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PubMed abstracts for UC sleep/apnea/circadian digest 004

Saved 10 records from NCBI E-utilities on 2026-06-17.

PMID 24764789 — Sleep and inflammatory bowel disease: exploring the relationship between sleep disturbances and inflammation.

Sleep disturbances are associated with a greater risk of serious adverse health events, economic consequences, and, most importantly, increased all-cause mortality. Several studies support the associations among sleep, immune function, and inflammation. The relationship between sleep disturbances and inflammatory conditions is complex and not completely understood. Sleep deprivation can lead to increased levels of inflammatory cytokines, including interleukin (IL)-1β IL-6, tumor necrosis factor-α and C-reactive protein, which can lead to further activation of the inflammatory cascade. The relevance of sleep in inflammatory bowel disease (IBD), a chronic immune-mediated inflammatory disease of the gastrointestinal tract, has recently received more attention. Several studies have shown that patients with both inactive and active IBD have self-reported sleep disturbances. Here, we present a concise review of sleep and its association with the immune system and the process of inflammation. We discuss the studies that have evaluated sleep in patients with IBD as well as possible treatment options for those patients with sleep disturbances. An algorithm for evaluating sleep disturbances in the IBD population is also proposed. Further research is still needed to better characterize sleep disturbances in the IBD population as well as to assess the effects of various therapeutic interventions to improve sleep quality. It is possible that the diagnosis and treatment of sleep disturbances in this population may provide an opportunity to alter disease outcomes.

PMID 36406652 — Systematic review and meta-analysis of sleep quality in inactive inflammatory bowel disease.

Poor sleep in people with inflammatory bowel disease (IBD) has been demonstrated to be prevalent and has been associated with disease activity. This meta-analysis aimed to assess the prevalence of poor sleep in inactive IBD and in controls by considering cohort and cross-sectional studies. Electronic databases were searched for publications from inception to 1 November 2021. Poor sleep and IBD activity were defined according to self-reported subjective sleep measures. A random effects model was used to determine the standardized mean difference between poor sleep in inactive IBD and healthy controls. Publication bias was assessed by funnel plot and Egger’s test. Five hundred and nineteen studies were screened with 9 studies included in the meta-analysis incorporating a total of 729 people with IBD and 508 controls. A random effects model showed a standardized mean difference with poor sleep being more frequent in those with inactive IBD than controls with moderate effect size (Hedge’s g 0.41, CI [0.22-0.59]) and no significant heterogeneity. There was no publication bias evident. Poor sleep is more common in individuals with inactive IBD than healthy controls. Further studies should consider potential mechanisms to explain this result, including the role of subclinical inflammation and psychosocial factors that may influence sleep quality in people with IBD.

PMID 36998248 — Simple Novel Screening Tool for Obstructive Sleep Apnea in Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) has been associated with an increased risk of obstructive sleep apnea (OSA). We aimed to examine the associations of obstructive sleep apnea, sleepiness, and IBD-related data and comorbidities, with the aim of developing a screening tool for sleep apnea in this population. An online survey of adults with IBD was administered which included measures of assessment of the risk of OSA, and measures of IBD activity, IBD-related disability, anxiety, and depression. Logistic regression was performed to investigate the associations between the risk of OSA and IBD data, medications, demographics, and mental health conditions. Further models were built for an outcome of severe daytime sleepiness and a combined outcome of risk of OSA and at least mild daytime sleepiness. A simple score was constructed for the purpose of screening for OSA. There were 670 responses to the online questionnaire. The median age was 41 years, the majority had Crohn’s disease (57%), the median disease duration was 11.9 years, and approximately half were on biologics (50.5%). Moderate-high risk of OSA was demonstrated in 22.6% of the cohort. A multivariate regression model for moderate-high risk of OSA included increasing age, obesity, smoking, and abdominal pain subscore. For a combined outcome of moderate-high risk of OSA and at least mild daytime sleepiness, a multivariate model included abdominal pain, age, smoking, obesity, and clinically significant depression. A simple score was constructed for screening for OSA utilizing age, obesity, IBD activity, and smoking status with an area under the receiver-operating curve of 0.77. A score >2 had a sensitivity of 89% and a specificity of 56% for moderate-high risk of OSA and could be utilized for screening for OSA in the IBD clinic. Over one-fifth of an IBD cohort met significantly high-risk criteria for OSA to warrant referral for a diagnostic sleep study. The risk of OSA was associated with abdominal pain, along with more traditional risk factors such as smoking, increasing age, and obesity. Consideration should be given for screening for OSA in IBD patients utilizing a novel screening tool that utilizes parameters typically available in IBD clinic.

