Serologic Activity and Gluten‐Free Diet Adherence Are Associated With Sleep Disturbances in Paediatric Coeliac Disease

AIM: This study aimed to evaluate sleep disturbances in children with coeliac disease (CD) and to investigate their associations with serologic activity and adherence to a gluten-free diet (GFD). METHODS: This cross-sectional study included 203 children with biopsy-confirmed CD and 100 age- and sex-matched healthy controls. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC). Dietary adherence was evaluated according to tissue transglutaminase IgA (tTG-IgA) levels. RESULTS: Children with CD had significantly higher total SDSC scores compared with healthy controls (38.24 ± 9.23 vs. 31.76 ± 3.75, p < 0.001). Subscale scores for difficulties initiating and maintaining sleep (DIMS), daytime sleepiness (DOES) and sleep-wake transition disorders (SWTD) were also significantly higher in the CD group (all p < 0.001). Children with poor GFD adherence demonstrated significantly higher total SDSC scores and higher DIMS, DOES and night-time awakening scores compared with those showing good dietary adherence. tTG-IgA levels showed weak but statistically significant positive correlations with total SDSC scores, DIMS and DOES scores. ROC analysis demonstrated an association between higher SDSC total scores and elevated serologic activity (AUC = 0.84). CONCLUSION: Children with CD demonstrated higher sleep disturbance scores compared with healthy peers, particularly in domains related to sleep initiation and daytime functioning. Poor dietary adherence and higher serologic activity were associated with increased sleep disturbance severity. Further longitudinal studies are needed to clarify the clinical significance and long-term implications of these findings.