scholarly journals Poor Sleep Quality in Crohn’s Disease Is Associated With Disease Activity and Risk for Hospitalization or Surgery

2019 ◽  
Author(s):  
M Anthony Sofia ◽  
Anna M Lipowska ◽  
Nada Zmeter ◽  
Edgar Perez ◽  
Robert Kavitt ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Poor Sleep ◽  
Clinical Relapse ◽  
Poor Sleep Quality ◽  
Control Subjects

Abstract Background and Aims Poor sleep quality in Crohn’s disease (CD) is associated with histologic activity and clinical relapse. We sought to characterize sleep dysfunction and determine the effect of poor sleep quality on risk for hospitalization and surgery. Methods Clinical data were collected for CD subjects including the Pittsburgh Sleep Quality Index (PSQI) and Harvey-Bradshaw index (HBI). The PSQI score and a brief medical history were obtained for control subjects. The PSQI and HBI correlation was tested at an initial clinic visit and at follow-up. Crohn’s disease subjects with and without poor sleep were compared for risk of hospitalization or surgery by Kaplan–Meier and Cox proportional hazards. Results Ninety-two CD and 82 control subjects were included. Crohn’s disease and control subjects shared similar baseline characteristics and PSQI (8.3 vs 7.8, P = 0.31), and 77% of the CD population had PSQI >5. Crohn’s disease subjects with PSQI >5 more often had inflammatory phenotypes and reported increased benzodiazepine and psychiatric medication use. Crohn’s disease subjects with PSQI >5 also reported more night awakenings due to pain and bathroom use. The PSQI correlated with HBI (r = 0.256, P = 0.014), and ΔPSQI on follow-up correlated with ΔHBI (r = 0.47, P = 0.002). Cox proportional hazards model for hospitalization or surgery showed that PSQI >8 was predictive of surgery or hospitalization (hazards ratio 5.37; 95% confidence interval, 1.39–27.54). Conclusion There is a high burden of poor sleep quality in CD, which is associated with risk for adverse outcomes. Sleep quality may identify CD patients at risk for complications and have prognostic value in CD.

Mo1821 - Poor Sleep Quality is a Risk Factor for Hospitalization and Surgery in Crohn's Disease

2018 ◽  
Vol 154 (6) ◽  
pp. S-815
Author(s):  
M. Anthony Sofia ◽  
Anna M. Lipowska ◽  
Edgar Y. Perez ◽  
Nada Zmeter ◽  
Robert T. Kavitt ◽  
...  
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality

Poor Sleep Quality in Crohn's Disease is Associated with Antibiotic Use and Gerd Symptom Severity

2017 ◽  
Vol 152 (5) ◽  
pp. S799 ◽  
Author(s):  
Mark A. Sofia ◽  
Anna M. Lipowska ◽  
Edgar Y. Perez ◽  
Nada Zmeter ◽  
Robert Kavitt ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Symptom Severity ◽  
Gerd Symptom ◽  
Antibiotic Use ◽  
Poor Sleep ◽  
Poor Sleep Quality

scholarly journals Discontinuation of Azathioprine Could Be Considered in Pediatric Patients with Crohn’s Disease who Have Sustained Clinical and Deep Remission

2021 ◽  
Author(s):  
Tae Jong Jeong ◽  
Eun Sil Kim ◽  
Yiyoung Kwon ◽  
Seonwoo Kim ◽  
Sang Won Seo ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Combination Therapy ◽  
Pediatric Patients ◽  
Proportional Hazards ◽  
Treatment Strategies ◽  
Cox Proportional Hazards ◽  
Clinical Relapse ◽  
Factors Affecting ◽  
Factors Associated