PMID 40332348 — Circadian Rhythm Dysregulation in Inflammatory Bowel Disease: Mechanisms and Chronotherapeutic Approaches.

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is characterized by chronic intestinal inflammation. Recent research has highlighted the significant interplay between IBD pathogenesis and circadian rhythms. This review synthesizes current evidence regarding circadian regulation in IBD, covering three main areas: (1) circadian rhythms in intestinal physiology, (2) circadian disruption patterns in IBD patients, and (3) the role of clock genes in IBD pathogenesis. We discuss how these findings may inform novel chronotherapeutic approaches for IBD treatment. Future research directions that could facilitate translation of chronobiological insights into clinical applications are also explored.

PMID 21162647 — Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare?

Inflammatory bowel disease (IBD) is a waxing and waning disease characterized by diarrhea, abdominal pain and weight loss. Recently, there has been an increased interest in the roles that sleep, circadian rhythms and melatonin could have as regulators of inflammation in the Gl tract. Advances in our understanding of the molecular machinery of the circadian clock, and the discovery of clock genes in the GI tract are opening up new avenues of research for a role of sleep in IBD. Altering circadian rhythm significantly worsens the development of colitis in animal models, and preliminary human studies have shown that patients with IBD are at increased risk for altered sleep patterns. Further research is needed to clarify the role of disturbances in IBD.

PMID 39052880 — Chronic Poor Sleep is Associated with Increased Disease Activity in Patients with Ulcerative Colitis: Prospective Observational Study in Japan.

Although sleep disorders are associated with the pathogenesis of inflammatory bowel disease, the causal relationship is unclear. Therefore, in this study we aimed to clarify the causal relationship between them. We administered the Pittsburgh Sleep Questionnaire to participants during regular visits to evaluate their sleep condition, and prospectively observed the participants. Participants were divided into poor sleep and non-poor sleep groups according to their first and second questionnaire scores. We compared inflammatory bowel disease relapse rates between the two groups. The study population included 139 patients with inflammatory bowel disease, including 60 with chronic poor sleep. Disease relapse rate was significantly higher in the poor sleep group than in the non-poor sleep group [28.3% vs 8.9%; p = 0.0033]. Ulcerative colitis relapse rate was significantly higher in the poor sleep group than in the non-poor sleep group [34.5% vs 10.3%, p = 0.031]. Multivariate analysis identified chronic poor sleep as a clinical factor that affected inflammatory bowel disease relapse (odds ratio [OR] = 6.69, 95% confidence interval [CI]: 2.23-20.0, p = 0.0007] and ulcerative colitis relapse [OR = 8.89, 95% CI: 1.57-50.2, p = 0.014]. The Kaplan - Meier curve showed significantly lower cumulative treatment retention rates in the poor sleep group than in the non-poor sleep group [all patients, p = 0.0061; ulcerative colitis, p = 0.025]. Concomitant chronic poor sleep may have a negative influence on the disease activity in patients with inflammatory bowel disease, particularly in those with ulcerative colitis.

PMID 36777429 — Prevalence of Obstructive Sleep Apnea Is Increased in Patients With Inflammatory Bowel Disease: A Large, Multi-Network Study.

Crohn’s disease (CD) and ulcerative colitis (UC) involve an inflammatory state where sleep dysregulation is common. Little is known about implications, if any, of inflammatory bowel disease (IBD) on the development of obstructive sleep apnea (OSA). This study aims to investigate if IBD patients are at higher risk for OSA. This retrospective multivariate analysis utilized a commercial database named Explorys (IBM Watson). We identified patients from 1/2015 to 1/2020 with UC and CD. Cohorts of these patients with and without OSA were then created and prevalence values were obtained. A multivariate analysis was used to correct for several potential confounding variables. The overall prevalence of OSA was 7.8% in UC and 7.2% in CD, as compared with a prevalence of 4.3% in non-IBD patients (odds ratio [OR] for UC: 1.9 [95% CI 1.86-1.94, P < .0001], OR for CD: 1.72 [95% CI 1.69-1.76, P < .0001]). In multivariate analysis, age above 65, Caucasian race, male sex, obesity, smoking, hypertension, and diabetes were all independent risk factors for the development of OSA, with obesity being the most significant. After controlling for the listed variables in the multivariate analysis, IBD was an independent risk factor associated with OSA (OR 1.46, 95% CI 1.43-1.48). In this large population-based study, IBD was independently associated with increased prevalence of OSA. This has implications for screening for OSA in IBD, as well as management of other risk factors for OSA in IBD.

