School of Health & Related Research (ScHARR), University of Sheffield, UK.
Clinical Psychology Unit, Department of Psychology, University of Sheffield, UK.
Br J Health Psychol. 2021 Feb;26(1):90-108. doi: 10.1111/bjhp.12457. Epub 2020 Jul 7.
Poor global sleep quality is commonly reported in people with inflammatory bowel disease (IBD) and is linked to poorer health-related quality of life (HRQoL). However, understanding is currently limited by a lack of: (1) longitudinal research and (2) research investigating the impact of specific types of problems sleeping on IBD-related outcomes, particularly on HRQoL.
Observational longitudinal cohort study.
N = 276 participants with IBD completed measures at baseline (T1) and 4 weeks later at T2. Four specific sleep disturbances associated with IBD including sleep apnoea, insomnia, restless legs, and nightmares were measured alongside depression, anxiety and stress, and HRQoL.
After controlling for participant demographics and clinical characteristics, T1 depression, anxiety, stress, and T1 HRQoL, more severe symptom severity of sleep apnoea (B = -0.30, p < .05) and insomnia symptoms (B = -0.23, p < .05) at T1 significantly predicted poorer HRQoL at T2. However, the experience of restless legs (B = -0.03, p > .87) and nightmares (B = -0.14, p > .11) at T1 did not predict HRQoL.
Symptoms synonymous with sleep apnoea and insomnia might represent modifiable risk factors that provide independent contributions to HRQoL over time in those with IBD. These findings suggest that interventions designed to improve sleep apnoea and insomnia could confer benefits to HRQoL in those with IBD. However, more longitudinal research is needed to understand the contribution of sleep disturbances over the longer term, as well as more randomized controlled trials testing the effect of improving sleep on IBD-related outcomes.
炎症性肠病(IBD)患者常报告全球睡眠质量较差,且与较差的健康相关生活质量(HRQoL)相关。然而,目前的理解受到以下两个因素的限制:(1)缺乏纵向研究;(2)缺乏研究调查特定类型的睡眠问题对 IBD 相关结果的影响,尤其是对 HRQoL 的影响。
观察性纵向队列研究。
276 名 IBD 患者完成了基线(T1)和 4 周后(T2)的测量。四项与 IBD 相关的特定睡眠障碍(包括睡眠呼吸暂停、失眠、不宁腿和噩梦)与抑郁、焦虑和压力以及 HRQoL 一起进行了测量。
在控制了参与者的人口统计学和临床特征、T1 抑郁、焦虑、压力和 T1 HRQoL 后,T1 时睡眠呼吸暂停(B = -0.30,p < 0.05)和失眠症状(B = -0.23,p < 0.05)的症状严重程度显著预测了 T2 时的 HRQoL 较差。然而,T1 时不宁腿(B = -0.03,p > 0.87)和噩梦(B = -0.14,p > 0.11)的体验并未预测 HRQoL。
与睡眠呼吸暂停和失眠相关的症状可能代表可改变的危险因素,随着时间的推移,这些因素对 IBD 患者的 HRQoL 有独立贡献。这些发现表明,旨在改善睡眠呼吸暂停和失眠的干预措施可能会使 IBD 患者的 HRQoL 受益。然而,需要更多的纵向研究来了解睡眠障碍在更长时间内的贡献,以及更多的随机对照试验来测试改善睡眠对 IBD 相关结果的影响。