Objective To examine the association between sleep pattern, which integrates sleep duration, chronotype and quality, with risk of bowel resection and all-cause mortality in patients with inflammatory bowel disease (IBD) based on a long-term prospective cohort. Design Prevalent patients with IBD were categorised into poor (0–2 score), intermediate (3 score) and healthy (4–5 score) based on sleep score. The score assigned 1 point for each of five low-risk sleep behaviours: sleep 7–8 hours per day, early chronotype, no snoring, never/rarely insomnia symptoms and no frequent daytime sleepiness. The primary outcome was all-cause death, with bowel resection as a secondary outcome. Multivariable Cox proportional hazards models were used to explore the association. Setting This study used the data from the UK Biobank with participants recruited in 2006–2010. Participants Among 502 411 participants recruited in UK biobank, 4262 cancer-free patients with IBD at baseline were finally included. Results During a median of 14.6-year follow-up, 793 received bowel resection and 498 deaths developed. Compared with poor sleep pattern, both healthy (HR=0.75, 95% CI 0.59 to 0.94) and intermediate (HR=0.77, 95% CI 0.66 to 0.95) sleep groups had reduced mortality risk, with a dose-response relationship across sleep scores (HR=0.89, 95% CI 0.82 to 0.98). Specifically, appropriate sleep duration (HR=0.79, 95% CI 0.66 to 0.95) and early chronotype (HR=0.82, 95% CI 0.68 to 0.98) were associated with 21% and 18% lower mortality risk, respectively. Marginally significant lower risk of bowel resection was observed with healthy (HR=0.86, 95% CI 0.72 to 1.04) and intermediate (HR=0.87, 95% CI 0.73 to 1.03) sleep pattern, with 22% lower risk associated with never/rarely insomnia symptoms (HR=0.78, 95% CI 0.65 to 0.94). Conclusions A healthy sleep pattern, particularly sleep duration and early chronotype, is associated with reduced all-cause mortality risk in patients with IBD, with probably beneficial effect on lowering risk of bowel resection, highlighting the importance of maintaining healthy sleep behaviours for long-term prognosis in IBD.
Zhang et al. (Thu,) studied this question.