Abstract Few studies have demonstrated treatment strategies about the duration and cessation of medications in patients with Crohn’s disease (CD). We investigated factors affecting clinical relapse after infliximab (IFX) or azathioprine (AZA) withdrawal in pediatric patients with CD on combination therapy. Pediatric patients with moderate-to-severe CD receiving combination therapy were analyzed retrospectively and factors associated with clinical relapse were investigated. Discontinuation of IFX or AZA was performed in patients who sustained clinical remission (CR) for at least two years and achieved deep remission. A total of 75 patients were included. Forty-four patients (58.7%) continued with combination therapy and 31 patients (41.3%) discontinued AZA or IFX (AZA withdrawal 10, IFX withdrawal 15, both withdrawal 6). Cox proportional-hazards regression identified four factors associated with clinical relapse: IFX cessation (hazard ratio; HR 2.982, P=0.0081), formation of antibody-to-IFX (ATI) (HR=3.12, P=0.0373), IFX trough level (TL) (HR=0.581, P=0.003) and 6-thioguanine nucleotide (6-TGN) level (HR=0.978, P<0.001). However, AZA cessation was not associated with clinical relapse (P=0.9021). Even when applied in pediatric patients who meet stringent criteria, IFX cessation increased the relapse risk. However, withdrawal of AZA could be contemplated in pediatric patients with CD who have sustained CR for at least two years and achieved deep remission.

scholarly journals P192 Heartburn in Crohn's disease is associated with increased disease activity, poor sleep quality and prior ileocecectomy

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S173-S174 ◽  
Author(s):  
M.A. Sofia ◽  
A.M. Lipowska ◽  
E.Y. Perez ◽  
N. Zmeter ◽  
R.T. Kavitt ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Disease Activity ◽  
Poor Sleep ◽  
Poor Sleep Quality

scholarly journals P207 Poor sleep quality is a risk factor for hospitalisation and surgery in Crohn’s disease

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S204-S204 ◽  
Author(s):  
M A Sofia ◽  
A M Lipowska ◽  
E Y Perez ◽  
N Zmeter ◽  
R T Kavitt ◽  
...  
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality

scholarly journals Discontinuation of Azathioprine could be considered in pediatric patients with Crohn’s disease who have sustained clinical and deep remission

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Tae Jong Jeong ◽  
Eun Sil Kim ◽  
Yiyoung Kwon ◽  
Seonwoo Kim ◽  
Sang Won Seo ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Combination Therapy ◽  
Pediatric Patients ◽  
Proportional Hazards ◽  
Treatment Strategies ◽  
Cox Proportional Hazards ◽  
Clinical Relapse ◽  
Internal Validation ◽  
Factors Associated

AbstractFew studies have demonstrated treatment strategies about the duration and cessation of medications in patients with Crohn’s disease (CD). We investigated factors affecting clinical relapse after infliximab (IFX) or azathioprine (AZA) withdrawal in pediatric patients with CD on combination therapy. Pediatric patients with moderate-to-severe CD receiving combination therapy were analyzed retrospectively and factors associated with clinical relapse were investigated. Discontinuation of IFX or AZA was performed in patients who sustained clinical remission (CR) for at least two years and achieved deep remission. A total of 75 patients were included. Forty-four patients (58.7%) continued with combination therapy and 31 patients (41.3%) discontinued AZA or IFX (AZA withdrawal 10, IFX withdrawal 15, both withdrawal 6). Cox proportional-hazards regression and statistical internal validation identified three factors associated with clinical relapse: IFX cessation (hazard ratio; HR 2.982, P = 0.0081), IFX TLs during maintenance therapy (HR 0.581, P = 0.003), 6-thioguanine nucleotide (6-TGN) level (HR 0.978, P < 0.001). However, AZA cessation was not associated with clinical relapse (P = 0.9021). Even when applied in pediatric patients who met stringent criteria, IFX cessation increased the relapse risk. However, withdrawal of AZA could be contemplated in pediatric patients with CD who have sustained CR for at least 2 years and achieved deep remission.

scholarly journals Association of poor sleep burden in middle age and older adults with risk for delirium during hospitalization

2021 ◽  
Author(s):  
Ma Cherrysse Ulsa ◽  
Xi Zheng ◽  
Peng Li ◽  
Arlen Gaba ◽  
Patricia M Wong ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Proportional Hazards ◽  
Time Lag ◽  
Cox Proportional Hazards ◽  
Poor Sleep ◽  
Cardiovascular Risks ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
The Uk

