Abstract Background Patients with Inflammatory Bowel Disease (IBD) frequently experience persistent symptoms that profoundly affect their quality of life (QoL) and daily functioning, such as fatigue, which often remains under-investigated and undertreated. Approximately 47% of patients report fatigue even during periods of disease remission, suggesting that factors beyond active inflammation, such as sleep disturbances, may contribute to this symptom. The aim of this study was to assess fatigue, sleep quality and their correlation in IBD patients in clinical and biochemical remission. The main psychophysical determinants of fatigue were also investigated. Methods We conducted a cross-sectional observational study in which IBD patients in clinical (defined as Harvey-Bradshaw Index 5 for CD and partial Mayo score 2 for UC) and biochemical (defined as C-reactive protein 5 mg/dL plus fecal calprotectin 150 μg/g) remission were included. Patients were asked to complete the following questionnaires: FACIT-F to assess fatigue; PSQI, ISI, ESS and MEQr to investigate sleep quality; HADS to screen for anxiety and depression; IPAQ to assess physical activity, and IBD-Q to examine QoL. Univariate and multivariate logistic regression analysis were conducted to analyze independent predictors of fatigue. Pearson correlation coefficient was calculated to assess the relationship between variables. A p-value 0.05 was considered statistically significant. Results Seventy-two IBD patients in remission were enrolled. Demographic and disease characteristics are reported in table 1. Thirty-nine out of 72 (54%) patients reported fatigue. Among them, 27/39 (69%) had significantly worse sleep quality (PSQI5) compared to 11/33 (33%) in the non-fatigued group (p = 0.002). Differences in questionnaire’s scores between the two groups are showed in Figure 1. Patients complaining of fatigue reported significantly higher PSQI score than patients without fatigue, in the following items: increased sleep latency (18/39 vs 3/33, p = 0.007), shorter sleep duration (19/39 vs 5/33, p = 0.005), reduced efficiency (20/39 vs 4/33, p 0.001), and greater daytime dysfunction (4/39 vs 1/33, p = 0.003). PSQI5, poor sleep efficiency, lack of enthusiasm, anxiety, poor QoL, and FACIT-F TOI score were identified as independent predictors of fatigue at multivariate regression analysis. Finally, fatigue showed a negative correlation with sleep quality (r=–0.494) and a positive correlation with QoL impairment (r = 0.641). Conclusion Fatigue is significantly associated with sleep disorders in IBD patients. Systematic assessment of fatigue and sleep quality, even during disease remission, could aid in early identification of psycho-functional impairment. References: Farrell D, McCarthy G, Savage E. Self-reported symptom burden in individuals with inflammatory bowel disease.J Crohns Colitis 2016;10:315–22. D’Silva A, Fox DE, Nasser Y, et al. Prevalence and risk factors for fatigue in adults with inflammatory bowel disease: a systematic review with meta-analysis. Clin Gastroenterol Hepatol 2022;20:995– 1009.e7. Conflict of interest: Onnis, Francesca: No conflict of interest Dr. Favale, Agnese: Advisory Board for abbVie Olla, Federica: No conflict of interest Piras, Raffaela: No conflict of interest Demurtas, Mauro: No conflict of interest Ibba, Ivan: No conflict of interest Italia, Angelo: No conflict of interest Redolfi, Stefania: No conflict of interest Fantini, Massimo Claudio: MCF has acted as a consultant for: AbbVie, AlfaSigma, Celgene, Celltrion, Gilead, Pfizer, MSD, Bristol-Meyer, Takeda, Johnson & Johnson, Roche, Galapagos, Biogen, Sandoz, Eli-Lilly, Lionhealth, Teva, Giuliani, Dr Falk Pharma, Sanofi he has received financial support for research from Johnson & Johnson and Pfizer. Onali, Sara: Consultant/lecture fees to: Abbvie, Alfasigma, MSD, Takeda, J & J, Galapagos, Pfizer, Eli Lilly
Onnis et al. (Thu,) studied this question.
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