Sleep Med Rev. 2021 Jun 17;60:101518. doi: 10.1016/j.smrv.2021.101518.Online ahead of print.

Andrea Ballesio ¹, Andrea Zagaria ², Flavia Baccini ³, Federica Micheli ³, Giovanni Di Nardo ⁴, Caterina Lombardo ²

Author information

• ¹Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. Electronic address: andrea.ballesio@uniroma1.it.
• ²Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
• ³Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
• ⁴NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Italy.

Abstract

Evidence of poor sleep quality in inflammatory bowel disease (IBD, i.e., Crohn's disease and ulcerative colitis) has been reported but never systematically reviewed or meta-analysed. We conducted a systematic review and meta-analysis of pairwise comparisons that included 1) IBD patients/controls, 2) Crohn's disease/ulcerative colitis, 3) active/inactive IBD on standardised measures of sleep quality. PubMed, Medline, PsycINFO, Scopus, and CINAHL were searched up to March 2021. Forty-two studies met the inclusion criteria. Results showed poorer subjective sleep quality in IBD patients than in controls, with moderate effect sizes (g = .49, [95% CI = .32 - .66], p < .001). No differences within IBD subtypes were found (g = -.07, [95% CI = -.17-.05], p = .208). Individuals with an active IBD reported poorer sleep quality than those in remission, with a large effect size (g = .66, [95% CI = .35 - .98], p < .001). Results on objectively recorded sleep were mixed, with no clear evidence of objective sleep impairments in individuals with IBD. Results support the view of subjective poor sleep quality as a relevant comorbidity in IBD. As a potential factor affecting immune and inflammatory responses as well as patients' quality of life, sleep quality should be taken into account in the treatment of IBD.