PEOPLE WITH IBD WANT TO TALK ABOUT SLEEP: RECOMMENDATIONS ON WHAT TO ASK AND HOW TO RESPOND TO SLEEP COMPLAINTS

Abstract

Background: Poor sleep occurs in 75% of people with IBD and is prospectively associated with increased risk for disease flare, hospitalization, surgery, and reduced quality of life. While IBD providers know the link between poor sleep and IBD, few are adequately armed to ask patients about sleep and provide concise, evidence based suggestions for management. We aimed to understand patients’ beliefs about sleep and IBD, their treatment preferences, and offer recommendations to providers on how best to ask about and address sleep problems in this population. Method: We conducted an anonymous, online survey of 312 adults with Crohn’s disease or ulcerative colitis who sought treatment at the Dartmouth-Hitchcock IBD center. Participants were asked about sleep patterns, thoughts and behaviors related to sleep, and open-ended questions about sleep and IBD. Results: Participants ranged from 18-85 years old (M=48.6, SD=16.1) and were 66% women, 96% White. 61% of participants had Crohn’s and 39% had UC; mean symptom duration=20.7 years (SD=13.7). Overall, 81% of participants endorsed some interaction between sleep and IBD. Based on thematic analysis, participants thought that their sleep was worse during flares and sleeping poorly made IBD symptoms worse, while good sleep was protective. Pain, nighttime bowel movements, and general and IBD-specific anxiety all worsened sleep. Participants with poor sleep evidenced more dysfunctional beliefs about sleep (d=1.68, p