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Volume 15 No. 01
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Scientific Investigations

Evaluation of Home Polysomnography Findings, Quality of Sleep, and Fatigue in Inflammatory Bowel Disease: A Case Series

Deise Luna Paixão, MD, MSc1; Dalva Poyares, MD, PhD2,3; Marta Sevilha de Paula3; Joselmo Willamys Duarte, MSc1; Paula Midori Castelo, DDS, PhD4; Orlando Ambrogini-Júnior, MD, PhD5; Sender Jankiel Miszputen, MD, PhD5; Celina Tizuko Fujiyama Oshima, PhD1,5; Jair Ribeiro Chagas, PhD2; Ana Paula Ribeiro Paiotti, PhD1,5
1Department of Pathology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil; 2Department of Psychobiology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil; 3Sleep Institute, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil; 4Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil; 5Department of Medicine, Discipline of Gastroenterology, Universidade Federal de São Paulo, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil

Study Objectives:

The pathogenesis of inflammatory bowel disease (IBD) is not well understood, and sleep disorders may be potential triggers for IBD. Thus, an evaluation of the sleep characteristics, fatigue symptoms, and cytokine levels was performed in patients with IBD during periods of active disease and remission.

Methods:

A total of 20 participants presenting with Crohn's disease or ulcerative colitis, with active disease (n = 7) or in remission (n = 13), underwent home polysomnography (H-PSG). Pittsburgh Sleep Quality Index (PSQI) and Modified Fatigue Impact Scale (MFIS) were applied, in addition to the evaluation of interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNF-α) serum levels. Exploratory analysis, t test and Mann-Whitney U test were used.

Results:

The mean sleep latency in patients with active disease was 133.07 minutes and 106.79 minutes in those in remission. The sleep efficiency and sleep fragmentation in patients with active disease and those in remission were 80.90% and 84.20% (median), and 76.36/min and 69.82/min (mean), respectively, although the H-PSG parameters did not differ between the groups. The PSQI scores indicated poor sleep quality (global score above 5) in all participants with IBD, and the participants with active disease presented more symptoms of fatigue (P = .032). IL-6 and TNF-α average levels were higher in the participants with disease remission, although with a larger dispersion of the data.

Conclusions:

No significant difference in the H-PSG characteristics was observed between the patients with IBD with active disease and those in remission; however, the perception of the participants with IBD showed significant effect on the sleep quality and fatigue symptoms.

Citation:

Paixão DL, Poyares D, de Paula MS, Duarte JW, Castelo PM, Ambrogini-Júnior O, Miszputen SJ, Oshima CT, Chagas JR, Paiotti AP. Evaluation of home polysomnography findings, quality of sleep, and fatigue in inflammatory bowel disease: a case series. J Clin Sleep Med. 2019;15(1):39–45.




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