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A1997 - Sleep Disturbances in Children with Inflammatory Bowel Disease
Author Block: S. M. Pillai1, F. Deshmukh2, J. Lentine2, R. Sockolow2, P. Christos3, Y. Lao3, H. Veler1, G. M. Loughlin1, E. Barfield2; 1Pediatric Pulmonology Allergy and Immunology, Weill Cornell Medicine, New York, NY, United States, 2Pediatric Gastroenterology and Nutrition, Weill Cornell Medicine, New York, NY, United States, 3Department of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, United States.
Background: It is estimated that in the U.S. more than 80,000 children have inflammatory bowel disease (IBD), a relapsing and remitting group of diseases that includes Crohn’s disease (CD), Ulcerative colitis (UC) and Indeterminate colitis (IC). Twenty-five percent of patients with IBD are under the age of 20 years.Sleep disturbances including prolonged sleep latency, sleep fragmentation, increased need for sleep medications and fatigue have been reported in IBD, but the extent of these issues in pediatric IBD is uknown. Here, we aim to determine the prevalence of sleep disturbances in an urban pediatric IBD cohort and understand its impact on IBD disease severity.
Methods: The study was approved by the Weill Cornell Medicine IRB. Ninety-two IBD patients ages 12-22 years completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire, a validated measure of sleep quality and habits in children. A PSQI score >5 was suggestive of sleep problems. Chart review provided demographic information. Disease activity score (Pediatric Crohn’s disease Activity Index [PCDAI] or Pediatric Ulcerative Colitis Activity Index [PDCAI]) was recorded from the day of enrollment. REDCap™ was used for data collection.The prevalence of sleep disturbances in the cohort was calculated and compared to expected prevalence of sleep problems in healthy children using a one-sample test for a binomial proportion. Multivariable logistic regression analysis determined the independent effect of potential risk factors of interest on PSQI > 5. All p-values are two-sided with statistical significance evaluated at p≤0.05.Results: The median age of diagnosis of IBD was 13 years (range 3 to 18) and 58% were males (n=92); 77 % of children were diagnosed with CD; 17% had UC and 5% had IC. The prevalence of sleep problems was 29.4% (95% CI: 20.3% - 39.8%) compared to approximately 25% in healthy children (p=0.34). Data analysis did not show significant associations between sleep disturbances and other factors including age, race, gender, history of gastrointestinal surgery, medication use or IBD subtypes or disease duration.Conclusion: Contrary to adult studies, our results do not show significant sleep disturbances in children with IBD. This might be due to the small sample size. Also one can argue that sleep disturbances evolve with GI disease progression and may not be noticeable until early adulthood. However, routine inquiry about sleep habits seems warranted to diagnose and address sleep disturbances and further define specific sleep components that might be affected by IBD that may result in increased morbidity in this population.