Sleep Architecture Screening in Hospitalized Patients With Inflammatory Bowel Diseases: A Prospective Propensity Score-Matched Analysis

INTRODUCTION: To evaluate the effectiveness of sleep architecture screening in hospitalized patients with inflammatory bowel diseases (IBD) from the viewpoint of long-term survival from IBDs worsening. METHODS: A total of 1,024 patients were prospectively enrolled and stratified into screening cohort, receiving sleep architecture screening through the polysomnography approach, and control cohort matched by a 1:1 propensity score method. Primary endpoint was survival from disease progression including treatment escalation, severe infection, rehospitalization, emergency visit, or surgeries within 12 months after discharge. Secondary outcomes included complications and quality-adjusted life years. RESULTS: The screening cohort identified that 53.5% of patients experienced sleep deprivation. N1, N2, N3, and rapid eye movement sleep accounted for 6.8%, 62.0%, 14.9%, and 16.3% of their total sleep time. During a mean follow-up of 8.6 ± 4.5 months, 26.8% and 46.6% of cases reported an IBD-related events in screening and control cohorts ( P = 0.005). The mean survival time from disease worsening was significantly longer in patients receiving screening than those in control cohort (11.68 [95% CI: 11.03-12.32] vs 9.46 [95% CI: 8.86-10.06] months, log-rank test P < 0.001), yielding a hazard ratio of 0.684 (95% CI: 0.554-0.746). Superiority was met because the 95% CI fell within the predefined superiority margin of 0.75. The means quality-adjusted life years across all time points were significantly higher in screening cohort compared with controls (all P < 0.05). No serious complications were observed. DISCUSSION: Sleep architecture screening combined with specialized interventions in patients with IBD provided a better long-term survival from disease progression, resulting in a significant improvement in patients' quality of life within a 12-month follow-up.