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Published in: Digestive Diseases and Sciences 6/2023

25-02-2023 | Insomnia | Original Article

Patients with IBD Want to Talk About Sleep and Treatments for Insomnia with Their Gastroenterologist

Authors: Jessica K. Salwen-Deremer, Cassandra M. Godzik, Christina H. Jagielski, Corey A. Siegel, Michael T. Smith

Published in: Digestive Diseases and Sciences | Issue 6/2023

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Abstract

Background and Aims

Poor sleep may be prospectively associated with worse disease course in inflammatory bowel disease (IBD). Chronic insomnia is the most common cause of poor sleep complaints in IBD and is theorized to be maintained by dysfunctional thoughts and behavioral patterns. However, data characterizing patterns specific to insomnia in IBD are lacking. Understanding the nuances of insomnia and patients’ preferences for treatment is critical for addressing this significant comorbidity in IBD.

Methods

We conducted an anonymous, mixed-method online survey of people with IBD and asked questions about sleep patterns, thoughts, and behaviors related to sleep, treatment preferences, and barriers to treatment.

Results

312 participants (60.9% Crohn’s, 66.3% women, mean age of 48.62 years) were included in this study. Participants with insomnia were significantly more concerned about the consequences of sleep loss, felt more helpless about their sleep, and were more likely to engage in behaviors known to perpetuate insomnia (e.g., spending time in bed in pain; ps ≤ 0.001) than those without insomnia. 70.3% of participants were interested in discussing sleep as part of IBD care, 63.5% were interested in receiving sleep recommendations from their gastroenterologist, and 84.6% of those with insomnia were interested in participating in sleep treatments.

