Gundogdu Dilsat, Urgancı Nafiye, Usta Merve
Pediatrics, SBU Sisli Hamidiye Etfal Training and Research Hospital, MD, Istanbul, Turkey.
Division of Pediatric Gastroenterology, SBU Sisli Hamidiye Etfal Training and Research Hospital, Kazim Karabekir Pasa, Bahcekoy No: 62 Sariyer, Istanbul, Turkey.
Eur J Pediatr. 2023 Sep;182(9):4095-4102. doi: 10.1007/s00431-023-05081-2. Epub 2023 Jul 5.
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.
本研究的目的是评估儿科炎症性肠病（IBD）患者睡眠障碍的患病率，并评估IBD的临床特征、疾病活动度、炎症标志物与睡眠质量之间的关系。共有99例在2015年至2020年间被诊断为IBD并接受随访的患者（44例克罗恩病（CD），55例溃疡性结肠炎（UC））以及80例健康对照纳入本研究。临床和人口统计学特征、实验室参数及疾病活动度通过回顾医疗报告获得。对所有参与者进行匹兹堡睡眠质量指数（PSQI）评估。患者组的PSQI评分显著高于对照组（P<0.001）。患者组的睡眠时间，尤其是UC患者的睡眠时间晚于对照组（P = 0.008）。对照组的睡眠时长比患者组长（P<0.001）。CD患者的疾病活动指数（r = 0.886；P<0.001）和腹痛（r = 0.781；P<0.001）与PSQI评分呈显著正相关。疾病活动指数、直肠出血、腹泻及大便次数与UC患者的PSQI评分具有统计学意义的显著正相关（P<0.001）。儿科克罗恩病活动指数和儿科溃疡性结肠炎活动指数是影响睡眠障碍的仅有的独立危险因素（敏感性分别为80%和91.67%，特异性分别为93.1%和96.15%）。结论：疾病活动度增加对睡眠质量有不良影响。PSQI和PCDAI是预测儿科IBD患者睡眠障碍的有效指标。已知信息：•睡眠障碍是炎症性肠病（IBD）常见的主诉，即使在临床缓解期也存在。•匹兹堡睡眠质量指数（PSQI）用于评估患者的主观睡眠质量。新发现：•PSQI和儿科克罗恩病活动指数（PCDAI）是预测儿科IBD患者睡眠障碍的有效指标。•PSQI和PCDAI评分与睡眠障碍的严重程度显著相关。
