224 Impaired sleep quality in children with inflammatory bowel disease present even in the remission phase and attributing to impaired health related quality of life

Abstract

<h3></h3> Children with inflammatory bowel disease (IBD) have significantly lower health related quality of life (HRQoL) compared to healthy controls. HRQoL presents a broad, multidimensional concept compromising one’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to the environment. Good sleep is essential in maintaining health and quality of life (QoL) and plays a role in regulation of immune and neuroendocrine system. The aim of our study was to evaluate the relationship between sleep quality and HRQoL in children with IBD in remission. A total of 33 paediatric IBD patients in remission (20 boys) aged 15.6 ± 1.9 years were included in the study (disease type: Crohn’s disease (CD), n=16, ulcerative colitis (UC), n=15, inflammatory bowel disease-unclassified (IBD-U), n=2). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, whilst HRQoL was assessed using IMPACT III questionnaire. Moreover, patients wore a triaxial accelerometer for five consecutive days for objective PA quantification. Anthropometric data and inflammatory markers’ values such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and faecal calprotectin values were recorded. Prevalence of impaired sleep quality (PSQI&gt;5) was 36.4%, with mean PSQI score 4.64±2.21. Highest mean scores were recorded in the sleep duration (mean score 1.06±0.99), sleep disturbance (mean score 1.06±0.35) and daytime dysfunction (mean score 1.00±0.79) components of the questionnaire. Mean IMPACT III score was 146.36±17.24. On average, patients spent 38 minutes in moderate-to-vigorous physical activity (MVPA), and 198 minutes in light physical activity (LPA) per day. PSQI score negatively correlated with IMPACT III score (coef. -0.446, p&lt;0.01); meaning that the more significantly impaired sleep quality the more impaired QoL; and with time spent in LPA (coef. -0.482, p &lt;0.01). Interestingly, faecal calprotectin only positively correlated with sleep disturbance score (coef. 0.352, p =0.048), but had no significant correlation with the total PSQI score. No correlation was found between anthropometric and other laboratory parameters, MVPA and PSQI and IMPACT III scores. More than a third of paediatric IBD patients suffer from poor sleep quality even in the remission phase. Further studies investigating the relationship between sleep quality, HRQoL and possible presence of subclinical inflammation in paediatric patients with IBD are warranted.