Abstract Background Delirium is a distressing neurocognitive disorder recently linked to sleep disturbances. However, the longitudinal relationship between sleep and delirium remains unclear. This study assessed the associations of poor sleep burden, and its trajectory, with delirium risk during hospitalization. Methods 321,818 participants from the UK Biobank (mean age 58±8y[SD]; range 37-74y) reported (2006-2010) sleep traits (sleep duration, excessive daytime sleepiness, insomnia-type complaints, napping, and chronotype–a closely-related circadian measure for sleep timing), aggregated into a sleep burden score (0-9). New-onset delirium (n=4,775) was obtained from hospitalization records during 12y median follow-up. 42,291 (mean age 64±8; range 44-83y) had repeat sleep assessment on average 8y after their first. Results In the baseline cohort, Cox proportional hazards models showed that moderate (aggregate scores=4-5) and severe (scores=6-9) poor sleep burden groups were 18% (hazard ratio 1.18 [95% confidence interval 1.08-1.28], p&lt;0.001) and 57% (1.57 [1.38-1.80], p&lt;0.001), more likely to develop delirium respectively. The latter risk magnitude is equivalent to two additional cardiovascular risks. These findings appeared robust when restricted to postoperative delirium and after exclusion of underlying dementia. Higher sleep burden was also associated with delirium in the follow-up cohort. Worsening sleep burden (score increase ≥2 vs. no change) further increased the risk for delirium (1.79 [1.23-2.62], p=0.002) independent of their baseline sleep score and time-lag. The risk was highest in those under 65y at baseline (p for interaction &lt;0.001). Conclusion Poor sleep burden and worsening trajectory were associated with increased risk for delirium; promotion of sleep health may be important for those at higher risk.

scholarly journals Factors associated with poor sleep quality in women with cancer

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Thalyta Cristina Mansano-Schlosser ◽  
Maria Filomena Ceolim
Keyword(s):  
Sleep Quality ◽  
Quality Index ◽  
Sleep Disturbances ◽  
Pittsburgh Sleep Quality Index ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Factors Associated ◽  
Scale Data

ABSTRACT Objectives: to analyze the factors associated with poor sleep quality, its characteristics and components in women with breast cancer prior to surgery for removing the tumor and throughout the follow-up. Method: longitudinal study in a teaching hospital, with a sample of 102 women. The following were used: a questionnaire for sociodemographic and clinical characterization, the Pittsburgh Sleep Quality Index; the Beck Depression Inventory; and the Herth Hope Scale. Data collection covered from prior to the surgery for removal of the tumor (T0) to T1, on average 3.2 months; T2, on average 6.1 months; and T3, on average 12.4 months. Descriptive statistics and the Generalized Estimating Equations model were used. Results: depression and pain contributed to the increase in the score of the Pittsburgh Sleep Quality Index, and hope, to the reduction of the score - independently - throughout follow-up. Sleep disturbances were the component with the highest score throughout follow-up. Conclusion: the presence of depression and pain, prior to the surgery, contributed to the increase in the global score of the Pittsburgh Sleep Quality Index, which indicates worse quality of sleep throughout follow-up; greater hope, in its turn, influenced the reduction of the score of the Pittsburgh Sleep Quality Index.

scholarly journals Sleep Quality and Associated Factors among Peoples with Epilepsy Who Have a Follow-Up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: An Institutional Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kemeriya Adem ◽  
Tilahun Kassew ◽  
Addis Birhanu ◽  
Ayalew Abate
Keyword(s):  
Sleep Quality ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Sectional Study ◽  
Poor Sleep Quality ◽  
Cross Sectional ◽  
Specialized Hospital

