Impact of Sleep Quality on Disease Activity and Clinical Outcomes in Older Patients with Inflammatory Bowel Disease

Objective: Sleep quality can affect how inflammatory bowel disease (IBD) is assessed, managed, and monitored in older patients.This study aimed to investigate the relationship between sleep quality, geriatric syndrome, and IBD disease activity in older patients. Materials and Methods:This study included a cohort of 91 individuals diagnosed with IBD.The Harvey-Bradshaw Index (HBI) and mayo score (MS) were used as tools for assessing disease activity in crohn's disease (CD) and ulcerative colitis (UC), respectively.The Pittsburgh sleep quality index were used (PSQI) to evaluate sleep quality.A logistic regression analysis was performed to identify the independent components of sleep quality. Results:The median age of the patients was 60 (50-80) years, and 44% (n=40) of the patients were female.The CD group accounted for 46.2% (n=42) of the IBD group.Sleep quality was impaired in 47.6% (n=20) in CD and 46.9% (n=23) in UC.The HBI of those with poor sleep quality was statistically higher than that of those with normal sleep quality [5 (2-9) vs. 4 (1-8), p=0.035].No significant relationship was found between sleep quality and MS.There was a moderately significant correlation between the PSQI score and the HBI (r=0.509,p=0.008); on the contrary, there was no significant correlation between the PSQI score and MS.Those with active CD had a higher PSQI score than inactive disease [score 6 (1-11) vs. 3 (1-7), p=0.005].Upon logistic regression analysis, the parameters independently related to sleep quality were p<0.001], urinary incontinence [OR=7.706 (1.177-50.463),p=0.033], and 4-m gait speed [OR=0.360(0.002-0.617), p=0.022]. Conclusion:In patients with IBD, sleep quality can be affected not only by disease activation and geriatric syndromes.Therefore, a comprehensive and inclusive approach, including the utilization of comprehensive geriatric assessment, may be an important component of patient management.