒素的能力，从而导致医疗发病率的增加--这一途径可能对炎症性肠病(IBD)的发病机制和/或临床病程具有潜在的重要意义。IBD是一种慢性免疫性炎症性胃肠道疾病，与生活质量显著下降有关。这是第一项全面检查IBD患者睡眠问题的研究。方法采用匹兹堡睡眠质量指数、Epworth嗜睡量表、炎症性肠病问卷、SF-12和单次夜间多导睡眠图对16例经活检证实的非活动期IBD患者(克罗恩病8例，溃疡性结肠炎8例)、9例IBS患者和7例健康人进行测试。根据标准标准对多导睡眠图和觉醒进行评分。多变量分析被用来比较不同组之间的主观和客观睡眠参数，并确定睡眠抱怨和生活质量之间的联系。结果IBD患者与已有睡眠主诉的IBS患者差异无统计学意义。在多导睡眠图上，总睡眠时间很好地区分了三组，IBS组和IBD组在数值上看起来相似。虽然IBS组和IBD组在观察到的睡眠参数方面相似，但IBS患者报告的担忧最多，这与早期的研究一致，该研究表明，过度觉醒和知觉差异可能有助于症状报告。结论睡眠参数极大地影响了两组患者的生活质量，强调了在IBD治疗中解决睡眠问题的必要性。
BACKGROUND There is an increased prevalence of gastrointestinal symptoms, peptic ulcer disease, and colon cancer in night-shiftworkers, whose sleep is commonly disrupted. Sleep complaints are an extrapyramidal symptom of irritable bowel syndrome (IBS). Sleep disruption may contribute to increased medical morbidity by weakening the ability of the immune system to protect against endotoxins-this pathway could be of potential importance to the pathogenesis and/or clinical course of inflammatory bowel disease (IBD), a chronic immunoinflammatory gastrointestinal disorder associated with marked reductions in quality of life. This is the first study to comprehensively examine sleep concerns in patients with IBD. METHODS Sixteen patients with biopsy-proven inactive IBD (8 with Crohn disease and 8 with ulcerative colitis), 9 patients with IBS, and 7 healthy controls completed the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Inflammatory Bowel Disease Questionnaire, SF-12, and a single overnight polysomnogram. Polysomnography and arousals were scored according to standard criteria. Multivariate analyses were used to compare subjective and objective sleep parameters between groups and to identify associations between sleep complaints and quality of life. RESULTS Patients with IBD did not seem to significantly differ from patients with IBS, who have established sleep complaints. On polysomnography, total sleep time differentiated the 3 groups well, with the IBS and IBD groups appearing numerically similar. Whereas IBS and IBD groups were similar with respect to observed sleep parameters, IBS patients did report the most concerns, consistent with earlier research suggesting that hyperarousal and perceptual differences may contribute to symptom reporting. CONCLUSION Sleep parameters greatly influenced quality of life in both groups and highlight the need to address sleep concerns as part of IBD management.