Background. Sleep is an active cyclic biological phenomenon and necessary for survival. Individuals who suffer from sleep disturbance are less productive, decreased performance, and negative effects on mental health. Despite there are different studies on sleep quality in Ethiopia, no studies have been conducted on magnitude and predictors of sleep quality among people with epilepsy in the study setting. Objective. To assess sleep quality and associated factors among people with epilepsy who have a follow-up at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. Method. An institution-based cross-sectional study was employed from May-June 2019. Systematic random sampling following face to face interview technique was employed. Epi-data version 3.1 and SPSS version 25 statistical packages were used for data entry and analysis, respectively. Frequencies, proportions, means, SDs, and cross-tabulations were used to summarize descriptive statistics of the data and tables, texts, and graphs were used for data presentation. To identify association and significant predictor with the outcome variable, binary logistic regression was fitted. The variable which has statistical significance was identified on the basis of p values ≤ 0.05 and AOR with 95% confident intervals. Results. A total of 423 participants have been enrolled to the study with a response rate of 98.1%. The prevalence of poor sleep quality among peoples live with epilepsy was found 65.4% (95% CI: 61.0, 69.9). Being female (AOR=2.94; (95% CI; 1.79, 4.85)), having stress full life events (AOR=2.38; (95% CI; 1.43, 3.97)), nonadherent to AED medication (AOR=1.86; (95% CI; 1.05, 2.78), poly-therapy treatment (AOR=2.24; (95% CI; 1.05, 2.78)), poor seizer control (AOR=2.4; (95% CI; 2.21, 12.46)), comorbid medical illness (AOR=2.6; (95% CI; 1.18, 5.61)), and anxiety (AOR=2.54; (95% CI; 1.52,4.24)) were factors significantly associated with poor sleep quality. Conclusion. This study revealed that more than half of the study participants were found to have poor sleep quality. So, considering the regular assessment of sleep quality and factors associated followed with appropriate intervention is recommended among peoples living with epilepsy.

scholarly journals Sleep quality and associated factors among patients with chronic illness at South Wollo Zone Public Hospitals, Northeast Ethiopia

2021 ◽  
Vol 5 (1) ◽  
pp. 043-050
Author(s):  
Edmealem Afework ◽  
Ademe Sewunet ◽  
Andualem Atsedemariam
Keyword(s):  
Chronic Illness ◽  
Sleep Quality ◽  
Associated Factors ◽  
Public Hospitals ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Northeast Ethiopia ◽  
Ethical Approval ◽  
Study Participants

Background: Pathological and nighttime sleep deprivations have substantial adverse effects on regulation of weight, sugar and blood pressure because of endothelial dysfunction, sympathetic nervous system stimulation, regulation and activation of systemic inflammation. Thus, this study was aimed to assess quality of sleep among patients with chronic illness and its associated factors at South Wollo Zone Public Hospitals, Northeast Ethiopia. Methods and Materials: The study was conducted at South Wollo Zone Public Hospitals, Northeast Ethiopia from February 15 2019 till April 15 2019. Institutional based cross sectional study design was employed. All patients with chronic illness who are on follow up in South Wollo Zone Public Hospitals were sources of population. Sample size was calculated by using EPI info version 7 and the total sample size was 344. The study employed stratified random sampling technique and study participants were selected by systematic sampling. After taking ethical approval from College of Medicine and Health Sciences Ethical Approval Committee, permission from selected Hospitals and informed verbal consent from patients, the data were collected by a tool which has 3 parts: Sociodemographic data, Pittsburgh Sleep Quality Index and factors affecting sleep quality. Data were entered in to Epi data version 4.1 and exported to Statistical Package for Service Product 25 for analysis. Different data presentation tools and binary logistic regression were enrolled by considering 95% confidence level and p value of 0.05. Result: Among the total study participants, near to one third (31.7%) of them got sleep after 30 minutes. More than one fourth of them slept for less than 7 hours. Less than half of the study participants had habitual sleep efficiency of more than 85% however 296(86%) of them did not face day time dysfunction Conclusion and recommendations: more than one third of patients with chronic illness had poor sleep quality. One third of study participants had sleep duration of less than the recommendations(less than 7 hours). Age, educational status, residence, and perception of prognosis of disease were factors that have associations with poor sleep quality among patients with chronic illness. Health care providers who are doing in chronic illness follow up clinic should be initiated to assess and screen those patients with poor sleep quality.

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