Skip to main content
SpringerLink
Log in

Altered sleep quality is associated with Crohn’s disease activity: an actimetry study

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Background

Sleep is involved in the regulation of inflammation, healing, and digestion. The pathophysiology of Crohn’s disease (CD) is unclear, and the role of sleep disturbances has recently been suggested.

Objective

The present study investigated a putative association between sleep disturbances and CD activity.

Methods

We conducted a prospective observational monocenter translational study, recruiting major CD patients from 2013 to 2015. Disease activity was assessed by the Harvey-Bradshaw index and the CD activity index. Objective sleep quantity and quality were measured by wrist actigraphy over a period of 7 days. The primary objective was to look for an association between wrist actigraphy parameters and CD activity.

Results

Thirty-four CD patients, including 14 with active disease and 20 in remission, were included. Sleep efficiency measured by wrist actigraphy was lower in patients with active CD compared to patients in remission. Wake after sleep onset time best predicted CD activity with an AUROC of 0.83. Patients with active CD were more frequently characterized as “poor sleepers” and frequently suffered from excessive daytime sleepiness.

Conclusion

Sleep efficiency is lower in patients with active CD than in those in remission. Further studies aimed at better characterizing CD patients’ sleep are warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Zhang M, Sun K, Wu Y, Yang Y, Tso P, Wu Z (2017) Interactions between intestinal microbiota and host immune response in inflammatory bowel disease. Front Immunol 8:942

    Article  PubMed  PubMed Central  Google Scholar 

  2. Abegunde AT, Muhammad BH, Bhatti O, Ali T (2016) Environmental risk factors for inflammatory bowel diseases. World J Gastroenterol 22(27):6296–6317

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Hoogerwerf WA (2009) Role of biological rhythms in gastrointestinal health and disease. Rev Endocr Metab Disord 10(4):293–300

    Article  PubMed  Google Scholar 

  4. Orr WC (2009) Sleep and gastrointestinal disease: a new horizon in sleep medicine. Sleep Med juin 10(6):595–596

    Article  Google Scholar 

  5. Asif N, Iqbal R, Nazir CF (2017) Human immune system during sleep. Am J Clin Exp Immunol 6(6):92–96

    PubMed  PubMed Central  Google Scholar 

  6. Irwin MR, Olmstead R, Carroll JE (2016) Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry 80(1):40–52

    Article  PubMed  Google Scholar 

  7. Parekh PJ, Oldfield EC, Johnson DA (2018) The effects of sleep on the commensal microbiota: eyes wide open? J Clin Gastroenterol 52(3):204–209

    Article  PubMed  Google Scholar 

  8. Kanaly T, Shaheen NJ, Vaughn BV (nov 2009) Gastrointestinal physiology and digestive disorders in sleep. Curr Opin Pulm Med 15(6):571–577

    PubMed  Google Scholar 

  9. Edwards RR, Almeida DM, Klick B, Haythornthwaite JA, Smith MT (2008) Duration of sleep contributes to next-day pain report in the general population. Pain 137(1):202–207

    Article  PubMed  PubMed Central  Google Scholar 

  10. Marcus SB, Strople JA, Neighbors K, Weissberg-Benchell J, Nelson SP, Limbers C et al (2009) Fatigue and health-related quality of life in pediatric inflammatory bowel disease. Clin Gastroenterol Hepatol 7(5):554–561

    Article  PubMed  Google Scholar 

  11. Graff LA, Vincent N, Walker JR, Clara I, Carr R, Ediger J, Miller N, Rogala L, Rawsthorne P, Lix L, Bernstein CN (2011) A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflamm Bowel Dis 17(9):1882–1889

    Article  PubMed  Google Scholar 

  12. Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A (2007) Impact of sleep disturbances in inflammatory bowel disease. J Gastroenterol Hepatol 22(11):1748–1753

    Article  PubMed  Google Scholar 

  13. Swanson GR, Burgess HJ, Keshavarzian A (2011) Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare? Expert Rev Clin Immunol 7(1):29–36

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD (2013) Sleep disturbance and risk of active disease in patients with Crohn’s disease and ulcerative colitis. Clin Gastroenterol Hepatol 11(8):965–971

    Article  PubMed  PubMed Central  Google Scholar 

  15. van Langenberg DR, Papandony MC, Gibson PR Sleep and physical activity measured by accelerometry in Crohn’s disease. Aliment Pharmacol Ther 41(10):991–1004

  16. Keefer L, Stepanski EJ, Ranjbaran Z, Benson LM, Keshavarzian A (2006) An initial report of sleep disturbance in inactive inflammatory bowel disease. J Clin Sleep Med 2(4):409–416

    Article  PubMed  Google Scholar 

  17. Ali T, Madhoun MF, Orr WC, Rubin DT (2013) Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflamm Bowel Dis 19(11):2440–2443