PMID 39924756 — Association of Poor Sleep Quality With Adverse Outcomes in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Inflammatory bowel disease (IBD) is a group of chronic diseases with adverse events such as disease flare, progression, drug escalation, hospitalization, and surgery. Meanwhile, patients with IBD often have sleep disorders. We performed this systematic review and meta-analysis aiming to investigate the relationship between sleep quality of patients with IBD and their prognosis. MEDLINE and Web of Science Core Collection databases were searched for articles published up to November 2024. We pooled the hazard ratio (HR) and odds ratio (OR) with the corresponding 95% confidence interval (CI) for adverse outcome events during the follow-up period in patients with poor sleep quality at baseline compared with those with normal sleep quality. Five studies were included with a total of 2333 patients with IBD. Poor sleep quality in patients with IBD was significantly correlated with the occurrence of adverse outcome events at follow-up (OR 1.63, 95% CI 1.14-2.33). Patients with Crohn’s disease (CD) with poor sleep quality had a significantly higher risk of adverse outcome events at follow-up (OR 1.58, 95% CI 1.26-1.99), whereas those with ulcerative colitis (UC) did not (OR 1.10, 95% CI 0.76-1.60). Early identification of poor sleep quality in patients with IBD, especially CD, has a predictive effect on their prognosis.

PMID 24780288 — Sleep duration affects risk for ulcerative colitis: a prospective cohort study.

  • Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2014)
  • DOI: 10.1016/j.cgh.2014.04.021
  • URL: https://pubmed.ncbi.nlm.nih.gov/24780288/

Sleep deprivation is associated with production of inflammatory cytokines. Disturbed sleep quality has been associated with increased risk of disease flare in patients with Crohn’s disease (CD) or ulcerative colitis (UC). However, the association between sleep and risk of incident CD and UC has not been previously examined. We conducted a prospective study of women who were enrolled in the Nurses’ Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with >90% follow-up. We examined the association of sleep duration reported in 1986 in NHS I and 2001 in NHS II with incident CD and UC, diagnosed through 2010, in NHS I and 2009 in NHS II. Cox proportional hazards models adjusting for potential confounders were used to calculate hazard ratios and 95% confidence intervals (CIs). Among 151,871 women, we confirmed 191 cases of CD (incidence, 8/100,000 person-years) and 230 cases of UC (incidence, 10/100,000 person-years) over 2,292,849 person-years. Compared with women with reported usual sleep durations of 7-8 h/day (incidence, 8/100,000 person-years), women with reported sleep duration <6 h/day (11/100,000 person-years) or >9 h/day (20/100,000 person-years) had a higher incidence of UC (P < .05). The multivariate hazard ratios for UC were 1.51 (95% CI, 1.10-2.09) for sleep durations <6 h/day and 2.05 (95% CI, 1.44-2.92) for sleep durations >9 h/day, compared with sleep durations of 7-8 h/day. In contrast, sleep duration did not modify risk of CD. Duration of rotating night shift work was not associated with CD or UC. On the basis of data from the NHS I and II, less than 6 hours sleep/day and more than 9 hours sleep/day are each associated with an increased risk of UC. Further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD.

PMID 34567156 — Efficacy and Safety of Melatonin as an Adjunctive Therapy on Clinical, Biochemical, and Quality of Life in Patients with Ulcerative Colitis.

Ulcerative colitis (UC) is characterized by recurring episodes of inflammation limited to the mucosal layer of the colon. The exact etiology of UC is unknown, but the role of autoimmunity and activated inflammatory cascade is quite clear. Melatonin possesses anti-inflammatory and immune-modulative properties in animal and clinical trials. The aim of the present study was to evaluate the efficacy and safety of oral melatonin as an adjudicative therapy in clinical, biochemical, and quality of life in UC patients. Thirty patients diagnosed with mild to moderate UC, were randomly allocated to either receive melatonin (3 mg/d) or the placebo group for three months. Simple clinical colitis activity index (SCCAI), fecal calprotectin (FC), C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), and Sf-36 questionnaire have been used for assessment at the baseline and the end of the trial. Melatonin significantly improve SCCAI score, FC, role-emotional, energy and general health relative to placebo (p = 0.03, 0.05, 0.002, 0.032, 0.004 respectively). Regarding CRP, ESR, and the other components of SF-36 there is not any significant difference between melatonin and placebo group. Melatonin supplementation over a three-month period is effective and safe in improving clinical index, FC, and some quality of life in patients with mild to moderate UC.

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