Conclusion

Participants with IBD and insomnia are interested in treatment and reported patterns that can be targeted in Cognitive Behavioral Therapy for Insomnia, as opposed to traditional sleep hygiene guidelines. Additionally, people with insomnia engaged in several sleep-interfering behaviors related to pain. Clinical trials that target insomnia in people with IBD should include pain management in the intervention.
Literature
1.
go back to reference Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD. Sleep disturbance and risk of active disease in patients with Crohn’s disease and ulcerative colitis. Clin Gastroenterol Hepatol. 2013;11:965–971.CrossRefPubMedPubMedCentral Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD. Sleep disturbance and risk of active disease in patients with Crohn’s disease and ulcerative colitis. Clin Gastroenterol Hepatol. 2013;11:965–971.CrossRefPubMedPubMedCentral
2.
go back to reference Ali T, Madhoun MF, Orr WC, Rubin DT. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflamm Bowel Dis. 2013;19:2440–2443.CrossRefPubMed Ali T, Madhoun MF, Orr WC, Rubin DT. Assessment of the relationship between quality of sleep and disease activity in inflammatory bowel disease patients. Inflamm Bowel Dis. 2013;19:2440–2443.CrossRefPubMed
3.
go back to reference Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A. Impact of sleep disturbances in inflammatory bowel disease. J Gastroenterol Hepatol. 2007;22:1748–1753.CrossRefPubMed Ranjbaran Z, Keefer L, Farhadi A, Stepanski E, Sedghi S, Keshavarzian A. Impact of sleep disturbances in inflammatory bowel disease. J Gastroenterol Hepatol. 2007;22:1748–1753.CrossRefPubMed
4.
go back to reference Uemura R, Fujiwara Y, Iwakura N et al. Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare. SpringerPlus. 2016;5:1792.CrossRefPubMedPubMedCentral Uemura R, Fujiwara Y, Iwakura N et al. Sleep disturbances in Japanese patients with inflammatory bowel disease and their impact on disease flare. SpringerPlus. 2016;5:1792.CrossRefPubMedPubMedCentral
5.
go back to reference Sofia MA, Lipowska AM, Zmeter N, Perez E, Kavitt R, Rubin DT. Poor sleep quality in Crohn’s disease is associated with disease activity and risk for hospitalization or surgery. Inflamm Bowel Dis. 2020;26:1251–1259.PubMed Sofia MA, Lipowska AM, Zmeter N, Perez E, Kavitt R, Rubin DT. Poor sleep quality in Crohn’s disease is associated with disease activity and risk for hospitalization or surgery. Inflamm Bowel Dis. 2020;26:1251–1259.PubMed
6.
go back to reference Scott AJ, Flowers O, Rowse G. A comparative study of the nature and magnitude of problems sleeping in inflammatory bowel disease (IBD) compared to healthy controls. Psychol Health Med. 2020;1–11. Scott AJ, Flowers O, Rowse G. A comparative study of the nature and magnitude of problems sleeping in inflammatory bowel disease (IBD) compared to healthy controls. Psychol Health Med. 2020;1–11.
8.
go back to reference Graff LA, Vincent N, Walker JR et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflamm Bowel Dis. 2010;17:1882–1889.CrossRefPubMed Graff LA, Vincent N, Walker JR et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflamm Bowel Dis. 2010;17:1882–1889.CrossRefPubMed
9.
go back to reference Keefer L, Stepanski EJ, Ranjbaran Z, Benson LM, Keshavarzian A. An initial report of sleep disturbance in inactive inflammatory bowel disease. J Clin Sleep Med. 2006;2:409–416.CrossRefPubMed Keefer L, Stepanski EJ, Ranjbaran Z, Benson LM, Keshavarzian A. An initial report of sleep disturbance in inactive inflammatory bowel disease. J Clin Sleep Med. 2006;2:409–416.CrossRefPubMed
10.
go back to reference Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165:125–133.CrossRefPubMed Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165:125–133.CrossRefPubMed
11.
go back to reference Edinger JD, Arnedt JT, Bertisch SM et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17:263–298.CrossRefPubMedPubMedCentral Edinger JD, Arnedt JT, Bertisch SM et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17:263–298.CrossRefPubMedPubMedCentral
12.
go back to reference Cohen ER, Melmed GY. Making a case for patient-reported outcomes in clinical inflammatory bowel disease practice. Clin Gastroenterol Hepatol. 2018;16:603–607.CrossRefPubMed Cohen ER, Melmed GY. Making a case for patient-reported outcomes in clinical inflammatory bowel disease practice. Clin Gastroenterol Hepatol. 2018;16:603–607.CrossRefPubMed
13.
go back to reference Bewtra M, Brensinger CM, Tomov VT et al. An optimized patient-reported ulcerative colitis disease activity measure derived from the Mayo score and the simple clinical colitis activity index. Inflamm Bowel Dis. 2014;20:1070–1078.PubMed Bewtra M, Brensinger CM, Tomov VT et al. An optimized patient-reported ulcerative colitis disease activity measure derived from the Mayo score and the simple clinical colitis activity index. Inflamm Bowel Dis. 2014;20:1070–1078.PubMed
14.
go back to reference Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.CrossRefPubMed Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.CrossRefPubMed
15.
go back to reference Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–608.CrossRefPubMedPubMedCentral Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–608.CrossRefPubMedPubMedCentral
16.
go back to reference Morin CM, Vallières A, Ivers H. Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep. 2007;30:1547–1554.CrossRefPubMedPubMedCentral Morin CM, Vallières A, Ivers H. Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep. 2007;30:1547–1554.CrossRefPubMedPubMedCentral
17.
go back to reference Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006;29:223–227.CrossRefPubMed Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006;29:223–227.CrossRefPubMed
18.
go back to reference Richards J, Pejsa M, Hand M et al. (166) Psychometric evaluation and predictive validity of the sleep and pain behaviors survey in knee osteoarthritis patients undergoing total knee replacement. J Pain. 2016;17:S17.CrossRef Richards J, Pejsa M, Hand M et al. (166) Psychometric evaluation and predictive validity of the sleep and pain behaviors survey in knee osteoarthritis patients undergoing total knee replacement. J Pain. 2016;17:S17.CrossRef
19.
go back to reference Holm S. A simple sequentially rejective multiple test procedure. Scan J Stat. 1979;65–70. Holm S. A simple sequentially rejective multiple test procedure. Scan J Stat. 1979;65–70.
20.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
21.
go back to reference Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin N Am. 1987;10:541–553.CrossRef Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin N Am. 1987;10:541–553.CrossRef
23.
go back to reference Salwen-Deremer JK, Smith MT, Aschbrenner KA, Haskell HG, Speed BC, Siegel CA. A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease. BMJ Open Gastroenterol. 2021;8:e000805.CrossRefPubMedPubMedCentral Salwen-Deremer JK, Smith MT, Aschbrenner KA, Haskell HG, Speed BC, Siegel CA. A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease. BMJ Open Gastroenterol. 2021;8:e000805.CrossRefPubMedPubMedCentral
24.
go back to reference Selvanathan J, Pham C, Nagappa M, et al. Cognitive behavioral therapy for insomnia in patients with chronic pain-a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2021;101460. Selvanathan J, Pham C, Nagappa M, et al. Cognitive behavioral therapy for insomnia in patients with chronic pain-a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2021;101460.
25.
go back to reference Ritterband LM, Thorndike FP, Ingersoll KS et al. Effect of a web-based cognitive behavior therapy for insomnia intervention with 1-year follow-up: a randomized clinical trial. Jama Psychiatry. 2017;74:68–75.CrossRefPubMed Ritterband LM, Thorndike FP, Ingersoll KS et al. Effect of a web-based cognitive behavior therapy for insomnia intervention with 1-year follow-up: a randomized clinical trial. Jama Psychiatry. 2017;74:68–75.CrossRefPubMed
26.
go back to reference Kuhn E, Miller KE, Puran D et al. A pilot randomized controlled trial of the insomnia coach mobile app to assess its feasibility, acceptability, and potential efficacy. Behav Ther. 2022;53:440–457.CrossRefPubMed Kuhn E, Miller KE, Puran D et al. A pilot randomized controlled trial of the insomnia coach mobile app to assess its feasibility, acceptability, and potential efficacy. Behav Ther. 2022;53:440–457.CrossRefPubMed
27.
go back to reference Salwen-Deremer JK, Siegel CA, Smith MT. Cognitive Behavioral Therapy for Insomnia: a promising treatment for insomnia, pain, and depression in patients with IBD. Crohn’s Colitis 360. 2020;2:052. Salwen-Deremer JK, Siegel CA, Smith MT. Cognitive Behavioral Therapy for Insomnia: a promising treatment for insomnia, pain, and depression in patients with IBD. Crohn’s Colitis 360. 2020;2:052.
28.
go back to reference Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefPubMed Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefPubMed
29.
go back to reference Yu L, Buysse DJ, Germain A et al. Development of short forms from the PROMIS™ sleep disturbance and sleep-related impairment item banks. Behav Sleep Med. 2012;10:6–24.CrossRef Yu L, Buysse DJ, Germain A et al. Development of short forms from the PROMIS™ sleep disturbance and sleep-related impairment item banks. Behav Sleep Med. 2012;10:6–24.CrossRef
Metadata
Title
Patients with IBD Want to Talk About Sleep and Treatments for Insomnia with Their Gastroenterologist
Authors
Jessica K. Salwen-Deremer
Cassandra M. Godzik
Christina H. Jagielski
Corey A. Siegel
Michael T. Smith
Publication date
25-02-2023
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 6/2023
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-023-07883-8

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