    Article  PubMed  Google Scholar 

  18. Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M et al (2010) The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohns Colitis févr 4(1):7–27

    Article  Google Scholar 

  19. Harvey RF, Bradshaw JM (1980) A simple index of Crohn’s-disease activity. Lancet 8 mars 1(8167):514

    Article  CAS  Google Scholar 

  20. Winship DH, Summers RW, Singleton JW, Best WR, Becktel JM, Lenk LF et al (1979) National Cooperative Crohn’s Disease Study: study design and conduct of the study. Gastroenterology. 77(4 Pt 2):829–842

    Article  CAS  PubMed  Google Scholar 

  21. Guyatt G, Mitchell A, Irvine EJ, Singer J, Williams N, Goodacre R, Tompkins C (1989) A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology 96(3):804–810

    Article  CAS  PubMed  Google Scholar 

  22. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  23. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  PubMed  Google Scholar 

  24. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545

    Article  CAS  PubMed  Google Scholar 

  25. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131(7):485–491

    Article  CAS  PubMed  Google Scholar 

  26. Tang Y, Preuss F, Turek FW, Jakate S, Keshavarzian A (2009) Sleep deprivation worsens inflammation and delays recovery in a mouse model of colitis. Sleep Med 10(6):597–603

    Article  PubMed  PubMed Central  Google Scholar 

  27. Preuss F, Tang Y, Laposky AD, Arble D, Keshavarzian A, Turek FW (2008) Adverse effects of chronic circadian desynchronization in animals in a “challenging” environment. Am J Physiol Regul Integr Comp Physiol 295(6):R2034–R2040

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Voigt RM, Forsyth CB, Green SJ, Mutlu E, Engen P, Vitaterna MH, Turek FW, Keshavarzian A (2014) Circadian disorganization alters intestinal microbiota. PLoS One 9(5):e97500

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lockley SW, Skene DJ, Arendt J (1999) Comparison between subjective and actigraphic measurement of sleep and sleep rhythms. J Sleep Res 8(3):175–183

    Article  CAS  PubMed  Google Scholar 

  30. Vermeire S, Schreiber S, Sandborn WJ, Dubois C, Rutgeerts P (2010) Correlation between the Crohn’s disease activity and Harvey-Bradshaw indices in assessing Crohn’s disease severity. Clin Gastroenterol Hepatol 8(4):357–363

    Article  PubMed  Google Scholar 

  31. Mikocka-Walus AA, Turnbull DA, Moulding NT, Wilson IG, Holtmann GJ, Andrews JM (2008) Does psychological status influence clinical outcomes in patients with inflammatory bowel disease (IBD) and other chronic gastroenterological diseases: an observational cohort prospective study. Biopsychosoc Med 2:11

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wittmann M, Dinich J, Merrow M, Roenneberg T (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int 23(1–2):497–509

    Article  PubMed  Google Scholar 

  33. Parekh PJ, Oldfield Iv EC, Challapallisri V, Ware JC, Johnson DA (2015) Sleep disorders and inflammatory disease activity: chicken or the egg? Am J Gastroenterol 110(4):484–488

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the clinical research associates from the gastroenterology department and GENPHASS.

Author information

Authors and Affiliations

  1. University of Bordeaux, INRA, EA 3671, CHU Bordeaux, F-33000, Bordeaux, France

    Thomas Bazin

  2. Gastroenterology and Hepatology Department, Hôpital Haut Lévêque, Centre Hospitalier Universitaire de Bordeaux and Université de Bordeaux, F-33000, Bordeaux, France

    Thomas Bazin, Nathalie Terras, David Laharie & Frank Zerbib

  3. University Bordeaux, CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France

    Jean-Arthur Micoulaud Franchi, Jacques Taillard & Pierre Philip

  4. Bordeaux Hospital University Center, Clinique du sommeil, F-33000, Bordeaux, France

    Jean-Arthur Micoulaud Franchi & Pierre Philip

  5. GENPPHASS, Hôpital Pellegrin, Tripode 13ème Etage, Place Amélie Raba Léon, F-33076, Bordeaux CEDEX, France

    Pierre Philip

Authors
  1. Thomas Bazin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Arthur Micoulaud Franchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nathalie Terras
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacques Taillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Laharie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Frank Zerbib
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pierre Philip
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pierre Philip.

Ethics declarations

Conflict of interest

The authors declare that they no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bazin, T., Micoulaud Franchi, JA., Terras, N. et al. Altered sleep quality is associated with Crohn’s disease activity: an actimetry study. Sleep Breath 24, 971–977 (2020). https://doi.org/10.1007/s11325-019-01934-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-019-01934-z

Keywords

Search

Navigation